A widely quoted saying within the medical profession (and often attributed to Hippocrates) is the aphorism: first, do no harm. In recent years, this ethical admonition has become increasingly relevant given the well-documented instances of physician-induced (or iatrogenic) injury, especially in a hospital setting. As the Institute of Medicine reported in a study published six years ago, between 44,000 and 98,000 Americans die each year as a result of medical errors that occur in hospitals. Even assuming that the lower figure is accurate, the results still mean that more people die in a given year from medical errors than from motor vehicle accidents, breast cancer, or AIDS. More recently, the United States federal government has estimated the figure to be at the higher end of that estimate--around 100,000.

The fact that these deaths occur in a hospital setting is, from a historical point of view, ironic. Many hospitals were founded in the medieval period and were seen as largely charitable institutions designed to care for the poor. Only in the second half of the 19th century were hospitals transformed into their modern form. As the sociologist Paul Starr observed in his Pulitzer prize winning book The Social Transformation of American Medicine,

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