Ethical issues in patient safety.

Making progress in patient safety poses many challenges, practical and theoretical, to the way physicians practice medicine. The ethical challenges are among the most profound. They include the ethical imperative to do all things practical to prevent errors and injury to patients, the need to respond appropriately when things go wrong to find new methods to prevent recurrence, the requirement for honesty and openness in dealing with our patients when things go wrong, and taking responsibility for ensuring that all of our colleagues are safe and competent. This is an immense challenge. It is not easy to "first, do no harm." But only we as a profession can meet this challenge. No one else can do it; we must.