Mistakes occur in medicine as in other walks of life. Their consequences may be trivial, but often they are serious, and they may be catastrophic. Some errors cannot be helped; others are avoidable, even culpable. Steps may be taken to correct errors but in many instances the mistake is irrevocable; the only benefit is the prevention of similar errors in future. Doctors are expected to profit from their experiences, and from their earliest days medical students are exhorted to learn from their mistakes. To learn only from one's own mistakes would be a slow and painful process and unnecessarily costly to one's patients. Experiences need to be pooled so that doctors may also learn from the errors of others.
This requires a willingness to admit that one has erred and to discuss the factors that may have been responsible. It calls for a critical attitude to one's own work and to that of others. Unfortunately medical students and doctors see little evidence of such openness around them. Gorowitz and Maclntyre wrote: "No species of fallibility is more important or less understood than fallibility in medical practice. The physician's propensity for damaging error is widely denied, perhaps because it is so intensely feared.... Physicians and surgeons often flinch from even identifying error in clinical practice, let alone recording it, presumably because they themselves hold...that error arises either from their or their colleagues' ignorance or ineptitude."' But errors need to be recorded and to be analysed if we are to discover why they occurred and how they could have been prevented.
