Taboada Xavier Eddie An 3/17/08 Commentary on Iatrogenesis and Medical Error
This week's discussion involved the matters of iatrogenesis and medical error. In session 2, it specifically involved the socialization of physicians with respect to medical error and failures that occur in the surgery room. Charles L. Bosk, a sociologist, makes an analysis of his observations from a medical school teaching surgery in his book Forgive and Remember. Bosk makes an analysis on what errors occur and how the errors are dealt with by the superiors who overlook the work being done in the surgical unit. The findings of his work implied that errors committed by attendees were punished in a far less manner if the mistake had been made as a result of the person's technical ability or judgment. This is in contrast with the more harsh punishments given as a result of the person being careless or inattentive to the needs. patient's As Bosk points out, the reasoning behind this is fairly obvious as the need for doctors who must be careful and attentive outweighs the need for a person who is simply "book-smart". Since Bosk wrote this in the 1970s, the work was fairly new and his methods were not completely unbiased (he followed only two surgical units who were also a part of a surgical school). A larger study involving a greater number of observations and a more robust definition of errors would result in a more valid study. Though this is not to say the study is unimportant and can be disregarded, as it does offer a view into the way the medical students were taught and disciplined with relation to errors. The chapter by Lief in The Psychological Basis of Medical Practice discussing the "Training for `Detached Concern' in Medical Students" explains in greater detail the transition