Clinicians' perspectives on the duty of candour: Implications for medical ethics education

Abstract

Content

Truth-telling is an integral part of medical practice in many parts of the world. However, recent public inquiries, including the Francis Inquiry reveal that a duty of candour in practise, are at times compromised. Consequently, the duty of candour became a statutory requirement in England. This study aimed to explore clinicians’ perspectives of the implications of the legislation for medical ethics education, as raising standards to improve patient safety remains an international concern.

Methods

One-to-one interviews with clinical educators from various specialties who contribute to the MBChB programme at the authors’ university. Once data saturation had been assessed, transcripts were analysed using a thematic approach by the following concurrent activities: data reduction and coding into themes. Example quotations are used to illustrate that key themes are grounded in the data.

Results

Eleven clinical educators were interviewed; three general practitioners, six physicians and two surgeons. Thematic analysis identified three key themes; reaction to legislation, barriers to implementation and areas of the medical curriculum that can be further developed to better prepare future doctors.

Conclusions

Currently, the legislation is not reaching all frontline staff; there remains a lack of appropriate training and teaching on the legislation that responds to the perceived challenges to implementing candour. These challenges include tensions in the clinical workplace and concerns about the patient’s best interests conflicting with requirements of the legislation. Both undergraduate and postgraduate curricula need to integrate teaching on the implications of the legislation and take a practice based approach in doing so.