1 Montreal, Canada 2 London, UK
EditorAs a young resident, a long time ago, I attended a conference by Professor Alon P. Winnie who explained that inadvertence referred to negligence and was, consequently, a term that should not be used to describe an adverse event that occurs accidentally, especially in anaesthesia. According to Websters dictionary, inadvertence refers to the fact of not turning the mind to a matter, to being inattentive. To be honest, the dictionary also mentions, as the second definition of inadvertent: unintentional. However, this is not the main definition of inadvertence.
Since those days, I have often seen the word used inappropriately in a number of articles. This is not the first time I have seen it used in the title of an article. A cursory PubMed search revealed 768 similar occurrences, including five in our own journal! The use of inadvertent, especially in this case, to qualify repeated endobronchial intubation is most inappropriate as the authors were aware of the adverse event and made all efforts to correct the situation.1
Given the negative connotation of inadvertence, especially in anaesthesia where a lack of attention can be disastrous for our patients, I urge all authors and colleagues to use other, more appropriate, adjectives such as unintentional, accidental, unintended, etc. Unless, of course, the adverse event was truly the result of inattention. Only in the latter case should it be labelled inadvertent.
J.-F. Hardy
Montreal, Canada
EditorWe would like to thank Dr Hardy for his letter and are grateful to him for pointing out our inadvertent use of the word inadvertent. This surely was a case of inattention to the correct use of the English language! For the sake of minutiae, the title of our original submission did not include this word, but was suggested by the editorial board of this journal. We do, however, admit that it was still the first word of our abstract!1
Interestingly, a casual internet search highlighted several non-medical (mis)uses of this word, including in a definition of Collateral damage as inadvertent casualties and destruction inflicted on civilians in the course of military operations.2 One would hope that this kind of tragedy would not be caused by simple inattention. We should all take care to say exactly what we mean.
M. Mackenzie
K. MacLeod
London, UK
References
1 Mackenzie M, MacLeod K. Repeated inadvertent endobronchial intubation during laparoscopy. Br J Anaesth 2003; 91: 2978