The attitude that accidents just happen and no one is to blame has long since changed. Victims expect compensation from someone who can be held liable or responsible. Doctors who make mistakes are not excepted. The criminalisation of medical blunders, however, is becoming more common elsewhere. In Britain, 23 doctors were prosecuted from 1990 to 2003 for medical manslaughter, compared with four in the previous 20 years. This trend reflects the development of the law in response to hardening community views. It has not yet reached Hong Kong. The Hospital Authority, however, does not rule out the possibility that a Prince of Wales hospital doctor could be charged with manslaughter over a fatal medical blunder in which a cancer patient received an injection of a chemotherapy drug in the spine instead of in a vein. A British doctor was jailed in 2003 for the same fatal mistake. No prosecution of this kind has ever taken place in Hong Kong and police have said that in the current case there is, at this stage, not sufficient evidence to substantiate a criminal offence. Even so, the Hospital Authority is right to prepare for any eventuality. Whether doctors should be prosecuted for medical blunders is, understandably, a matter of intense debate in the medical community. An inquiry into the Prince of Wales case found gaps in training and flaws in the system as well as human error. The US Institute of Medicine and a British health department expert group have taken similar positions on medical mistakes. The first said 'the problem is not bad people - the system needs to be made safer'. The second said the causes of most serious failures 'stretch far beyond the actions of [those] immediately involved'. There may be circumstances in which a doctor's actions are so negligent that manslaughter charges are appropriate. But the nature of the job is such that mistakes will occur, sometimes with tragic results. Any decision to prosecute must be weighed carefully. The priority should be to find out what went wrong and act to prevent future tragedies. It is hoped the system of accountability being explored by the Hospital Authority will achieve this aim.