book
Human Error
Reason, James. Human Error. Cambridge: Cambridge University Press, 1990.
Related concepts3 concepts
Concept
Accountability
Accountability names whether consequence still reaches the people who can respond. It becomes important when scale, narrative, or abstraction thins contact between action and effect. It helps preserve correction and proportionate answerability, but can fail when moral sorting replaces sustained contact with outcomes. It differs from responsibility because accountability emphasizes exposure to consequence; responsibility includes the ongoing obligation to account even when control is partial.
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Concept
Feedback
Feedback names how systems stay in contact with their own effects. It becomes important whenever action and consequence are separated by time, scale, or abstraction. It helps preserve learning, correction, and trust in ongoing coordination, but can fail when dashboards stay green while lived harm accumulates off the ledger. It differs from trust because feedback is the returning signal itself; trust is the bridge that lets people act before every signal arrives. It differs from correction because feedback is what returns; correction is the work of updating in response.
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Concept
Harm
Harm names where cost lands when influence is exercised—who absorbs it, who is kept in view, and what displacement is treated as acceptable. It marks the lived consequence of action, authority, design, or coordination. The visibility dimension matters—who is harmed in particular, not on average? Can they name it? Can they respond? Does the system register it or treat it as acceptable loss? Harm continues while interpretation expands, briefings make harm legible without smaller, people can still tell when something is doing harm. The question harm raises—is harm unchanged outside while we analyze inside? When does naming harm substitute for reducing it? The failure mode—harm persists while moral work feels complete, delays continue after excellent postmortems, harm becomes statistical at scale. The restoration path—return to particular harms and people, check effects outside the room after briefings, stop when outcomes for people are unchanged, pair analysis with named remedy attempts, accept harm as inevitable without abandoning response.
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Related books2 books

Book
Trust Beyond Similarity
How Trust Remains Possible Across Difference
How people learn to trust perspectives they do not share—and why trust becomes more valuable when perspectives differ.
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Book
When Others Look to You: Companion Edition
Forming, Renewing, Eroding, Repeating
How leadership influence forms, renews, erodes, and repeats across the full cycle of responsibility in practice.
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