Hi doc,
You have asked an awful lot in a couple of sentences.
Let me also state that you should assume this post to be ‘gender neutral.’
Let me start with an old ‘saw.’ “ A surgeon buries his mistakes but a pilot arrives with his.
There is a complication facing both medicine and aviation and that is the litigious nature of the US society -- I say that from the perspective of a Canadian married to an American -- which is creeping across the border. But, that should be another thread.
There was a time, not too long ago, when every crash was ‘pilot error’ -- aircraft crashed -- pilot was in ‘command’ -- ergo ‘pilot error.’
Gradually crash investigators started to look at outside influences. Was the weather as forecast? Was there an aircraft warning that the pilot could have, should have seen? Was there a mistake made by someone in the Air Traffic Control organization? Were all maintenance procedures done correctly? Were there ‘systemic’ factors that contributed to the crash?
Should training be changed? Should an aircraft be modified?
Remember crash investigators and lawyers all have 20/20 (or is it 6/6) vision and all the time in the world. It stikes me that inquests - assuming that the case comes to that -- are more about lawyers protecting their client’s interests than really fixing the ‘system.’
Very few aviation accidents have a single cause; there is a lot of redundancy built into most systems / aircraft.
The Standard Operating Procedure for most airline malfunctions at altitude is to get the book out and work your way thorough the problem.
How many deaths had occurred before the fittings on various gas hoses in hospitals were changed so that the wrong gas could not be connected to the patient. Surgery was correctly done but patient dies from post surgical infection from the general hospital environment. Is that the surgeon’s ‘fault?’
The day is probably not too far off when surgeons will do many, certainly complicated, cases to a simulator that has been fed the data that relates directly the patient; CAT scan, blood pressure, ultra sound, etc.
“One of my suspicions is that while errors both in medicine and aviation may lead to disastrous outcomes, the time and ability to 'correct' may be greater in medicine.”
Answer: Not necessarily.
If a pilot is not happy with a landing approach, he can always ‘go-around’ and have another go at it -- although there is a lot of pressure not to -- while I would imagine that a heart surgeon who has an aorta - suddenly and unexpectedly -- rupture does not have time to open the text book - read, aircraft operating manual. Seems to me that ‘STAT’ is a word that I have heard more than once in a hospital setting.
Previous posts have rightly indicated the safety is a culture; how you change the medical culture is a daunting task.
Good luck.
David