Silence In Healthcare: Non-Disclosure Of Medical Errors And The Protection Of Patient Rights

INTRODUCTION

Medical practice, at its core, exists to preserve life and alleviate suffering. Yet it is carried out by human actors operating within imperfect systems. The inevitability of error captured in the maxim errare humanum est is not, in itself, the central concern. Rather, the legal and ethical fault line emerges in what follows: the failure to disclose those errors.

In Nigeria, the issue of transparency in healthcare has moved from the periphery to the center of legal and policy discourse, particularly within the context of ongoing reforms between 2023 and 2026. At stake is a fundamental question: whether the healthcare system will prioritise institutional self-preservation or the rights and dignity of the patient.

A PRACTICAL ILLUSTRATION

Consider a relatively common scenario. A patient undergoes what is described as a routine surgical procedure. Post-operatively, complications arise persistent pain, delayed recovery, and unexpected deterioration. The treating team attributes these developmentts to “normal post-surgical complications” and reassures the patient accordingly.

Months later, following further investigation at a different facility, it is discovered that a surgical instrument or material had been inadvertently retained during the initial procedure. The patient is now faced not only with additional medical intervention, but also with prolonged suffering that might have been mitigated had the error been disclosed promptly.

In such circumstances, the harm is twofold. First, there is the primary clinical error. Secondly and often more significantly there is the failure of candour. The patient is denied the opportunity to make informed decisions, seek timely corrective care, or pursue appropriate remedies. What might have been addressed as a medical complication becomes, instead, a matter of legal and ethical breach.

This scenario is neither hypothetical nor rare. It reflects a general pattern within healthcare systems where the instinct to manage reputational risk overrides the duty of transparency.

The scale of the issue in Nigeria is reflected in data suggesting that medical errors remain a significant contributor to hospital mortality. Available reports indicate that a substantial proportion of deaths within healthcare settings in developing African contexts, including Nigeria, may be attributable directly or indirectly to medical error.

Notwithstanding established professional and ethical obligations requiring timely and transparent disclosure, a persistent culture of silence continues to characterise parts of the Nigerian medical community. This pattern of non-disclosure extends beyond an ethical failing; it raises serious legal concerns, amounting to a potential violation of fundamental patient rights and a breach of the duty of care owed by healthcare practitioners to those under their treatment.

UNDERSTANDING MEDICAL ERROR

A medical error is commonly defined as the failure of a planned action to be completed as intended, or the use of an incorrect plan to achieve a clinical objective. It encompasses a wide spectrum of conduct, including diagnostic inaccuracies, surgical errors, medication mismanagement, and systemic failures.

These errors may be classified broadly as

• Error of Execution: The failure of a planned action to be completed as intended. Example, Administering 50mg of a drug instead of the prescribed 5mg due to a misread chart.
• Error of Planning: The use of a wrong plan to achieve a specific clinical aim. Example, deciding to proceed with surgery before obtaining necessary biopsy results.
• Error of Omission: Harm resulting from an action that was not taken. Example, Failure to strap a patient into a wheelchair, leading to a fall
• Error of Commission: Harm resulting from the wrong action being taken. Example, Transfusing a patient with the wrong blood group.
• Near Misses: Errors that do not cause harm by chance or because they were intercepted. Example, A pharmacist catching a wrong prescription before it reaches the patient.

While not all medical errors result in immediate harm, each carries the potential to undermine the fiduciary foundation of the doctor–patient relationship. Unlike a conventional commercial interaction, this relationship is grounded in trust, candour, and professional integrity.

In Nigeria, diagnostic, surgical, and prescription errors remain the most prevalent categories. A 2025 study conducted in Edo State reported a self-disclosed medical error prevalence of 58.6% among healthcare workers, with medication-related errors accounting for 46.3% of cases. Within this category, dose omissions and incorrect dosage administration continue to be the primary drivers of adverse clinical outcomes.

The deliberate withholding of material information in such circumstances erodes the trust inherent in the doctor–patient relationship and gives rise to significant legal consequence.

THE NIGERIAN REALITY: ERROR WITHOUT DISCLOSURE

Evidence suggests that medical errors remain a significant contributor to adverse patient outcomes within Nigeria. More troubling, however, is the persistence of what may be described as a “culture of non-disclosure. ”

Recent cases have highlighted both individual and systemic failures. In a widely reported 2006 incident, an infant contracted HIV following a blood transfusion at Lagos University Teaching Hospital, notwithstanding that both parents were HIV-negative. A subsequent Federal Government investigation identified systemic lapses and recommended disciplinary action against senior officials.

More recently, in 2026, the Kano State Hospitals Management Board confirmed a case of medical negligence involving the retention of surgical scissors in a patient’s body, which resulted in her death and prompted disciplinary proceedings. Other reported incidents ranging from medical negligence resulting to multiple surgical procesdures to denial of emergency careunderscore recurring lapses in both clinical practice and institutional accountability.

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The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.