I see this recent obsession with human error in safety as strange. All this noise about human error as NOT a cause, human error demonised as evil and human error as somehow disconnected from personhood. How strange because there is no discussion of human fallibility, mortality or finiteness in such discourse. Then when we step into the challenges of risk, there is this naïve idea that all risk can be prevented or managed. None of this makes sense. Unless we come to the challenges of risk through an ethic of personhood, whatever follows will produce much of this confused nonsense.

The foundation for understanding risk is the fallible person. You can’t move in this world without embracing risk. Risk is essential for living and learning because we live as fallible beings in a fallible world. It’s about time Risk and Safety came to grips with the realities of fallibility (https://www.humandymensions.com/product/fallibility-risk-living-uncertainty/).

Fallibility is not a bad thing, it is what makes us human, not gods and superheroes.

Error is foundational to fallibility. Human life is ecological, limited and finite, just as death is certain. So, whatever one tries to develop in systems to tackle risk, wishing away human fallibility and the error that comes with it, is foolish. Of course, human error is a cause, don’t put your head in the sand.

The real problem is not human error but rather what we do about it.

What do we do about fallibility and error? What is the nature of resilience we use to tackle the events of life thrown at us? (https://safetyrisk.net/thrownness-and-risk-challenging-beliefs/; How does our methodology and worldview help us make sense of fallibility, error and resilience? (https://www.humandymensions.com/product/everyday-social-resilience-being-in-risk/).

We would do well to think about Weick’s six properties of ‘thrownness’ (https://safetyrisk.net/weicks-six-properties-of-thrownness/) when it comes to addressing an ethic of risk and personhood.

In Prof. Karl E.Weick’s second book Sensemaking in Organisations he introduces the reader to ‘thrownness’ (p.44) which comes from Heidegger (dasein). Weick was such an extensive researcher and drew many of his ideas and thoughts from social psychology, phenomenology, existentialism and eastern wisdom.

His discussion of thrownness is here:

The idea of being thrown into the unexpected is what life is about. There is no drift into failure, we are always in fallibility, vulnerability and mortality. If error surfaces, then it’s just a fact of fallible life, it’s is how events emerge. The idea of ‘drift into failure’ opens up all avenues for blame and being ‘lost’, ‘aimless’, lacking purpose and control. That is not how we live. That is not how we organise.

The same applies to the many models in safety such as Reason’s swiss-cheese that have no connection to the reality of life that is messy, unpredictable and chaotic. Such is the nature of fallibility and error in the real world.

It is because we are fallible that we make errors. It is because we are fallible we must risk in order to learn. Life and being is not mechanical or linear. This is why most of what we do is more like a ‘leap of faith’ than a step into the know. We are always wise in hindsight but life is lived forwards not backwards (Kierkegaard). And with risk comes the unknown and sometimes suffering and harm. The real question is not the silly questions associated with zero but rather: how will we build resilience when we are vested by suffering and harm?

Whilst we don’t wish harm on anyone, neither do we dream up a world where risk and harm don’t exist. The ideology of zero is destructive and only leads to brutalism (https://www.humandymensions.com/product/zero-the-great-safety-delusion/). Coming to any human person with any assumption of zero, can only demonise them by expectation. When you expect error and fallibility, the way you approach persons, life and being changes.

This is a positive thing but you need new methods in how you tackle risk to approach human persons in this way.

This is what we do in SPoR. We have positive and practical methods that better address the nature of fallibility and personhood, error, risk and everyday social resilience. If you want to know how this works, you can start by reading here: https://www.humandymensions.com/product/it-works-a-new-approach-to-risk-and-safety-book-for-free-download/