Advertisement

A duty of candour: Implications for Australian osteopaths

Published:December 06, 2019DOI:https://doi.org/10.1016/j.ijosm.2019.11.002

      Abstract

      A duty of candour is a duty to tell the truth. Yet, there is no legal duty of candour for Australian osteopaths. However, osteopaths worldwide have a vested interest in meeting patient's needs, identifying risks and improving clinical outcomes.
      The objective of this paper is to enhance osteopath's legal literary concerning ethical decision-making in clinical practice re open disclosure conversations or report adverse events. The aim is to identify the best way to manage open disclosure conversations and why Australian osteopaths should report adverse events.

      Method

      This paper reports on doctrinal research related to open disclosure and the reporting of adverse events. It reports on thematic and critical analysis of the content of pertinent osteopathic regulatory documents to identify if and how, the ethical principles of non-maleficence, beneficence, justice and autonomy and the clinical principles of patient-safety and person-centred care are applied.

      Findings and conclusion

      The ethical principles of beneficence and non-maleficence, justice and autonomy and the concepts of patient-safety and person-centred underpin the Code of Conduct's directive to osteopaths to engage in open disclosure and to report adverse events. Frameworks for how to manage open disclosure conversations are offered. Prior to engaging in open disclosure conversation's osteopaths must consult their professional indemnity insurers. Suggestions are offered for future studies.

      Keywords

      To read this article in full you will need to make a payment

      References

        • Kerridge I.
        • Lowe M.
        • Stewart C.
        Ethics and law for the health professionals.
        fourth ed. Federation Press, 2013
      1. Australian open disclosure Framework. Australian Commission on Safety and Quality in Health Care, Sydney2013
        • Madden B.
        • Cockburn T.
        Bundaberg and beyond: duty to disclose adverse events to patients.
        J Law Med. 2007; 14: 501-521
        • Australian Council for Safety and Quality in Health Care & Australian Health Ministers' Conference
        First national report on patient safety. Australian council for safety and quality in health care.
        (accessed May 2019)
        • Shirley M.L.
        • Cockburn T.L.
        Implementing the open disclosure of adverse events in Australia through a medical skills model.
        in: Burrows Graham D. Proceedings 11th Greek Australian international legal & medical conference: Justice and health: moving Forward with confidence. 2007: 29-33 (Crete)
      2. Australian Council for Safety and Quality in Health Care. Open Disclosure Standard: a national standard for open communication in public and private hospitals, following an adverse event in health care. ACSQHC, Sydney2003 (accessed May 2019)
        • Studdert D.M.
        • Mello M.M.
        • Brennan T.A.
        Medical malpractice.
        N Engl J Med. 2004; : 287
        • Iedema R.
        • Allen S.
        • Sorensen R.
        • Gallagher T.H.
        What prevents incident disclosure, and what can Be done to promote it?.
        Jt Comm J Qual Patient Saf. 2011; 37: 409-417
        • Iedema R.
        • Sorensen R.
        • Donella Piper D.
        Open disclosure: a review of the literature.
        Centre for Health Communication, UTS, Sydney2008
        • Allan A.
        • Munro B.
        Open disclosure: a review of the literature.
        Edith Cowan University, Joondalup, Western Australia2008
        • Studdert D.M.
        • Piper D.
        • Iedema R.
        Legal Aspects of open disclosure II: attitudes of health professionals: findings from a national study.
        Med J Aust. 2010; 193: 351-355
        • Gallagher T.H.
        • Waterman A.D.
        • Ebers A.C.
        • Fraser V.J.
        • Levinson W.
        Patients' and physicians' attitudes regarding the disclosure of medical errors.
        J Am Med Assoc. 2003; 289 (1001─7)
        • Gallagher T.H.
        • Studdert D.
        • Levinson W.
        Disclosing harmful medical errors to patients.
        N Engl J Med. 2007; 356 (2713─9)
        • Gilmore V.
        The barriers to open disclosure.
        Aust Nurs J. 2002; 9: 15
        • Kuhn A.M.
        • Youngberg B.J.
        The need for risk management to evolve to assure a culture of safety.
        Qual Saf Health Care. 2002; 11 (158─62)
        • Hartley A.
        • Rassaby A.
        Quality assurance: an Australian lawyer's perspective.
        Qual Assur Health Care. 1993; 4 (103─5)
        • Brown D.
        Open Disclosure: morally right, but is it legally safe?.
        Medico-Legal Society of NSW Inc Scientific Meeting, Sydney2008
        • Piper Donella A.
        The insurance implications of open disclosure in healthcare [online].
        Precedent, Sydney, N.S.WMay-June 2011: 27-30 (104) (ISSN:1449–7719. [cited 10 May 19])
      3. Osteopaths liabilities insurance policy. Guild Insurance Australia, 2019: 31
        • Johnstone M.-J.
        Clinical risk management and the ethics of open disclosure Part 1. Benefits and risks to patient safety.
        Australas Emerg Nurs J. 2008; 11: 88-94
      4. Victorian government. A statutory of duty of candour, consultation paper. Department of Health and Human Services, 2017
        • Carnes D.
        What can osteopaths learn from concerns and complaints raised against them? A review of insurance and regulator reports.
        Int J Osteopath Med. 2014; 22: 3-10
        • Ryan A.T.
        • Too S.A.
        • Bismark M.M.
        Complaints about chiropractors, osteopaths, and physiotherapists: a retrospective cohort study of health, performance, and conduct concerns.
        Chiropr Man Ther. 2018; : 12
      5. Osteopathy board of Australia, Code of conduct. Australian Health Practitioner Regulation Agency, 2014 (accessed April 2019)
        • Hutchinson T.
        Research and writing in the law.
        fourth ed. Lawbook Co. Thomson Reuters, 2018: 51-52
        • Patton M.Q.
        Qualitative research and evaluation methods.
        third ed. Sage, London2002
        • Beauchamp T.L.
        • Childress J.F.
        Principles of biomedical ethics.
        5th. Oxford University Press, New York2001
      6. Patient Safety: making health care safer. World Health Organization, Geneva2017 (accessed April 2019)
      7. People-centred health care: a policy Framework Western Pacific region. World Health Organisation, 2007 (accessed April 2019)
      8. Patient centred care: improving quality and safety through partnerships with patients and consumers. 978-0-9870617-1-3 Australian Commission on Safety and Quality in Health Care, Sydney2011 (accessed April 2019)
        • Carnes D.
        • Mars T.
        • Mullinger B.
        • Underwood M.
        Adverse events in manual therapy: a systematic review. Full report.
        European School of Osteopathy, Warwick Medical School, Barts and The London, School of Medicine and Dentistry, 2009 (accessed April 2019)
        • Thompson O.
        • Petty N.
        • Moore A.P.
        Osteopaths' professional views, identities and conceptions – a qualitative grounded theory study.
        Int J Osteopath Med. 2014; 14: 146-159
        • Harris P.G.
        • Nagy S.
        • Vardaxis N.
        Mosby's dictionary of medicine, nursing and health professions.
        third ed. Elsevier Australia, 2014
        • Rajendran D.
        • Mullinger B.
        • Fossum C.
        • Collins P.
        • Froud R.
        Monitoring self-reported adverse events: a prospective, pilot study in a UK osteopathic teaching clinic.
        Int J Osteopath Med. 2009; 12: 49-55
        • Carnes D.
        • Mars T.
        • Mullinger B.
        • Underwood M.
        Adverse events in manual therapy: a systematic review. Full report: European school of osteopathy.
        Warwick Medical School, Barts and The London, School of Medicine and Dentistry, 2009 (accessed April 2019)
        • Carnes D.
        • Mullinger B.
        • Underwood M.
        Defining adverse events in manual therapies: a modified Delphi consensus study.
        Man Ther. 2010; 15: 2-6
        • Degenhardt B.
        • Johnson J.
        • Brooks W.
        • Norman L.
        Characterizing adverse events reported immediately after osteopathic manipulative treatment.
        J Am Osteopath Assoc. 2018; 118: 141-149
        • Chaibi A.
        • Russell M.B.
        A risk–benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: a comprehensive review.
        Ann Med. 2019; (accessed April 2019)https://doi.org/10.1080/07853890.2019.1590627
        • Carlesso L.C.
        • Cairney J.
        • Dolovich L.
        • Hoogenes J.
        Defining adverse events in manual therapy: an exploratory qualitative analysis of the patient perspective.
        Man Ther. 2011; 16: 440-446
        • Carnes D.
        • Mars T.S.
        • Mullinger B.
        • Froud R.
        • Underwood M.
        Adverse events and manual therapy: a systematic review.
        Man Ther. 2010; 15: 355-363
        • Australian Health Practitioner Regulation Agency
        • Osteopathy Board of Australia
        Capabilities for osteopathic practice, capabilities for osteopathic practice.
        (accessed November,2019)
        • Thompson O.
        • Petty N.
        • Moore A.P.
        Osteopaths' professional views, identities and conceptions – a qualitative grounded theory study.
        Int J Osteopath Med. 2014; 14: 146-159
        • Iedema R.
        • Sorensen R.
        • Donella Piper D.
        Open disclosure: a review of the literature.
        Centre for Health Communication, UTS, Sydney2008
        • Allan A.
        • Munro B.
        Open disclosure: a review of the literature.
        Edith Cowan University, Joondalup, Western Australia2008
        • Northern Island Health
        Guidance and resources on candour and being open for health and social care staff and for service users, their families and carers in other jurisdictions.