Medical errors remain one of the leading causes of death, yet healthcare systems continue to struggle to reduce them. A new perspective article argues that fear of legal consequences, institutional secrecy, and poor communication prevent healthcare from learning from failure. It calls for a cultural shift toward transparency, responsibility, and psychological safety, framing learning from mistakes as essential to saving lives and restoring trust in medicine.
Medical errors remain one of the leading causes of death worldwide, rivaling heart disease and cancer. Yet while medicine has made dramatic progress in treating illness, it has made far less headway in preventing avoidable harm. A new perspective article by Prof. Mayer Brezis from the Hebrew University of Jerusalem, published in Risk Management and Healthcare Policy, examines why efforts to reduce medical errors so often fall short and what must change to protect patients.
The article argues that the greatest barriers to patient safety are not technological or scientific, but cultural. Fear of legal consequences, institutional defensiveness, and a widespread reluctance to acknowledge responsibility frequently lead healthcare organizations to deny or conceal mistakes rather than learn from them. This “deny and defend” approach, Prof. Brezis explains, prevents meaningful correction and allows the same errors to recur.
Prof. Brezis draws on decades of work in healthcare quality and safety, as well as a personal family tragedy, to illustrate how resistance to transparency can delay life-saving reforms. He highlights communication failures as a leading cause of medical errors, noting that many healthcare professionals hesitate to speak up when something seems wrong, out of fear of blame or retaliation. Evidence from healthcare systems and other high-risk fields shows that environments lacking psychological safety are far more prone to catastrophic failures.
“Mistakes become deadly when systems refuse to learn from them,” says Prof. Brezis. “Acknowledging failure and assuming responsibility are not about assigning blame. They are about preventing the next tragedy and giving meaning to the suffering that has already occurred. I learned this firsthand after the death of my grandson, whose complex heart defect was missed on a pregnancy ultrasound. Following his tragedy, universal pulse oximetry screening was implemented nationally, a step that likely saves dozens of children each year from the same fate.”
The article calls for a shift toward a culture of openness, humility, and respectful listening, in which errors are disclosed, discussed, and addressed constructively. Prof. Brezis emphasizes that leadership plays a critical role in fostering psychological safety, encouraging staff to speak up, and transforming failure into improvement rather than silence.
Ultimately, the perspective argues that reducing medical errors requires rethinking how healthcare systems respond when things go wrong. Transparency, accountability, and organizational learning are not optional ideals, Prof. Brezis concludes, but essential tools for saving lives and restoring trust in healthcare.
The primary challenge is conceptual; recognizing that failure is essential for progress. Medical errors can be reduced by understanding their valuable learning opportunities and taking responsibility to improve.