Protection after medical error

In one of many recent articles on Building a Safer System, the report of a steering committee formed by the Royal College of Physicians and Surgeons of Canada, Barbara Sibbald1 focused on the fear of litigation associated with reporting complications in medicine and the protection offered by provincial evidence acts. The tone of this and similar articles suggests that the entire Canadian medical community experiences medical incidents and errors and that none of these problems is reported or analyzed because of fear of litigation.

This implication is incomplete and perhaps untrue. I cannot speak for other provinces, but in British Columbia the Evidence Act2 protects from disclosure any reports and investigations of committees such as hospital morbidity and mortality committees.

Similarly protected by designation under the Act is the British Columbia Anesthesiologists' Society Critical Incident Reporting Service.3 This service is a patient safety and quality assurance program offered by BC anesthesiologists, the existence of which seems to have been overlooked by the authors of the original report.

I do not see fear of litigation as a barrier to establishing specific patient safety programs. Rather, there is a need to establish a supportive environment in which overly busy clinicians can reflect upon and analyze the quality and results of the care they provide. Such support will necessarily involve not only education on the value of self-analysis but also appropriate support facilities, with funding, staff, and access to tools and information. Such an undertaking will not be inexpensive.

Richard N. Merchant Chairman, Patient Safety Committee British Columbia Anesthesiologists' Society Vancouver, BC