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Citation |
Adams J. Br. J. Gen. Pract. 2002; 52(479): 454-455, 457-458. |
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Copyright |
(Copyright © 2002, Royal College of General Practitioners) |
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DOI |
unavailable |
PMID |
unavailable |
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Abstract |
On 2 June 2001, the British Medical Journal published an editorial with the title "BMJ bans 'accidents'". The authors -- Barry Pless, editor of Injury Prevention, and Ron Davis, North American editor of the BMJ -- explained: "most injuries and their precipitating events are predictable and preventable. That is why the BMJ has decided to ban "accidents". What word would they use in its stead? After considering and rejecting a number of alternatives they say "... the English language may simply fail us here. Perhaps we should coin a word to refer collectively to the incidents that may produce injury (injidents?)". Their principal objection to the use of the word 'accident' is that it deflects blame: "when we use 'accident,' we exonerate from blame the person injured, the parent, the manager, the facility, the company, or 'the system'". They should perhaps have pondered longer on why a language as rich and ancient as English should lack a word adequate to their purpose. Their proposal loads the word 'accident' with a bias that it does not have in common parlance. In everyday usage it is blame-neutral: it is simply an unfortunate, undesired and unintended event. They would replace it with a word that is blame-loaded: every undesired outcome must be someone's fault. (While they say 'most' injidents are predictable and preventable, they are prepared to exonerate only those for which preventive or avoiding measures are impossible -- perhaps asteroid impacts.) They may protest that their new word is neutral, but words, especially new words, acquire their meanings from the contexts in which they are used, and the editors make clear in the manifesto with which they launch it that they want a word that attaches blame to events that were predictable and that should, therefore, have been prevented.... Risk management, is a balancing act; one cannot have the rewards without taking risks, and one cannot take risks without having accidents. The bottom-loop bias of those who would consign 'accidents' to the Orwellian memory hole is transforming the way that the medical profession performs this act. It is possible to have too few accidents. An obsession with eliminating accidents by finding someone to blame for everything that goes wrong will incur large opportunity costs in the form of rewards foregone. A more complete examination than has been attempt- ed here of the way in which the profession is now constrained to manage risk would, I suspect, come to the conclusion that it does not have enough injidents. Language: en |