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Patient safety and the question of dignitary harms

Research output: Contribution to journalArticlepeer-review

Polly Mitchell, Alan Cribb, Vikki A. Entwistle

Original languageEnglish
Pages (from-to)33-49
Number of pages17
JournalJournal of Medicine and Philosophy
Issue number1
Accepted/In press12 Aug 2020
Published17 Feb 2023

Bibliographical note

Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the Journal of Medicine and Philosophy Inc.

King's Authors


Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior towards patients can cause harm, even when it does not lead to physical injury. This paper investigates the nature of such dignitary harms and explores whether they should be included within the scope of patient safety as a field of practice. We argue that dignitary harms in health care are-at least sometimes-preventable, iatrogenic harms. While we caution against including dignitary harms within the scope of patient safety just because they are relevantly similar to other iatrogenic harms, we suggest that thinking about dignitary harms can help to elucidate the value of patient safety, and to illuminate the evolving relationship between safety and quality.

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