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August 9, 1995

Error in Medicine

JAMA. 1995;274(6):458. doi:10.1001/jama.1995.03530060031019

To the Editor.  —Dr Leape1 is to be congratulated for a highly needed and provocative analysis of error in medicine. Unfortunately, his article and the accompanying Editorial2 largely ignore the patient's perspective. Unlike the manufacturing industry, where the product is an inanimate object, the product in medicine is quality health care. As autonomous individuals, patients are active participants in the process, not passive recipients. Based on my experience in completing in-flight consumer satisfaction surveys, I am convinced that consumer feedback is used extensively in the aviation industry. As the participant in and consumer of the health care product, patients have a priceless and unique perspective both on error prevention and on error resolution. Unfortunately, there is only sparse research and philosophical inquiry into patients' attitudes, values, and beliefs about the management of medical errors and mistakes.Leape states, "[Tjotal quality management calls for grassroots participation to identify and

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