There has been significant interest internationally in involving patients in efforts to improve patient safety. In this issue of the journal, Melinda Lyons uses the principles of safety engineering and insights from human reliability analyses to argue that relying on patients to check on the delivery of their health care would be ineffective as a general strategy for promoting patient safety (see page 140).¹ Lyons also notes that such reliance would burden patients with responsibilities that many would be unable to fulfil.

The claim that relying on patients to check on the care they receive from health professionals is neither an effective nor an appropriate strategy for promoting patient safety has several implications. One obvious inference is that those seeking to improve patient safety should be investing in other strategies. However, the claim need not lead us to conclude that all attempts to support patient involvement in efforts to promote patient safety are misguided. There are important differences between relying on patients to check on the delivery of their health care to ensure their safety and involving patients in their care while efforts are made to improve their safety. Some forms of patient involvement might be justified for reasons other than their potential to improve patient safety. They need not burden patients beyond their ability. Lyons’ …