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Blame and its consequences for healthcare professionals: response to Tigard
  1. Elizabeth A Duthie1,
  2. Ian C Fischer2,
  3. Richard M Frankel3
  1. 1 Patient Safety Resource Center, Montefiore Health System, Bronx, New York, USA
  2. 2 Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
  3. 3 Indiana University School of Medicine, Indianapolis, Indiana, USA
  1. Correspondence to Dr Elizabeth A Duthie, Patient Safety Resource Center, Montefiore Health System NPG, 6 Executive Plaza, Suite 112A, Yonkers, New York, 10701, USA; eduthie{at}


Tigard (2019) suggests that the medical community would benefit from continuing to promote notions of individual responsibility and blame in healthcare settings. In particular, he contends that blame will promote systematic improvement, both on the individual and institutional levels, by increasing the likelihood that the blameworthy party will ‘own up’ to his or her mistake and apologise. While we agree that communicating regret and offering a genuine apology are critical steps to take when addressing patient harm, the idea that medical professionals should continue to ‘take the blame’ for medical errors flies in the face of existing science and threatens to do more harm than good. We contrast Dr Tigard’s approach with the current literature on blame to promote an alternative strategy that may help to create lasting change in the face of unfortunate error.

  • applied and professional ethics
  • education for healthcare professionals
  • medical error

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  • Contributors EAD and RMF developed the idea for the manuscript, and EAD drafted the initial outline of the manuscript. RMF and ICF edited and expanded the manuscript. All authors contributed to the manuscript revisions and have approved the final manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.