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Old 4th Mar 2017, 08:24
  #799 (permalink)  
safetypee
 
Join Date: Dec 2002
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Pure Pursuit, you make an interesting point at #797.
Just Culture involves the reporting of events or activity which could identify safety improvement, and assumes that the individual(s) involved knew of the contributing factors, and thus consciously understood what occurred at the time.
In this incident the 'cause' appears to have been deduced with hindsight, and thus an individual's contribution has been constructed - most probable cause.
From an individual viewpoint there was no 'error' to report, only the event, best described and investigated in technical terms, thus does not involve the process of Just Culture. Even so the close association with Just Culture will be very damaging.

The admission of 'error' was after the choice of legal activity.
In civilian terms this would be a separate process involving the law of the land, but in military terms, the investigation, choice of action, and legal process are all under the same umbrella. This is what 'we' sign-up for in the Military, but in return there is an exchange of trust involving fairness and proportionality.
This incident has challenged that trust, the loss of which may be far more damaging than apparently not promoting a Just Culture.
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