TY - JOUR T1 - Is honesty the best policy? Why trustworthiness is no easy answer JF - British Journal of General Practice JO - Br J Gen Pract SP - 558 LP - 559 DO - 10.3399/bjgp14X682129 VL - 64 IS - 628 AU - David Misselbrook Y1 - 2014/11/01 UR - http://bjgp.org/content/64/628/558.abstract N2 - The Department of Health recently commissioned the Royal College of Surgeons (RCS) to review the medical profession’s statutory ‘duty of candour’. The RCS has now published its report, Building a Culture of Candour (BCC).1 The report seeks to explore the barriers for doctors, other healthcare workers, and healthcare organisations to their duty, and hopefully their desire, to be honest to patients when things go wrong.The Oxford English Dictionary defines candour as ‘the quality of being open and honest; frankness’. It is therefore about being truthful, but with the emphasis on our openness to disclose uncomfortable truths. Onora O’Neill helpfully reminds us that trust can only exist if we are consistently trustworthy.2 So truth is vital to our craft. No one is going to argue with this, so why does it need to be said?BCC lists powerful barriers to openness that exist within the medical culture of the UK. These include the obvious, such as our natural human reluctance to admit that we are wrong, the fear of litigation, and the fear of a punitive response from regulators such as the Care Quality Commission (CQC) and the General Medical Council (GMC). It also identifies more subtle barriers such as reluctance to talk about other people’s errors when we do not know the whole story, anxiety about unleashing a bureaucratic burden, and worry about organisational reputation. And who is clear about the boundary between minor problems and ‘significant harm’ … ER -