This paper shows how discontinuities in the process of drug delivery enable but also underdetermine the isolation of a culprit in adverse medication events. A case example illustrates how we are forced to abandon conceptualizations of blame that assume a dichotomy , and shift instead to a more nuanced version that estimates the degree to which an actor desired, generated, or could have foreseen the harmful outcome, and the extent to which constraints external to the actor altered the event. The (...) paper concludes that meaningful safety interventions in a system as diverse, socially embedded and complex as health care delivery cannot just build on “good science” to generate “root” causes. Rather, they need to somehow be sensitive to how and which narratives of success and failure are created, as these constrain which countermeasures are likely to be encouraged, funded, and accepted. (shrink)

We say that celebrated accidents shape public perception of safety and risk in health care. Take the so-called celebrated story of the three Colorado nurses who, by administering bezathine penicillin intravenously, caused the death of a neonate. The nurses were charged with criminal negligence, with one pleading guilty to a reduced charge and another fighting the charge and eventually being exonerated. “Celebrated” accidents seem to follow a predictable script and cast participants in recognizable roles. They present heroes, survivors, and victims. (...) And, of course, they put villains, or anti-heroes, center stage – the chief protagonists of a fatal plot. (shrink)

This paper reconsiders the event in International Relations (IR) through the writings of Hannah Arendt. The event has for too long been neglected in IR; international events are overwhelmingly conceived as mere happenings that have meaning only within the process and temporal structure of the theory from which they are understood, and as holding no or only limited meaning in and of themselves. In her work on political theory and her reflections on totalitarianism, however, Arendt elaborates a rich view of (...) the event and its relationship to history, one that offers an alternative way of thinking about international relations. Arendt urges us to remain open to the possibility, however difficult, of conceiving of the event as meaningful outside of the processes within which our established mode of thoughts would have us subsume it. This requires on the part of the historian a commitment to judgement, to a recognition of the importance of imagination and impartiality that gives meaning to the event for others. In explicating Arendt's complex notion of the genuine political event, the paper aims not merely to demonstrate the intrinsic interest of this conception of the event to her thought, but to add to the small but growing number of works in IR that have found fruitful new avenues of thought in Arendt's various writings, and also to recent discussions on the proper relationship between history and IR theory. (shrink)