Merry and McCall Smith’s Errors, Medicine and the Law

Abstract

Several years ago Alan Merry and Alexander McCall Smith became deeply concerned by the fact that morally innocent persons could be convicted of manslaughter due to an event that did not involve moral culpability. This prompted their in-depth critique of the moral and legal basis for attributing blame in these circumstances within healthcare environments and culminated in the birth of Errors, Medicine and the Law. Sixteen years later, the book is now in its second edition, nearly twice its original length and with considerable development of its original format, as well as the addition of two new chapters.

In the second edition, Merry and (now) Brookbanks retain their principal assertion that error is an unintentional act. Whether or not the consequent outcome is disastrous or otherwise, is separated by a fine line that is influenced by chance as well as a range of other circumstantial factors. Many of the errors in healthcare do not involve moral culpability. Yet apportioning blame on a specific individual can divert attention from bigger pictures of systemic failings and deficiencies. Thus, any toxic “environmental” predispositions to error can be missed, thereby reducing opportunities to develop safer environments by correcting weaknesses in the system for the protection of patients.