{"title":"Hansei (): The Surgeon's Quiet Reckoning.","authors":"Javier Arredondo Montero","doi":"10.1177/00031348251385108","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251385108"},"PeriodicalIF":0.9000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Surgeon","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00031348251385108","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
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Abstract
This manuscript uses two personal surgical cases to explore hansei, 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 hansei's 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, hansei is presented not as self-punishment but as a technical and ethical tool to refine judgment, maintain integrity, and improve patient care.
期刊介绍：
The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.
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