Intended for healthcare professionals


Abandon the term “second victim”

BMJ 2019; 364 doi: (Published 27 March 2019) Cite this as: BMJ 2019;364:l1233
  1. Melissa D Clarkson, assistant professor1,
  2. Helen Haskell, president2,
  3. Carole Hemmelgarn, patient advocate3,
  4. Patty J Skolnik, president4
  1. 1Division of Biomedical Informatics, University of Kentucky, Lexington, KY, USA
  2. 2Mothers Against Medical Error, Columbia, South Carolina, USA
  3. 3Highlands Ranch, CO, USA
  4. 4Citizens for Patient Safety, Centennial, CO, USA
  1. Correspondence to: M Clarkson mclarkson{at}

An appeal from families and patients harmed by medical errors

The term “second victim” was introduced by Albert Wu in a BMJ editorial published in March 2000.1 His purpose was to bring attention to the need to provide emotional support for doctors who are involved in a medical error.

His effort was successful. The Web of Science reports that the article has been cited nearly 400 times. PubMed identifies over 100 articles with the term “second victim” in the title or abstract. Educational materials have been produced for doctors and nurses on the topic of second victims, and the term appears in the materials of the Joint Commission and the Agency for Healthcare Research and Quality in the US. Support groups for second victims have been developed at numerous institutions.2

The term has been adopted, adapted, and extended by authors and educators. Articles make reference to the “second victim phenomenon” and “second victim syndrome.”3 Healthcare organisations have now been termed the “third victim”45 …

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