The claim that “4% of human activity is error” may be one of those statistics made up on the spur of the moment, but it seems about right to me. Systems can be engineered to minimise the consequences of these errors—think aviation—but not to do away with them completely. The question for us is how best to handle the inevitable cock-ups that occur in the delivery of health care.

It goes almost without saying that the first step should be a comprehensive explanation of what went wrong, followed by an apology if warranted. And yet patients or their aggrieved relatives often complain to us that healthcare providers stick with misinformation …