Regarding the Disclosure of Adverse or Unexpected Outcomes, I have several issues with this standard. 1. The name of it. Harm is substantially different than an unexpected outcome. An unexpected outcome could be anything from death to something like "the bacteria we were treating before our cultures returned is actually resistant to that antibiotic so now we have to change the antibiotic" to "it's actually a girl when we thought it would be a boy" to "That lump is not malignant, it is actually benign". All of those might be considered unexpected outcomes but not all of them need to be disclosed and nor are there any harms done with the latter two examples. 2. In section 5, it requires MDs to disclose information to family members and close friends. This is far too broad a definition and also may violate confidentiality. Am I supposed to disclose information to every "close friend" of a patient who died as to why the patient died? If another "close friend" calls my office three weeks after the death of his or her friend asking for information, as it is written, I am compelled to disclose that information to that person, even if I don't really even know who that person is. 3. Near misses - these are not harms and there are several different levels of misses. A clerk mixing up two patients at intake and checking in a patient under the wrong information could lead to a disaster but if it is caught early and the admission cleared up, no harm is done.