{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:44:43Z","timestamp":1777448683455,"version":"3.51.4"},"reference-count":6,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    This manuscript uses two personal surgical cases to explore\n                    <jats:italic toggle=\"yes\">hansei<\/jats:italic>\n                    , 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\n                    <jats:italic toggle=\"yes\">hansei\u2019s<\/jats:italic>\n                    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,\n                    <jats:italic toggle=\"yes\">hansei<\/jats:italic>\n                    is presented not as self-punishment but as a technical and ethical tool to refine judgment, maintain integrity, and improve patient care.\n                  <\/jats:p>","DOI":"10.1177\/00031348251385108","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T14:53:21Z","timestamp":1760021601000},"page":"1349-1351","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hansei (\u53cd\u7701): The Surgeon\u2019s Quiet Reckoning"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0943-6367","authenticated-orcid":false,"given":"Javier","family":"Arredondo Montero","sequence":"first","affiliation":[{"name":"Complejo Asistencial Universitario de Le\u00f3n"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198401123100211"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7237.726"},{"key":"e_1_3_7_4_2","volume-title":"Do No Harm: Stories of Life, Death and Brain Surgery","author":"Marsh H","year":"2014","unstructured":"Marsh H. Do No Harm: Stories of Life, Death and Brain Surgery. Hachette; 2014."},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.331.7528.1343"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/10901020590919040"},{"key":"e_1_3_7_7_2","volume-title":"The Reflective Practitioner: How Professionals Think in Action","author":"Sch\u00f6n DA","year":"1992","unstructured":"Sch\u00f6n DA. The Reflective Practitioner: How Professionals Think in Action. Routledge; 1992."}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251385108","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251385108","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251385108","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:37Z","timestamp":1777379917000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251385108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/00031348251385108"],"URL":"https:\/\/doi.org\/10.1177\/00031348251385108","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]}}}