Learning Objectives:

1. Discuss the implications of the idea that medical accidents have multiple causes.

2. Explain how human error as a cause of accidents arises from hindsight bias, and how stakeholder agendas and hindsight bias combine to generate the outcome of most accident investigations.

3. Review how to delineate the usual responses to accidents in health care and how they do little to reduce the risk of future accidents, but do increase practitioner liability.

4. Describe the robust structure of the response accidents across domains, including the time line and social forces that come in play.

5. Discuss how to combine the ideas of risk homeostasis and production pressure explain why accidents wil1 continue happen.