Omission bias entails the preference for a more harmful act of omission (not taking action) over a less harmful act of commission (taking action) [ 25].
The distinctive difference between the principle of non-maleficence on the one hand and that of beneficence on the other lies in the fact that the former frequently – but not always – involves the omission of harmful action and the latter active contribution towards the welfare of others [ 9].
The FORTA (Fit fOR The Aged) classification was introduced in 2008 with the aim of guiding physicians in their screening process for inappropriate or harmful medications and drug omissions in older patients in an everyday clinical setting [ 7, 8 ].
The FORTA (Fit fOR The Aged) classification system was proposed in 2008 [ 23, 24] as a tool for aiding physicians from participating countries (initially Germany) in screening for unnecessary, inappropriate or harmful medications and drug omissions in older patients in an everyday clinical setting.
This approach quantitatively and systematically integrates several important clinical management priorities, including avoiding serious diagnostic errors of omission and avoiding harmful or expensive tests.
For a defense of the view that certain types of inactions, namely omissions, can be harmful see, e.g., Feinberg (1984), ch. 4 and Birnbacher (1995), chs.
This emphasis on treatment benefit, together with omission of information on harmful effects, could misinform anyone trying to make balanced treatment decisions.
To assume that bad intentions are required to make serious harms fundamentally unethical also ignores "errors of omission" and focuses merely on commission having harmful intent.
In general, in a clinical situation similar to the one considered here, a decision maker deals with two types of regret: failure to provide benefit (regret of omission) versus administering unnecessary and potentially harmful treatment (regret of commission) [ 3- 5].
None of the omissions in prescription documentation were considered harmful to the patient because the actual three-dimensional radiotherapy plan was assessed and approved separately on a radiotherapy planning terminal and there were no errors in this section noted.
