After Harm: Medical Error and the Ethics of ForgivenessBMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7528.1343 (Published 01 December 2005) Cite this as: BMJ 2005;331:1343
- Farr A Curlin, assistant professor ([email protected])
- section of general internal medicine and the MacLean Center for Clinical Medical Ethics, University of Chicago
The title of the US Institute of Medicine's 1999 report, “To Err is Human,” truncates a well known aphorism, “To err is human; to forgive, divine.” In After Harm, Medical Error and the Ethics of Forgiveness Nancy Berlinger notes that the omission of the second clause symbolises the way modern health care has, in its preoccupation with preventing medical error, neglected the moral obligations that follow from the errors that human agents inevitably commit. In a laudable effort to address the imbalance, Berlinger applies a “religious studies perspective” to describe the words and actions that make forgiveness possible after medical harm.
Before harms can be addressed they must first be disclosed. In a turn that initially seems paradoxical, Berlinger commends the norm of disclosure by appropriating the German pastor Dietrich Bonhoeffer's theological justification for lying to his Nazi interrogators in the period before his eventual execution. Bonhoeffer was repulsed by Immanuel Kant's notion that lying, on principle, is not justifiable even to defend the innocent from evil. Against Kant, Bonhoeffer argued that our moral obligations can never be reduced to anything less …
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