Discontinuity and Disaster: Gaps and the Negotiation of Culpability in Medication Delivery

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Title Discontinuity and Disaster: Gaps and the Negotiation of Culpability in Medication Delivery
Author Dekker, Sidney
Journal Name Journal of Law Medicine and Ethics
Year Published 2007
Place of publication United States
Publisher Wiley-Blackwell Publishing, Inc.
Abstract This paper shows how discontinuities in the process of drug delivery enable but also underdetermine the isolation of a culprit in adverse medication events. A case example illustrates how we are forced to abandon conceptualizations of blame that assume a dichotomy (either culpable or not), and shift instead to a more nuanced version that estimates the degree to which an actor desired, generated, or could have foreseen the harmful outcome, and the extent to which constraints external to the actor altered the event. The paper concludes that meaningful safety interventions in a system as diverse, socially embedded and complex as health care delivery cannot just build on “good science” (e.g., good methods) to generate “root” causes. Rather, they need to somehow be sensitive to how and which narratives of success and failure are created, as these constrain which countermeasures are likely to be encouraged, funded, and accepted.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1111/j.1748-720X.2007.00168.x
Volume 35
Issue Number 3
Page from 463
Page to 470
ISSN 1073-1105
Date Accessioned 2011-03-08
Date Available 2011-05-30T06:54:41Z
Language en_AU
Faculty Arts, Education and Law
Subject Environmental and Occupational Health and Safety
URI http://hdl.handle.net/10072/38849
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1x

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