JAMA
Vol. 302 No. 8, pp. 825-914, August 26, 2009
http://jama.ama-assn.org/current.dtl

Commentaries
Setting Priorities for Patient Safety: Ethics, Accountability, and Public Engagement
Peter J. Pronovost; Ruth R. Faden

[First 150 words per JAMA convention]
Patients continue to experience preventable harms. As a result, policy makers, physicians, and members of the public have intensified their efforts to improve patient safety. The Joint Commission publishes National Patient Safety Goals, the National Quality Forum recommends safe practices, the Centers for Medicare & Medicaid Services (CMS) will not pay for certain preventable complications, and health care organizations are taking action to reduce preventable harm. Although these actions are welcome, they raise ethical questions about selecting health care areas or patient populations for improvement efforts. In this Commentary, we explore the contentious issue of deciding what warrants a priority in patient safety and offer strategies to guide further discussion, policy, and research.

When patient safety garnered the attention of policy makers with the 1999 To Err Is Human1 report, resources were scarce, harm was ubiquitous, and the…

Author Affiliations: Departments of Anesthesiology and Critical Care Medicine, and Surgery and Bloomberg School of Public Health, Department of Health Policy and Management, The Johns Hopkins University School of Medicine (Dr Pronovost) and The Johns Hopkins Berman Institute of Bioethics (Dr Faden), Baltimore, Maryland.