title: Blame and accountability 1: understanding blame and blame pathologies.
abstract: OBJECTIVE
  In this first paper the role and dynamics of blame in the context of medical critical incidents is examined. Blame pathologies are described and the complex nature of medical adverse events and the environment are explored.
  
  
  METHODS
  The literature is examined and a case scenario explored.
  
  
  RESULTS
  Evidence regarding effects of a 'blame culture' on clinicians and organizations is presented. In an accompanying second paper the place of accountability in relation to clinicians and health organizations is elucidated.
  
  
  CONCLUSIONS
  The necessary conditions for an accountable, responsive, fair and transparent health culture are proposed.
authors: Sydney South West Area Mental Health Service, Australia. nick.oconnor@sswahs.nsw.gov.au
authors: Nick
authors: N
authors: O'Connor
authors: Beth
authors: B
authors: Kotze
authors: Murray
authors: M
authors: Wright
mesh_terms: D000328:Adult; D005190:Family; D006282:Health Personnel / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D015279:Organizational Culture; D010348:Patient Care Team; D011570:Psychiatry / Q000592:standards*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000628:therapy; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012935:Social Justice; D012941:Social Responsibility; D059020:Suicidal Ideation; D013405:Suicide
chemical_list: D011619:Psychotropic Drugs