{"id":36750,"date":"2016-05-27T12:40:27","date_gmt":"2016-05-27T11:40:27","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=36750"},"modified":"2016-05-27T12:40:27","modified_gmt":"2016-05-27T11:40:27","slug":"jeffrey-aronson-when-i-use-a-word-errors","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2016\/05\/27\/jeffrey-aronson-when-i-use-a-word-errors\/","title":{"rendered":"Jeffrey Aronson: When I use a word . . . Errors"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-32935\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson-223x300.jpg\" alt=\"jeffrey_aronson\" width=\"102\" height=\"137\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson-223x300.jpg 223w, https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson.jpg 446w\" sizes=\"auto, (max-width: 102px) 100vw, 102px\" \/><\/a>The village of Erice sits above the town of Trapani on top of a mountain about 750 metres above sea level in the north-west corner of Sicily (picture below). Its original name was \u1f18\u03c1\u03c5\u03be, after the Sicilian king of that name, a son of Aphrodite and either Boutes, an Argonaut, or Poseidon, the god of the sea. Eryx ruled over the Elymoi in western Sicily. When Herakles visited the island, Eryx challenged him to a wrestling match, staking his land against Herakles\u2019s cattle. Herakles killed him and Eryx was buried on the mountain where he had erected a temple to his supposed mother, Aphrodite.<!--more--><\/p>\n<figure id=\"attachment_36757\" aria-describedby=\"caption-attachment-36757\" style=\"width: 428px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-36757\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2016\/05\/aronson_error_one.png\" alt=\"aronson_error_one\" width=\"428\" height=\"244\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2016\/05\/aronson_error_one.png 412w, https:\/\/blogs.bmj.com\/bmj\/files\/2016\/05\/aronson_error_one-300x171.png 300w\" sizes=\"auto, (max-width: 428px) 100vw, 428px\" \/><figcaption id=\"caption-attachment-36757\" class=\"wp-caption-text\">Erice\u2019s Castelo di Venere commemorating Aphrodite<\/figcaption><\/figure>\n<p>The village still bears his name, although the mountain is now called Monte San Giuliano. The Greeks then claimed the land\u2014which had originally been established by the Phoenicians, evidence of whom can be seen in the nearby island of Mozia (\u039c\u03bf\u03c4\u03cd\u03b1)\u2014but their claim was contested by the Carthaginians, who occupied the land in the 3<sup>rd<\/sup> century. Daedalus is said to have built the wall that encloses the area at the top of the mountain, creating a fortress. Later Erice became a religious settlement, its monasteries named after such saints as Rocco, Francesco, and Domenico.<\/p>\n<figure id=\"attachment_36756\" aria-describedby=\"caption-attachment-36756\" style=\"width: 253px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-36756\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2016\/05\/aronson_error2-300x188.png\" alt=\"aronson_error2\" width=\"253\" height=\"159\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2016\/05\/aronson_error2-300x188.png 300w, https:\/\/blogs.bmj.com\/bmj\/files\/2016\/05\/aronson_error2.png 421w\" sizes=\"auto, (max-width: 253px) 100vw, 253px\" \/><figcaption id=\"caption-attachment-36756\" class=\"wp-caption-text\">The Via Gian Filippo Guarnotti\u2014the Ettore Majorana Foundation is on the left just before the arch<\/figcaption><\/figure>\n<p>Then in 1961 a group of physicists, led by Antonino Zichichi, established the <a href=\"http:\/\/www.ccsem.infn.it\/\">Ettore Majorana Foundation and Centre for Scientific Culture<\/a>\u00a0in Erice, naming it after the brilliant Italian physicist <a href=\"http:\/\/iopscience.iop.org\/article\/10.1088\/1742-6596\/173\/1\/012019\/pdf\">Ettore Majorana<\/a>, who was born in Sicily in 1906 and disappeared mysteriously in 1938. The foundation hosts conferences in 126 physical and biological sciences; my Veronese colleague Giampaolo Velo leads the pharmacology school.<\/p>\n<p>This year we organised a three day Erice conference on medication errors, following <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19594525\">the conference<\/a> that we held there in 2008. In 18 lectures given by 16 faculty members, our 30 students learned about topics ranging from definition, classification, contributory factors, detection, and prevention, to regulatory and legal aspects, pharmacovigilance activities, and the roles of computers, barcodes, and control theory.<\/p>\n<p>When <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19094162\">a systematic review<\/a> in 2008 showed that 4\u201382% of prescriptions written by junior doctors contained medication errors, this wide range was attributed in part to variations in the definitions used in different studies. A uniform definition was needed, and now <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10768430\">the definition that Robin Ferner and I proposed<\/a> in 2000 <a href=\"http:\/\/www.ema.europa.eu\/ema\/index.jsp?curl=pages\/special_topics\/general\/general_content_000570.jsp\">has been adopted by the European Medicines Agency<\/a>, with a single word added.<\/p>\n<p>Previous definitions had suffered from various defects, including circularity (for example, <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/7790981\">defining<\/a> a medication error as \u201cany error occurring in the medication process\u201d) and reference to factors that are irrelevant to the identification of medication errors, such as preventability, the individuals responsible, and standards of care or recommended practices or policies. The folly of referring to these as touchstones is underlined by Ambrose Bierce\u2019s definition, in <em>The Devil\u2019s Dictionary<\/em>, of an error as \u201can action that is contrary to my beliefs and actions.\u201d<\/p>\n<p>The Indo-European root ERS meant to be in motion, giving the Latin word errare to wander and hence to err. A metathetical version, R\u0112S, gave the English word race via Scandinavian derivatives, and a zero grade version, RS, gave the Indian word rishi, a holy poet or wandering minstrel, describing the sages who were thought to have composed the Vedas. These roots are also related to WERS, which meant to confuse or mix up, giving wurst, which is meat mixed up, and the adopted name of a Eurovision winner whose sex seems clear but whose gender is confusing, a crucial distinction that is often misunderstood.<\/p>\n<p>\u201cError\u201d is defined in the <em>Oxford English Dictionary<\/em> as \u201csomething incorrectly done through ignorance or inadvertence; a mistake, e.g. in calculation, judgement, speech, writing, action, etc\u201d. However, the acknowledged expert in the field of errors and the psychological factors that underlie them, <a href=\"http:\/\/www.goodreads.com\/review\/show\/825585536?book_show_action=true&amp;from_review_page=1\">James Reason<\/a>, has a different definition: \u201cThe failure of planned actions to achieve their desired ends without the intervention of some unforeseeable event.\u201d Reason\u2019s position derives from the observation that errors occur when plans are either wrong or are carried out incorrectly, despite being correct, that \u201csomething incorrectly done\u201d implies a failure, and that errors do not always result in harm.<\/p>\n<p>These definitions of error, largely ignored in previous definitions, laid the foundations for our definition of a medication error, which I shall discuss next week.<\/p>\n<p><em><strong>Jeffrey Aronson<\/strong> is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford&#8217;s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/p>\n<p><strong>Competing interests:<\/strong>\u00a0None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The village of Erice sits above the town of Trapani on top of a mountain about 750 metres above sea level in the north-west corner of Sicily (picture below). Its [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/05\/27\/jeffrey-aronson-when-i-use-a-word-errors\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5762],"tags":[],"class_list":["post-36750","post","type-post","status-publish","format-standard","hentry","category-jeff-aronsons-words"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jeffrey Aronson: When I use a word . . . 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