Patient safety and the question of dignitary harms

Polly Mitchell* (Corresponding Author), Alan Cribb, Vikki Entwistle

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
2 Downloads (Pure)


Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior
towards patients can cause harm, even when it doesn’t lead to physical injury. This paper investigates the nature of such dignitary harms and explores whether they should be included within the scope of patient safety as a field of practice. We argue that dignitary harms in healthcare are—at least sometimes—preventable, iatrogenic harms. While we caution against including dignitary harms within the scope of patient safety just because they are relevantly similar to other iatrogenic harms, we suggest that thinking about dignitary harms can help to elucidate the value of patient safety, and to illuminate the evolving relationship between safety and quality.
Original languageEnglish
Pages (from-to)33-49
JournalThe Journal of Medicine and Philosophy
Issue number1
Early online date2 Jan 2023
Publication statusPublished - Jan 2023

Bibliographical note

We are grateful to James Wilson for his insightful comments and suggestions, and to Rob Simpson for his invaluable advice at an early stage in the writing process. Many thanks to two anonymous reviewers for their thoughtful and constructive comments. This work was supported by the Wellcome Trust (209811). There is no supporting data relating to this work.


  • Patient safety
  • iatrogenic harm
  • dignitary harm
  • respect
  • healthcare quality


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