Hansei (反省): The Surgeon’s Quiet Reckoning

This manuscript uses two personal surgical cases to explore <i>hansei</i>, the Japanese discipline of structured self-reflection, as a framework for technical and professional growth. The first case illustrates the limits of technical perfection and the inevitability of some complications. The second reveals the cost of acting on overcaution. Together, they trace the difficult boundary between error, prudence, and inherent surgical risk. The discussion contrasts <i>hansei's</i> explicit, disciplined acknowledgment of shortcomings with the Western tendency to obscure responsibility through passive language and fear of reputational harm. The manuscript argues that adopting hansei in surgical culture can transform regret into actionable improvement, enhance morbidity and mortality reviews, and strengthen training by normalizing open discussion of fallibility. Ultimately, <i>hansei</i> is presented not as self-punishment but as a technical and ethical tool to refine judgment, maintain integrity, and improve patient care.

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Publication Details

Journal
The American Surgeon
Published
2025-10-09
DOI
https://doi.org/10.1177/00031348251385108
Primary Topic
Ethics in medical practice
Type
article
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article

Hansei (反省): The Surgeon’s Quiet Reckoning

Javier Arredondo Montero
The American Surgeon
Ethics in medical practice
article

Hansei (反省): The Surgeon’s Quiet Reckoning

Javier Arredondo Montero
article en

Abstract

This manuscript uses two personal surgical cases to explore <i>hansei</i>, the Japanese discipline of structured self-reflection, as a framework for technical and professional growth. The first case illustrates the limits of technical perfection and the inevitability of some complications. The second reveals the cost of acting on overcaution. Together, they trace the difficult boundary between error, prudence, and inherent surgical risk. The discussion contrasts <i>hansei's</i> explicit, disciplined acknowledgment of shortcomings with the Western tendency to obscure responsibility through passive language and fear of reputational harm. The manuscript argues that adopting hansei in surgical culture can transform regret into actionable improvement, enhance morbidity and mortality reviews, and strengthen training by normalizing open discussion of fallibility. Ultimately, <i>hansei</i> is presented not as self-punishment but as a technical and ethical tool to refine judgment, maintain integrity, and improve patient care.

The American SurgeonVol. 92(4)
Complejo Asistencial Universitario de Palencia (ES)
Openalex Percentile: Top 55%
Ethics in medical practice
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