ABSTRACT
Americans are experienced at fixing blame when things go wrong. Our political system lets us throw out the leaders whose lack of judgment, skill, or honesty seems to have been the cause. Our legal system lets us sue individuals or corporations perceived to have been at fault. Although it does not always solve the problem, finding the culprit often at least makes us feel better. It is not that finding fault where fault is genuine lacks a legitimate purpose. Wrongdoers, whether their actions were intentional or not, may deserve to face responsibility for cleaning up a mess of their making. Enforcing this duty also can serve as an invaluable deterrent. However, an obsession with finding fault can be counterproductive and leave underlying issues unresolved. It can lead us in circles when the causes of problems are complex. Some problems just seem to get worse the more we try to blame someone. Nowhere is this conflict more evident than in health care. As the Institute of Medicine so forcefully tried to explain, ‘systems, not individuals, are often the culprit and misbehaving individuals merely the unwitting accomplices. Attempts to correct problems by assigning blame in this environment are not just doomed to failure; they can actually make the situation worse by stifling open dialogue. What is more, with as many as 98,000 patients dying each year from medical errors in hospitals’, the stakes in approaching health care problems the wrong way are extremely high.
Field, Robert, Holding Health Care Accountable: Law and the New Medical Marketplace. 23 Journal of Legal Medicine 289 (2002).
First posted 2021-05-07 11:00:38
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