Tuesday, 27 December 2011

Accidents will happen

In nearly all accidents we need to distinguish two different levels of causation. The first is the immediate technical or mechanical reason for the accident; the second is the underlying human reason. It is quite true that design is not a very precise business, that unexpected things happen, that genuine mistakes are made, and so forth; but much more often the 'real' reason for an accident is preventable human error.

It is rather fashionable at present to assume that error is one of those things for which it is not really fair to blame people, who, after all, were 'doing their best', or are victims of their upbringing and environment, or the social system - and so on, and so on. But error shades off into what it is now very unpopular to call 'sin'. In the course of a long professional life spent, or misspent, in the study of the strength of materials and structures, I have had cause to examine a lot of accidents, many of them fatal. I have been forced to the conclusion that very few accidents just 'happen' in a morally neutral way. Nine out of ten accidents are caused, not by more or less abstruse technical effects, but by old-fashioned sin - often verging on plain wickedness.

Of course I do not mean the more gilded and juicy sins like deliberate murder, large-scale fraud or Sex. It is squalid sins like carelessness, idleness, won't-learn-and-don't-need-to-ask, you-can't-tell-me-anything-about-my-job, pride, jealousy, and greed that kill people.

[...]

Generally [accidents] are caused by lack of proper care and professional competence. I very much doubt if the remedy lies in the imposition of yet more regulations. It seems to me that what is wanted is the creation of more public awareness and a climate of opinion which regards such 'mistakes' as morally culpable. The man who drilled a hole in the wrong place in the wing-spar of a wooden aeroplane, plugged the hole, and said nothing, was acquitted. Presumably the jury thought that the moral blame was negligible.

What is wanted is much more publicity; the difficulty lies in the law of libel. In most cases, if the real causes of an accident are made public, somebody's face will be very red, and it is likely that their business or professional reputation will suffer. Most practicising engineers are accutely aware of this and have to keep quiet or risk heavy damages. In my opinion, there should be some way round this, for it is in the public interest that accidents and blunders should be publicised.

Professor J.E. Gordon, Structures, or Why things don't fall down

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