Why must physicians shoulder a responsibility that would compel them to act against their professional interest and perhaps the financial well being of their families?
Discussion of the purported duty of physicians to disclose medical error reveals less than a clear consensus as to what the professional obligation entails. Two arguments in particular have been consistently put forward in order to justify the nondisclosure of medical error to patients. The first relates directly to the malpractice implications of medical error, and suggests a sort of Fifth Amendment right against selfincrimination on the part of physicians. No one, so the argument runs, even the professional in the fiduciary relationship of physician and patient, should be under an ethical obligation to engage in self-incrimination and thereby provide a potential adversary with the informational basis for initiating legal proceedings that are (at least in the eyes of physicians) essentially punitive in nature. The second argument is based upon a less selfserving and, indeed, purportedly beneficent purpose. According to this argument, disclosure to a patient that an adverse outcome was
