Criminal proceedings will hamper calls for open culture

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7527.1272-b (Published 24 November 2005) Cite this as: BMJ 2005;331:1272
  1. Robin E Ferner, director (r.e.ferner{at}bham.ac.uk),
  2. Sarah E McDowell, research officer
  1. West Midlands Centre for Adverse Drug Reaction Reporting, City Hospital, Birmingham B18 7QH

    EDITOR—The National Patient Safety Agency urges healthcare staff to adopt an open culture where they admit to errors in order that the organisation can learn from them and treatment be made safer. Recently, 14 senior doctors candidly described their own experiences of medical errors.1 2

    However, we have previously pointed out that if doctors and others who err are charged with manslaughter, then exhortation to openness is likely to fail.3 When we examined cases due to errors in administering anaesthetics and in prescribing and giving medicines, we found a marked increase in the number of doctors charged between 1970 and 1999. We have now extended our analysis to consider all doctors charged, including surgeons, between 1970 and 2004, using the newspaper database Lexis Nexis, the Times digital archive, and the Medline and Embase databases. We discovered 36 cases, including 43 doctors, where the outcome was known (table). In the five years subsequent to our original publication, 17 doctors were charged with manslaughter.

    Doctors charged with manslaughter in the course of medical practice

    View this table:

    Error is unavoidable in the course of medical care. Criminal prosecution after a medical error may be an emotionally satisfying way to exact retribution, but it will not address the root cause of errors within a complex system such as the NHS. Charging doctors with manslaughter will make health care more dangerous, not safer.


    • Competing interests REF has provided medicolegal reports for healthcare professionals charged with manslaughter.


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