Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/5932
Type: Journal article
Title: Error, blame, and the law in health care - An antipodean perspective
Author: Runciman, W.
Merry, A.
Tito, F.
Citation: Annals of Internal Medicine, 2003; 138(12):974-979
Publisher: Amer Coll Physicians
Issue Date: 2003
ISSN: 0003-4819
Statement of
Responsibility: 
William B. Runciman, Alan F. Merry and Fiona Tito
Abstract: Patients are frequently harmed by problems arising from the health care process itself. Addressing these problems requires understanding the role of errors, violations, and system failures in their genesis. Problem-solving is inhibited by a tendency to blame those involved, often inappropriately. This has been aggravated by the need to attribute blame before compensation can be obtained through tort and the human failing of attributing blame simply because there has been a serious outcome. Blaming and punishing for errors that are made by well-intentioned people working in the health care system drives the problem of iatrogenic harm underground and alienates people who are best placed to prevent such problems from recurring. On the other hand, failure to assign blame when it is due is also undesirable and erodes trust in the medical profession. Understanding the distinction between blameworthy behavior and inevitable human errors and appreciating the systemic factors that underlie most failures in complex systems are essential for the response to a harmed patient to be informed, fair, and effective in improving safety. It is important to meet society's needs to blame and exact retribution when appropriate. However, this should not be a prerequisite for compensation, which should be appropriately structured, fair, timely, and, ideally, properly funded as an intrinsic part of health care and social security systems.
Description: © American College of Physicians
RMID: 0020030578
Published version: http://www.annals.org/cgi/reprint/138/12/974.pdf
Appears in Collections:Anaesthesia and Intensive Care publications

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