Forgiveness as morally serious response to errors in healthcare: A narrative review

Abstract

Retribution is often seen as a morally serious response to errors and undesirable behaviors, typically expressed through blame, punishment, and exclusion. These actions are meant to uphold professional standards, deter future wrongdoing, and restore moral balance. However, I argue that while retribution addresses certain ethical concerns, it is incomplete and can be counterproductive, particularly for patient safety and organizational learning. Systems that focus primarily on individual blame risk fostering underreporting, entrenching learning disabilities, and exacerbating harm. In this paper I propose that forgiveness — the foregoing of vindictive resentment toward a wrongdoer — offers a morally serious alternative. It facilitates accountability, restoration, and healing without trivializing the ethical weight of the harm done. By encouraging forward-looking accountability, forgiveness allows the wrongdoer to acknowledge their mistakes, make amends, and help improve practice. This not only respects the humanity of everyone involved, and addresses emotional and relational consequences, but also recognizes the systemic factors that contribute to errors. I outline concrete steps for integrating forgiveness into healthcare’s post-incident processes, balancing accountability with the need for healing and systemic change.