Ever since its emergence as a unitary and respected profession in the second half of the 19th century, the medical profession has endured criticism. This has ranged from sceptical blasts against a ‘conspiracy against the laity'1 to more moderate misgivings about monopolisation2 and the inadequacies of self-regulation.3 Although it is now almost 30 years since Ivan Illich's warnings about medical harm,4 a series of recent disasters have acted as powerful and graphic reminders. The sad and shocking stories of high mortality rates following paediatric heart surgery,5 the retention of human tissue without consent6 and the mass murders perpetrated by Harold Shipman7 have amply demonstrated different guises of possible medical harm. This article focuses on unintentional harm and medical error. Public knowledge about medical error has increased...