Seeing patient safety 'Like a State'

This paper examines how the syndrome of authoritarian high modernism, described in detail in the public policy sphere in James C Scott's Seeing Like a State, serves as the dominant, orthodox ideology informing patient safety. We compare Scott's conceptual framework to the currently dominant health care safety practices to surface foundational issues that would otherwise remain hidden, but which need to be revealed to make progress in safety. Although the paper focuses on safety in healthcare as a particular, specific exemplar, the elements of the syndrome are relevant to orthodox safety efforts in many hazardous activities.