The issues raised by Wendy Rogers and Angela Ballantyne in their paper on this
topic in IJFAB {1(1): 48-66} are reflected in what is going on in Newfoundland
at the moment in the inquiry into Breast Cancer
http://www.cihrt.nl.ca/default.htm

The revelations at the inquiry suggest that nobody ever read the New Zealand
inquiry, just as the Sinclair Inquiry in Winnipeg mirrors the earlier Bristol
Inquiry.

I had drawn the Commission's attention to the New Zealand reports and have
suggested the IJFAB paper be used as an analytic tool.

The issue in relation to professional obligations to monitor abuse reflects a
shift in the profession's code of ethics from the traditional position of not
impugning the reputation of colleagues to one of pro-actively reporting
concerns.

I do however have some concerns as to how this is working. An investigation by
the Organizational Ethics Committee at this institution
http://myweb.dal.ca/mgoodyea/files/organizationalethicsconsultationreport.doc

suggested, as have similar inquiries, that this responsibility all too easily
creates an organizational atmosphere of mistrust, and is open to abuse. Trust
is of course also a foundational value in organizational function, and striking
a balance between formative appraisal and a punitive atmosphere is not always
easy.

The core value in the emerging patient safety movement is the creation of safe
spaces for discourse on issues of concern and a no-fault approach to remedy.
The analysis of safety across many industries suggests that an internalised
commitment to monitoring and change is more likely to create improvement in the
long run than one over-reliant on rules and regulations.
-- 
Michael Goodyear, Department of Medicine, Dalhousie University, Canada
Email: [log in to unmask]
Website: http://myweb.dal.ca/mgoodyea/goodyear.html
Resource directory: http://myweb.dal.ca/mgoodyea/Documents/

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