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Fiduciary duty is the responsibility to act in the best interest of a person or organization. Health care professionals, as well as managers in other industries, struggle continuously with the dilemma of whether or not to admit potentially harmful mistakes to unsuspecting customers and patients. Limited public disclosure of medical errors will benefit health care staff, organizational executives, and patients if specific policies are enacted to improve error prevention.
Since its beginning, the purpose of organized medical care has been to help people, if possible, recover from illness or infirmity. Included in this mission is the obligation owed to the patient and the organization, or fiduciary duty. Fiduciary duty is an obligation to act in the best interest of a person or organization. This can place health care administrators and staff in a position of ethical conflict because, in general, managers are trained to believe that their chief duty is to represent the interests of their health care organizations. In doing so, they then further patient and community interests (Nowicki, 1998).
Health care professionals, as well as managers in other industries, struggle continuously with the dilemma of whether or not to admit potentially harmful mistakes to unsuspecting customers and patients. This situation is the subject of intense debate as a result of the Institute of Medicine's OM) study finding that between 40,000 to 98,000 hospital deaths are caused each year by medical errors (Asch-Goodkin, 2000). Furthermore, the IOM reported that an extra $17 to $19 billion are spent annually on nonlethal medical mistakes (Rovner, 2000). This report resulted in an immediate reaction by health professionals, the public, government agencies, and health care organizations. In an effort to reduce medical errors, several proposals have called for the mandatory reporting and public disclosure of all medical mistakes (IOM, 2000; Isenstein, 2000).
Health care professionals and medical ethicists agree that the problem of medical mistakes requires immediate attention. The public deserves to feel confident that when individuals enter the health care system, they will benefit from the care received. At issue is the best way to accomplish this mission while balancing fiduciary duties to patients and health care organizations.
The quest to provide quality patient care has never been questioned by health care providers nor by the...