ABSTRACT
Around the world, numerous public inquiries, a steady drumbeat of media interest and hundreds of millions of dollars in research funds followed. Today, efforts to prevent medical injury have assumed a place among the health policy priorities of many countries and the World Health Organization. There are two main rationales, one grounded in considerations of justice and medical ethics, the other in considerations of injury prevention and public health. Informed consent, decision-making by families at the end of life and the sharing of prognostic information with patients are all manifestations of a broad consensus that competent adults are best placed to make their own health care choices. Medicine is a latecomer to the science of accidents, but decades of experience accumulated in other industries, such as aviation and nuclear power, indicate that openness about error is critical to prevention.
