Mistakes as a social construct: an historical approach

Area of Science:

• Medical history
• Neurosurgery
• Patient safety

Background:

• The Institute of Medicine's 1999 report, 'To Err is Human,' highlighted medical errors and proposed a 50% reduction target.
• This paper investigates the historical reporting of medical mistakes in neurosurgery between 1890 and 1934.
• Legal, scientific, and medical trends influenced the shift from open reporting to concealed error documentation.

Discussion:

• Early 20th-century neurosurgery journals featured open reporting of errors for educational purposes.
• By 1934, a more scientific and objective reporting system led to medical mistakes being 'underground.'
• The historical context of error reporting impacts the interpretation of modern patient safety recommendations.

Key Insights:

• Medical error reporting has evolved significantly over time.
• The culture of medicine influences how errors are documented and addressed.
• Historical trends in scientific and legal frameworks shaped error disclosure.

Outlook:

• Re-evaluating the Institute of Medicine's patient safety recommendations through a historical lens.
• Understanding past reporting practices is crucial for fostering a culture of transparency in medicine.
• The paper provides a historical baseline for assessing contemporary approaches to medical error reduction.