This text examines the concept of "medical narcissism" and how error disclosure to patients and families is often compromised by the health professional's need to preserve his or her self-esteem at the cost of honoring the patient's right to the unvarnished truth about what has happened. It explores common psychological reactions of healthcare professionals to the commission of a serious harm-causing error and the variety of obstacles that can compromise ethically sound, truthful disclosure. Insights are offered on how talented, capable persons who feel a driving need to demonstrate their competence can fall into narcissistic traps. Guidance on disclosing errors artfully and ethically is provided through a series of step-by-step recommendations along with a list of particularly helpful words and phrases.