The creation of professional and statutory duties of candour has formalised the requirement for clinicians and healthcare organisations to be honest with patients and families when treatment has gone wrong. This article explains the background to creating both duties, analyses the concept of candour, the role of apologies, and considers evidence about compliance. It argues that making candour a statutory requirement appropriately reflects the ethical imperative of telling the truth about harm and is a powerful signal for honesty. However, being candid is not easy in the context of complex professional cultures, the realities of delivering care in under-funded health systems, and in the shadow of possible legal and regulatory proceedings. Proposals in the current Health and Care Bill to create investigatory 'safe spaces' which prohibit the disclosure of information submitted to the Health Service Safety Investigations Body undermine candour. This article argues against such proposals, which are both wrong in principle and highly problematic in practice. Candour should be respected as a cardinal principle governing not only the conduct of those providing care, but also those who investigate such incidents. Harmed patients and their families deserve to know the whole truth.

中文翻译：

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医疗保健中坦率的责任：真相、全部真相和只有真相？

坦率的专业和法定义务的创建正式要求临床医生和医疗保健组织在治疗出现问题时对患者和家属诚实。本文解释了创建这两种职责的背景，分析了坦率的概念，道歉的作用，并考虑了有关合规的证据。它认为，将坦率作为法定要求恰当地反映了说出伤害真相的道德要求，并且是诚实的有力信号。然而，在复杂的专业文化背景下、在资金不足的卫生系统中提供医疗服务的现实以及可能的法律和监管程序的阴影下，坦诚相待并不容易。当前健康和护理法案中关于创建调查性“安全空间”的建议 禁止披露提交给健康服务安全调查机构的信息会破坏坦率。本文反对这样的建议，这些建议在原则上是错误的，在实践中也存在很大问题。坦率应被尊重为一项基本原则，不仅适用于提供护理的人的行为，也适用于调查此类事件的人的行为。受伤害的患者及其家人应该知道全部真相。