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Errors, Medicine and the Law

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When someone is hurt during medical treatment it is an understandable reaction to blame the doctor for the harm. However, the great majority of errors which occur in medicine are a simple consequence of conscientious doctors being fallible human beings just like the rest of us. Hospital systems are generally full of design faults which pre-dispose doctors to make mistakes. Blaming doctors for simply being human directs attention away from these design faults, reduces the chance that system improvements will be made, and makes it likely that the same error will repeat itself in the future - thus perpetuating patient harm. Human error cannot be avoided, but patient harm can, through better systems and procedures. Genuinely negligent acts do occur in medicine, but it is important that these are distinguished from the inevitable human errors of clinicians doing their best. This is a distinction which is also required in law to ensure fairness in both the prosecution of negligent doctors and the compensation of harmed patients. This book goes several steps beyond the Institute of Medicine Report ("To Err is Human") in identifying the mechanisms and nature of error within health care and in its detailed discussion of the intricacies of culpability, blame, violation, error, legal fairness, and patient safety.