Table 2 Example statements on the reaction to one’s own errors and ethical reconstruction

Respect for Autonomy

Respect ^d

“The autonomy of the patient is relevant: Can I tell my patient about the error? What do I risk? Things like termination of therapy… But I can’t live with “not telling” the patient. It’s always about treating others, as you would like to be treated yourself (…). This would be a short form of my ethical belief: I do not want to be patronized or stigmatized…I want to be treated autonomously” (T4, CBT, psychologist)^c

“Respect in treating patients, e.g. not judging them, their decisions – especially when disclosing an error.” (T23, psychoanalyst, psychiatrist)

Non-maleficence

Responsibility

“I would be inclined to tell the patient (about the error)… But there are a few patients, particularly in psychiatry, when I prefer to not talk about an error. For example when a patient suffers from delusions…” (T12, CBT, psychiatrist)

“I will take responsibility for the error, apologize and express my regret. This has always raised a lot of positive reactions…” (T7, client-centred therapist, psychologist)

Beneficence

(Professional) Competence

“The patient can benefit from me disclosing an error. They know they can trust me and it is not their fault if therapy does not work. A common error in my opinion is blaming patients for therapy failures.” (T22, CBT, psychologist)

“A common error ([is]) when therapists don’t know their limits. When therapists treat patients without having the necessary background knowledge or professional training…” (T15, psychoanalyst, psychologist)

Justice

Integrity ^e

This category was not coded

“Integrity – this is to not misuse one’s position of power… Integrity also means transparency. Taking this into account, I think there is a duty of disclosure…” (T4, CBT, psychiatrist)