Ethical Dilemma of Error Disclosure in Wrong-Site Craniotomy: A Systematic Review

Document Type : Systematic Review


1 Department of Neurosurgery, University Hospital Southampton, Southampton, UK

2 Altnalgelvin Area Hospital, Northern Ireland, UK


Introduction: Disclosure of errors to patients has long been fully endorsed by professional organizations and bioethicists because of its respect for patient autonomy, enhances informed decision-making and upholds the physician decision to tell the truth. Wrong site craniotomy have massive effects on both the patients and the surgeons. The purpose of this review was to apply moral philosophical analysis to this delicate and important issue that will for sure continually confront neurosurgeons in practice.
Methods: A comprehensive selected literature search was performed to establish evidence for informed and evidenced based discussion including the current literature relating to wrong-site craniotomy error disclosure. A total of 232 articles were gathered, but after removing duplicates, editorial comments and correspondences, only two articles met the criteria.
Results: In terms of the quality of the gathered evidence, only peer reviewed papers reached the limit. Generally, there is paucity of literature in the ethics of wrong site craniotomy. As a result, only two articles met the criteria (Cohen and Wu et al.).
Conclusion: Deontology strongly believed that all major accidental errors which occur when facing patients should be disclosed. This is due to the fact that surgeons are duty-bound to do the right thing including not lying, respecting patients’ dignity, practicing beneficence, sympathy and acting with gratitude and conscience without arrogance.