From a culture of blame to a culture of safety--the role of institutional ethics committees.

Institutional ethics committees are largely absent from the literature on patient safety, but if health service organizations are adequately to address medical error and patient safety, they must change internally from a "culture of blame" to a "culture of safety." This paper (1) looks at the concept of organizational culture as it currently exists and its components (jobs, people, and situations); (2) describes the safety culture in other high risk industries and (3) makes concrete suggestions to the health services industry. In particular, the author suggests that the functions and roles of ethics committees (ethics education, policy review and development, and case consultation) lend themselves perfectly to the development of those organizational characteristics that would support the creation and maintenance of patient safety culture in the healthcare industry.