Defining Failure: The Language, Meaning and Ethics of Medical Error
Christiane Schubert, Gerald Winslow, Susanne Montgomery,  AhlamJadalla

Abstract
Despite the technical sophistication of modern medicine errors cannot be avoided. As errors are situated in the complexity and dynamicity that characterize healthcare environments they are difficult to define. A conceptual framework of medical error needs to account for the reality of medical work and the nature of error as a language-mediated social and legal construct. We identify four aspects that serve as a distinct framework: the notion of intent, the etiology of medical error and its multi-factorial flow, peer-reviewed contexts, and outcomes that may or may not result in harm to patients. The former assume moral quality and become concerns of justice. Specifically, a restorative justice approach supports the disclosure of errors to patients and addresses their physical, mental, spiritual, and social effects. The result of this contextually grounded, outcome-oriented model and accompanying definition of medical error provides practical guidance for hospital policies on dealing with medical error issues.

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