Intent vs. Impact

So in looking at someone's behavior, which is more important, the intent behind the behavior or the impact?

We recently had a wonderful day-long training course at work, on a concept called "Just Culture". Arising out of the healthcare world, it posits that the greatest barrier to reducing medical errors is our culture of punishing healthcare providers for their mistakes. If someone makes an honest mistake, then the most appropriate response is to console them about what happened and then look at the system to see if it can be improved to prevent such things happening again. Only if someone chooses reckless behaviors is punishment a reasonable response.

For example, I recently entered two weeks worth of my time and attendance data against the wrong weeks. I'm a fairly careful person and I was surprised that I'd made such a mistake. Should I be punished for not carefully checking the dates? Should I be coached on making sure I check the dates in future? Should the system have warning messages if you enter data for a future timeperiod? The approach that would prevent the most errors in the future is the third one. And nobody yelled at me for the wrong data.

Thus if people with good intentions make serious errors, then we re-design the system to try and prevent those errors. That's what healthcare is trying to do.

But over time, we've begun to judge based on the impact. If the impact is severe, if someone dies even as the result of a truly unintentional mistake, we are outraged and still look for punishment. We look to imprison the parent whose child dies in a hot car, when the most appropriate response is one of empathy for the anguish of that parent. And we certainly look to sue the physician whose error causes a bad patient outcome.

A trusted colleague and coach told me recently that our parents don't intend to cause us pain. When I spoke of their responsibility to tend to their own pain so that they don't pass it down to the next generation, he spoke of impact rather than intent. Because he's right - remaining angry at our parents for their role in our imperfect childhood is futile.

I accept that they didn't intend to cause us harm. But did they fail to address their own issues to the extent that it could be called reckless behavior?

I suppose the difference is competence. If we make every effort to achieve competence, to be a good physician or parent, and have every intention to do the best for our patients or children, then we have done all we can. But if we do not, if we are negligent in our professional or parental duties, then the anger of our patients and future generations can come upon us.

The question of intent versus impact is one I haven't resolved to my own satisfaction. My own intent is to look after myself so that others don't have to. My intent is to be responsible for my own life. My intent is to minize the negative impact of my troubles on my son. But only he will be able to assess the ultimate balance of that intent versus that impact.