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What do you tell the family who asks, ‘What went wrong?’ The truth and nothing but the truth

Journal of Perinatology volume 30, pages 513–516 (2010)Cite this article

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In a recent article in The New England Journal of Medicine,1 the authors suggest that although clinicians strongly value truth telling, there are occasions, for example, a sudden and unexpected cardiac arrest or a ruptured aortic aneurism, when it is not only appropriate but imperative to intervene immediately. Acting without a previous discussion with the patient might apply as well in situations in which the emotional nature of some information irrelevant to treatment choices could result in unnecessary distress. The physician might also decide not to disclose some incidental finding simply to prevent ‘information overload’. These examples are not new insights. The ‘emergency’ and ‘therapeutic’ exceptions to the requirement of obtaining consent before a physician may legally touch a patient were noted in Canterbury v. Spence (1972),2 the landmark case that set the contemporary standard on informed consent. Judge Spottswood Robinson noted in that case that disclosure of everything known by the physician about the patient is neither required nor desirable. What the physician must tell the patient is not ‘everything’, but those things that a reasonable patient would consider as material in coming to an ‘informed’ choice on a treatment decision.

We wish to explore another area in which a doctor need not and should not disclose ‘everything’. It is in response to a family inquiry on ‘what went wrong’ in the earlier care of a patient newly transferred to the physician's care. Such a question might arise during a ‘second opinion’ evaluation or, even more likely, when a patient is transferred from another hospital.

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Authors and Affiliations

  1. Department of Theology, Boston College, Chestnut Hill, MA, USA

    J J Paris

  2. Department of Pediatrics, University of Chicago, Chicago, IL, USA

    J J Paris, A Chu & M D Schreiber

  3. Department of Surgery and MacLean Center for Clinical Ethics, University of Chicago, Chicago, IL, USA

    P Angelos

  4. Assistant Attorney General, The Commonwealth of Massachusetts, Boston, MA, USA

    M P Moore Jr

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  1. J J Paris
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  2. A Chu
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  3. P Angelos
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  5. M D Schreiber
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Correspondence to J J Paris.

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Paris, J., Chu, A., Angelos, P. et al. What do you tell the family who asks, ‘What went wrong?’ The truth and nothing but the truth. J Perinatol 30, 513–516 (2010). https://doi.org/10.1038/jp.2010.73

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