In a 1998 editorial of the Journal of the American Medical Association (JAMA), Dr. Lucian Leape of Harvard University’s School of Public health joined other leaders in the patient safety initiative to speak out about the prevention of medical error.
"The medical imperative is clear: to make health care safe we need to redesign our systems to make errors difficult to commit and create a culture in which the existence of risk is acknowledged and injury prevention is recognized as everyone’s responsibility. A new understanding of accountability that moves beyond blaming individuals when they make mistakes must be established if progress if to be made.A number of forces make implementing these concepts difficult, most notably an entrenched belief in the effectiveness of punishment for error prevention, a conviction richly reinforced by highly punitive legal and regulatory systems as well as the public media. Ironically, rather than improving safety, punishment makes reducing error much more difficult by providing strong incentives for people to hide their mistakes, thus preventing recognition, analysis, and correction of underlying causes."
(JAMA, Vol. 280, No. 16, 1998, pp. 1444-1447)
