For a fascinating alternative view (from the Netherlands) readers may enjoy the following article:
Certain uncertainties: Modes of patient safety in healthcare, Jerak-Zuiderent, S., Social Studies of Science, 2012, 42: 732

The author coins the very intriguing phrase "Certain unsafety and uncertain safety". The concept of "certain unsafety" refers to the challenges (that can lead to unintentional patient harm) created by over-reliance on rules, regulations and policies when working in complex adaptive systems. The concept of "uncertain safety" refers to the idea that adapting to the uncertainty inherent in a CAS like healthcare can actually create safety. This is indeed what happens on an hourly basis throughout Canadian healthcare when front-line direct care providers adapt to a variety of limits in their under-specified working environments (for instance insufficient time, resources, controls - feedback mechanisms - and pre-conditions) and find ways to provide safe quality care to patients in spite of what the rules and regulations direct them to do.