Drug errors, qualitative research and some reflections on ethics.

Abstract

AIMS AND OBJECTIVES: Observational methods as part of a qualitative approach have been specifically employed in the study of drug error and have undeniable strengths. This position paper will examine some recent research raising a number of ethical, and tangentially, methodological issues concerning the qualitative study of drug errors within United Kingdom National Health Service hospitals. Reflections on the views and ethical conduct of other qualitative researchers are provided to contextualize the discussion. BACKGROUND: The impact of a drug error, and any resultant adverse event can be significant. The human and financial costs are considerable. Establishing an accurate estimation of the frequency of adverse event and reporting rates has been difficult; additionally, methodological weaknesses in medical error research have sometimes caused further difficulties. Unsurprisingly, observational studies and for that matter, a whole range of other methods are now being considered in the quest to establish both understanding and predictability in relation to medical error. RELEVANCE TO CLINICAL PRACTICE: It is argued here that any participants in medical error research should be treated in a way that takes account of the prevailing culture of health care and, in the United Kingdom, the current ethos of government policy on medical error. This requires gaining informed consent, promoting transparency in method, and providing the opportunity for participants to learn. Effective error researchers can clearly increase the available knowledge in this critical area but ethical considerations and their chosen methods should show an appropriate level of respect for their participants. Carefully implemented qualitative approaches can help realize such respect.