Is it ever OK to hide a medical error?

As I was reading through the Paradise Hills Medical Center example in Chapter 1 of Frankie Perry's book, I was surprised that the option to hide the radiation overdose was even being considered. The text states that Paradise Hills has a reputation for "high-quality care", and "competent, caring staff". In my mind, that reputation would be severely jeopardized if anyone ever found out that a medical error like the one described was hidden from the patients who were affected by it. The text also mentions that Paradise Hills has "strong leadersship". Is hiding a medical error something a strong leader would do? The text mentions that the market share of the oncology division has been declining recently. Maybe the attitude of those in leadership positions has something to do with that.
The reasons given by the medical staff for not disclosing the error included not wanting to confuse terminal cancer patients and thereby destroy their faith in their physicians, frighten the patients unnecessarily which may lead to refusal of treatment, or inducing symptoms by telling the patients of potential ill effects. I think all these reasons are quite ridiculous and do not even begin to justify withholding the truth from these patients. The medical staff are probably more concerned with the potential of a lawsuit, but I would worry more about being sued for not telling them what happened.
The medical staff are assuming quite a lot about how these patients would react to the news that the equipment was not calibrated properly. I think most people would be worried if they knew and hope not to exhibit any ill effects, but would understand that every piece of equipment has the potential to malfunction. By not telling the patients about this, the hospital is opening itself up for lawsuits based on negligence. The physicians can not treat any ill effects of the radiation overdose unless the patient knows what is happening, therefore, if ill effects do occur, what does the doctor do? If he stands by and does nothing, he is committing medical malpractice. By not telling the patients, the hospital administration is banking on the fact that the patients will either die first or not suffer any ill effects that can be attributed to the radiation overdose.
In this case, I think that the CEO has no choice but to encourage the medical staff to "do the right thing" and disclose the error to the patients. He must support them through the consequences that may occur because of the disclosure, but in the long run, a climate of truth-telling will benefit the organization much better than one of hiding errors. The precedent can not be set that allows lying to patients to become justifiable. This time it may seem all right to hide a radiation overdose, but what about the next error that occurs? Having a clear, ethical position makes these types of decisions easy. Dealing with the consequences of an error is usually inevitable. Sooner or later, they will have to face them. I think I would like to do it sooner.
Lynne
reference:
Perry, F. (2002) The Tracks We Leave: Ethics in Healthcare Management. Chicago: Health Administration Press.

How should we make ethical decisions?

I don't know about you, but I took this class in healthcare ethics because I wanted to find out more about the dilemmas healthcare workers face everyday and how they come to terms with the inevitably difficult decisions they must make.
I am a pharmacist at Holmes Regional Medical Center in Melbourne, and I have worked there for 10 years now. Before that, I owned my own pharmacy and worked at a few different chain drugstores. As I have traveled through my healthcare experience, I have had occasion to discuss the seemingly heroic measures that many healthcare professionals provide in order to keep a patient alive. The question of whether to apply expensive therapies to patients who are determined to be "close to death" is an age old one and one I feel should be decided on by a case by case basis.
I had no idea until this week that there were helpful tools like the "Framework for Ethical Decision-Making" from the W. Maurice Young Centre for Applied Ethics. I guess I thought that there was some kind of decision-making guidelines out there, but now it is nice to finally see examples of them. Taking a difficult decision and breaking it down into the steps provided by this framework seems to help take the quess work out of whether your decision was "ethical" or not.
Recently, a 13 month old patient was admitted to our ICU because she was ventilator dependent since birth and electricity was cut to her home due to fire. She has multiple health issues including pulmonary hypertension which even an adult has difficulty surviving very long with. Our question in the pharmacy was "Is it ethical to keep this child alive due to her limited survivability and huge healthcare costs associated with her ventilator dependency?" Most of us felt that the child should be allowed to pass away peacefully due to the poor quality of life she (and her family) were experiencing.
I know there will be those that disagree wholeheartedly with my view. I am a mother and the idea that I would have to make this kind of decision is horrifying at best. The framework suggests that after you make your choice, you "Live with it" and "Learn from it". I only think that if this were indeed my decision to make that I would not only live with the knowledge that I did the right thing for the people involved but also learn that there is always pain associated with ethical decisions like this one.
I would love to hear your view if you have time to respond.
Lynne