Originally posted on October 14, 2017 @ 2:43 PM
Human Error is Unpreventable
I read yesterday about a group in a government department who were hauled off to a zero harm campaign indoctrination session, complete with a forced ‘commitment statement to zero harm’ at the end. The presenter asked for audience members to come up on stage in representation of the number of people who died in a month in road fatalities. Then the presenter asked the audience how many of these people they wanted to see dead and of course, the answer is zero (same logic as the ad for Transport for NSW https://www.youtube.com/watch?v=0PgXhBuVc-k&pbjreload=10 ). Then everyone was requested to sign off a statement to zero ideology and the ‘show’ finished.
As I read about this presentation and see the ad I couldn’t help but think of all the times I attended fundamentalist religious services that use binary manipulation and coercion to obtain a ‘confession of faith’. Of course, setting up people for a binary choice is easy. Here are a few examples:
‘Do you support the war on terror? No, well you must be a terrorist’
‘Do you believe in god? No, well you must be an atheist’
‘Do you smack your children? Yes, well you must be an abusive parent’
‘Do you vote yes for the marriage equality? No, well you must be a homophobe’
This is the nature of binary simplistic discourse. It denies complexity and takes away all the grey in the debate. It polarizes and then politicizes the choice and makes it a matter of belonging and commitment. In this way if you don’t agree with zero harm you are a murderer or sadist. This is the unconscious affect of binary language and questioning. It is language of entrapment and creates illogical discourse that denies reality.
In this government presentation and, in the zero harm training materials from the zero vision Congress there is this absurd language that ‘all accidents are preventable’ and that ‘all human error is preventable’. In what world can this language make sense? How simplistic is it to look back at anything in hindsight bias (https://en.wikipedia.org/wiki/Hindsight_bias) and state that it was preventable. Brilliant, we can all be gods too after the event. I think World War 2 was preventable, the genocide of Rwanda was preventable, the killing fields of Cambodia were preventable and the sacking of Gough Whitlam was preventable. Of course, you can see how silly such language is. History is the record and chronicle of human fallibility. Wishing it to be different is like turning on the news and expecting that you won’t hear of anything going wrong in the world. Such a view and its accompanying language and symbols, is immature and absurd.
Of course human error and mistakes are unpreventable. Unless you have a crystal ball or some sense of godly omniscience then, we don’t know what happens next. This is called risk! Risk makes Sense (https://www.humandymensions.com/product/risk-makes-sense/) because learning in fallibility makes sense. Future forecasting is not in the repertoire of fallible humans. Indeed, just imagine what kind of world we would live in if it was!
Now, just because human error and mistakes are unpreventable (http://www.independent.co.uk/arts-entertainment/books/features/oops-we-did-it-again-why-we-make-mistakes-1645571.html) doesn’t mean we do nothing about it, nor does it infer some sense of resignation to fatalism. This too is binary discourse.
When it comes to risk we need to be far more sophisticated in thinking and complexity than the binary language and symbols of zero (http://theconversation.com/explainer-how-our-understanding-of-risk-is-changing-79501). We know that so many things about being fallibly human in a random world can only be tackled and in the words of Prof. Karl Weick be ‘kept small’. Unfortunately, the more the discourse of safety focuses on the minutia of zero, the less able it will be able to ‘see’ the disasters being primed to explode.
I don’t know anyone in elite sports who speaks about zero errors or ‘all mistakes are avoidable’ or ‘all accidents are preventable’ instead, they speak a language about learning from mistakes and improvement, not denial of fallibility. They speak a language not fixated on a deficit worldview but rather know to be silent when it comes to nonsense binary discourse. Still, I know why my team lost the Grand Final. Ha!
Dr Rob Long
Latest posts by Dr Rob Long (see all)
- Visual and Verbal Mapping of Risk in SPoR - October 7, 2024
- Making Nothing Happen in Safety - October 7, 2024
- Understanding the Nature of Performance and HOP - October 5, 2024
- Forecasting Safety - October 3, 2024
- If You Want to Know About Mental Health, Don’t Ask Safety - September 30, 2024
Do you have any thoughts? Please share them below