Doctors are more dangerous than gun owners: a rejoinder to error counting.
OBJECTIVE
This paper analyzes some of the problems with error counting as well as the difficulty of proposing viable alternatives.


BACKGROUND
Counting and tabulating negatives (e.g., errors) are currently popular ways to measure and help improve safety in a variety of domains. They uphold an illusion of rationality and control but may offer neither real insight nor productive routes for improving safety.


METHODS
The paper conducts a critical analysis of assumptions underlying error counting in human factors.


RESULTS
Error counting is a form of structural analysis that focuses on (supposed) causes and consequences; it defines risk and safety instrumentally in terms of minimizing negatives and their measurable effects. In this way, physicians can be proven to be 7500 times less safe than gun owners, as they are responsible for many more accidental deaths.


CONCLUSIONS
The appeal of error counting may lie in a naive realism that can enchant researchers and practitioners alike. Supporting facts will continue to be found by those looking for errors through increasingly refined methods.


CONCLUSIONS
The paper outlines a different approach to understanding safety in complex systems that is more socially and politically oriented and that places emphasis on interpretation and social construction rather than on putatively objective structural features.
Dekker
Sidney W A
SW
Lund University, School of Aviation, 260 70 Ljungbyhed, Sweden. dekker@tfhs.lu.se
D015982:Bias; D003625:Data Collection; D003627:Data Interpretation, Statistical; D019538:Health Care Surveys; D006801:Humans; D019300:Medical Errors / Q000145:classification / Q000706:statistics & numerical data*; D017751:Safety Management / Q000379:methods* / Q000706:statistics & numerical data; D013597:Systems Analysis