Medical errors and patient safety in palliative care: a review of current literature.

BACKGROUND: Recently, the discussion about medical errors and patient safety has gained scientific as well as public attention. Errors in medicine have been proven to be frequent and to carry enormous financial costs and moral consequences. We aimed to review the research on medical errors in palliative care and to screen relevant literature to appreciate the relevance of safety studies to the field.
METHODS: We performed a literature search using the database PubMed that cross-matched terms for palliative care with the words "errors" and "patient safety." Publications were classified according to type of study and kind of error, and empiric research results were extracted and critically assessed.
RESULTS: We found 44 articles concerning medical errors in palliative care, most of which were case studies. Of these 44 articles, 16 deal with palliative care errors as a key issue, referring mostly to symptom control (n = 13). Other examples are errors in communication, prognostication, and advance care planning. There are very few empirical studies, which are mostly retrospective observational studies. DISCUSSION: Although patients in palliative care are more vulnerable to errors and their consequences, there is little theoretical or empirical research on the subject. We propose a specific definition for errors in palliative care and analyze the challenges of delineating, identifying and preventing errors in such key areas as prognostication, advance care planning and end-of-life decision-making.