With respect to the Post Office scandal, the Horizon inquiry Lord Arbuthnot who was Jo Hamiltons MP said on talk TV in 2023, this has gone beyond being a computer problem (systems problem) this has become a human problem. In 2014 when I realised that technical hard work and growth was not cutting it I realised that my future lay in human centricity, feedback, agility through continuous improvement, unconscious habitudes and plastic brains. Thank you for supplying me with a continued flow of essential self aware posts and articles. 🙏🙏
Thank you Trevor for sharing your approach to self and quality improvement. All roads lead to human action and decisions, and it's the only thing we can control about ourselves.
I agree. Individual responsibility will always be necessary as a central part of relationships, because we live the systems in relationships and common places, not in a vacuum.
On the other hand, systems approach is used because it makes sense (particularly if it's used with prudence): if systems influence and structure the lives of millions of people, then we can look at a system and see behaviours and repeated problems that typically emerge within that system. Then, if we want different "wide" outcomes, we can try a different system to prevent having the outcomes we don't want anymore.
A good example is that criminality arises where socioeconomic inequality is high (as in countries like Haiti, or El Salvador some years ago), while criminality is low in prosperous countries. Not only in countries, but also in the cities and neighbourhoods that fill those descriptions within a same country. This suggests that socioeconomic inequality (more on the side of poverty than wealth as crime is concentrated in poor areas, but also in wealth to an extent) correlates to risk factors for criminality: high stress, family dysfunction, lack of education, mental health problems, etc.
It doesn't make criminality less horrible, but it makes the wide context understandable in order to prevent future generations of criminals: the most peaceful countries are the most prosperous AND less inequal (this difference is relevant), and I believe they have other factors in common as well: they tend to be geographically small and neutral in wars (in practice, and even officially like Switzerland), etc.
(In brief words: individual responsibility, naming the specific people for their actions, is for the present and forever, and systems approach are for future outcomes and generations... and at the same time a system that gives general wellness can increase covert aggression, for which we still need moral development and enforced individual responsibility as you said).
I agree that systems analysis has predictive value. When patterns repeat across populations, it makes sense to examine the conditions that increase the probability of certain outcomes. Poverty, instability, and chronic stress do correlate with higher rates of crime, which is observable.
I am careful though about how quickly structural explanation becomes moral explanation.
Context can increase risk but it doesn't enact behaviour. Two people can experience the same structural constraints and make very different choices. Systems shape probabilities and individuals generate actions.
I also think it’s important to distinguish between designing for material stability and designing for moral constraint. A society can be prosperous and still cultivate covert aggression, status anxiety, or scapegoating under more civilised language. Stability reduces some harms but it doesn't eliminate human incentives regarding power, competition, and protection.
So I see it less as present versus future and more as two simultaneous layers. Structural conditions influence what becomes common and responsibility determines what becomes tolerated.
If we change systems without strengthening behavioural constraint, harm mutates rather than disappears.
Good point all around; systems are ultimately made by people, but people who are often no longer part of those systems. What we usually end up with is a system utilized and lived in by other people with individual personalities and level of virtue. Even the best engineered system can be hijacked, and even the most dysfunctional system can be improved. However, I'd offer that the latter needs to be approached with an attitude not of "how does this oppress me?" rather than "how can this be tweaked better?"
You raise an interesting point about who designs systems vs who is actually using them. Designers are not always users, and that's where some fail to fulfil its purpose, and fulfils a harmful purpose instead.
The focus on stregnths has been lost in so many conversations about improvement and change. Focusing on what's already working and what can be improved through tweaks is how we do improvement work rather than reducing problems. The problem based focus is such a trap especially because people reduce complex systems to issues vs seeing it as an ecosystem with risk and protective factors.
This is interesting thinking about it in terms of systems.
A few thoughts come to mind …
1.) When it comes to work, our family we can’t always change the system. But we can change how we respond to it.
2.) The system is likely never going to change so we have to find a system we can live with.
3.) Generally speaking, the more you try to fight a system the more upset you will make yourself. So refer back to point #1.
This doesn’t mean that we should tolerate abuse, illegal behavior, sustained harassment, etc. But generally systems are what they are so the faster we can recognize them and learn to navigate them in a healthy way the more successful we are likely to be :)
Very wise perspective. Knowing where we can reasonably exert control and what we might have to change to better navigate a system can improve our state of wellbeing. People live to fight and battle and wear themselves out.
.. just realised I’d commented earlier yet one of your thoughts brought me back and spurred further thought..,
i think you have it bang on Nathalie. My perspectives are IT ( over 37 years) and multiple clients, sectors, geographies and demographics and it’s not only the system software which i have blamed its the surrounding operations and organisational structural infrastructures too. It’s the self protecting system of regulation from malpractice and maladministration and the faulty immune system around audit, security and accessibility. I’ve written about these system failures and so have PMs in ‘lessons learned’ quad zillions of times. I include applications, operations, and unintegrated siloes; analysis, design, implementation, testing, service management, programme and project management, release management, requirements, development, architects, quality assurance, change management, security, bid management and cultural ethics. This is the miscarriage of justice which is covered up by legal illusion.
But what about harm to people?
When I realised something felt badly wrong around 2014, my technical quests for fulfilment and change through techcentric bias were simply not working, I reverted to my younger persona once again perhaps favouring art over science, refocusing on feedback and assertiveness. I realised this was an important part of my identity to reignite. It was the start of a journey to a full awakening in June 2022 about bullying, gaslighting, devastating illness and betrayal. So yes I think with the DEIB, culture warrens, cul de sacs journeyed, the grievances and appeals journeyed the 9 stages of healing from trauma largely travelled, its feelings, emotions and people that lead with the nervous system, the prefrontal cortex crucially the key variable. True discernment to select great leaders can only be sought and found through connection to the body, feelings, emotions, homeostasis and great leaders will work with their real identity on show with a healthy central nervous system too. 🙏
I think this is going to be another crucial article for me to chew over a great deal. Thankyou 🙏
Trevor, I appreciate the depth of your reflection and the breadth of experience you’re drawing from.
Your point about regulatory immune systems is interesting. In many institutions, audit, compliance, and governance mechanisms are designed to prevent visible malpractice, yet they can also become self-protective layers that insulate the organisation from scrutiny. Harm becomes procedural rather than accidental when protection of the structure overrides protection of people.
You ask what about harm to people, which is my concern too. Systems might be technical or regulatory, but injury is enacted relationally through repeated behaviour that's tolerated, coordinated and covertly legitimised.
Where I would place the emphasis is less on nervous system states and more on restraint, accountability, and incentive design. Emotional regulation matters, but without consequences and role clarity, even well-regulated individuals will adapt to what is rewarded.
Excellent thank you so much, this is all very exciting forward thinking and movement. Somatic healing and vagus nerve has been an incredible discovery for me since Andrea Edmondson talked about it at a bullying conference I attended in 2023. It has taken me two years to start to absorb it into my own soma and I’m still at base camp of that climb. ( it’s getting better when I practice, it’s no different from trying to perfect and hone my squash shots) I wish I’d known this stuff at 21 and not 61, ho hum never too late. My doctors prescribed sleeping pills ( zoplicone and Tamazepam) in 2005 ( which had horrible side effects meaning I battled through the days for years and years) and the later SSRIs ( how many millions of prescriptions in the uk alone) to keep me going on a sleep deprived half life were treating my symptoms of an impacted nervous system where I too often powered through an indisputable physiological sick stomach, tight chest (that could not properly breathe in and out) and insomnia ( foggy head) repressing, suppressing and numbing. It is no way to live. Operating sometimes on no sleep was like torture at times, always thinking I had to keep it quiet for fear of showing weakness and being stigmatised with man’s mental health. I also had to ensure my family and children were supported with my income. My wife worked incredibly hard too as a teacher.Thank God I met a wonderful loving trusted relation on linked in who taught me how to feel and notice my body again in 2022 through 2025, when encountering horrendous situations at Fujitsu on the Post Office account and other clients. She helped me to save myself through reconnecting me with my body and reintegrating my healthy I. She helped me to rediscover my identity of unity and loving others. So I think that somatic exercises could have saved me 20 years of lower grade living and helped me operate ( lead) at a higher level perhaps . I agree there is a danger of vagus nerve pop culture and vagus nerve hacking. So I don’t think it’s about pop culture it’s about having experienced a recurring living hell for decades ( survival mode) which led to me having suicidal thoughts on a number of occasions and led to me falling asleep at the wheel crashing into a parked HGV and miraculously surviving in 2019. I don’t want my children or the next generation to have to suffer what I went through, a living hell. Looking forward to reading this next recommended read. Thank you so much. Keep doing what you are doing. 👏👏🙏
I've been guilty of "blaming the system [as] a stopping point rather than a starting question." Wanting to change a faulty system isn't enough. It's important to figure out where and how it went wrong, figure out the "hidden assumptions," the unintended goals, and the corresponding incentivized behaviors. If those aren't addressed, the new system will keep producing these, which seems to be the case with what you're describing in the world of the PMC.
But it's not because a system incentivizes damaging behaviors that the actors acting accordingly shouldn't be held responsible for then. Intent has no bearing on the damage done and the corresponding responsibility. After all, "I was just following orders" isn't an admissible defense.
Systems are resistant to change, sure. But it's still possible to change them. Speaking up, calling out, sowing seeds of doubt, anything to break the illusion of a unified majority supporting the system. If you feel there's something wrong, rest assured that you're not alone in feeling that. It's scary to be the kid calling out that the emperor is naked. But as soon as someone says it, the illusion is broken.
A broken system probably has goals that drifted, or goals that inadvertently incentivizes unwanted behaviors. For (a simplified) example, if members of the PMC feel their positions are precarious, one of their goals will be survival, to hold on to their position. This incentivizes stamping out the competition and can lead to scapegoating.
Any ideas how different goals or purposes could shift such behaviors?
Alexandre, I agree that incentives and hidden assumptions matter. Tha's why I hesitate to call these systems broken.
Most large institutions have two enduring priorities: preserve legitimacy/reputation and generate enough revenue to sustain themselves. Everything else is subordinate to those goals.
From that vantage point, what looks like dysfunction often isn’t malfunction because it's alignment. Reputation management, procedural insulation, status protection, and elimination of perceived risk all serve those primary goals. Stated goals and actual operating goals can be worlds apart.
That doesn't remove individual responsibility but there's always a point at which someone chooses whether to restrain themselves or to comply.
Where I’m more cautious is around the idea that systems readily shift once illusions are broken. They change rapidly when efficiency, profit, or liability are at stake. They're far slower to change where moral constraint threatens internal hierarchies or reputational control.
If goals were to shift meaningfully, the system would need to prioritise behaviour constraint over image protection. That would require leaders willing to take on short-term reputational instability to protect long-term integrity in an environment that doesn't scapegoat them for doing so.
So I believe change is possible. It's just not the dominant organising principle most of the time.
Thank you Yuliana for the sharing the link. Peter Boghossian has the patience of a saint with some of these people. It helps that he holds a strong belief that you can reason with anyone.
Indeed, I am not one of the patient saints who possess the artful skill of planting seeds of doubt and contemplation, but luckily there are a few of them walking amongst us. It's hard for me to believe that absolutely anyone can be reasoned with, I think there has to be an opening for listening at the very least.
Totally agree, and I see this played in the practice of medicine, with "moral injury" claimed as a universal consequence of everything wrong in the healthcare system. The individual's capacity to shape themselves and the world around them matters; though of course there are limits. My work (esp in my own Substack) is on how to find that balance as individuals. Change does not always have to come from above.
Moral injury has replaced burnout in physician wellbeing discourse. I pushed back a lot (I used to a lot of work with physician wellbeing) on its use because they downplay the aspect of them causing harm to another person and focus more on their victimhood of working in a demoralising system. It enables them to maintain their innocence and noble professional self-image without reckoning with their actual violation of principles that led them to injure another person. This is often discussed in the context of doctor-patient relationship when we also know that relational aggression is rife among the profession that can eat away at one's conscience.
Your mission to help pull physicians into a more balanced view of themselves within systems is commendable. I hope you can build a solid community here.
Blaming the system is a dodge to put distance between you and your guilt. It is an attempt to blame others for your sin. It changes the morality of actions into social issues to dilute the impact on the conscience. And it doesn’t work, ultimately.
I think that's mostly true with a few exceptions. The mental health system in the US is known for exerting brutal force on some people in a crisis by police. There are some dangerous people but there are also non-dangerous, unarmed people who are harmed or killed because of the way the system is designed and agents are trained to respond.
With respect to the Post Office scandal, the Horizon inquiry Lord Arbuthnot who was Jo Hamiltons MP said on talk TV in 2023, this has gone beyond being a computer problem (systems problem) this has become a human problem. In 2014 when I realised that technical hard work and growth was not cutting it I realised that my future lay in human centricity, feedback, agility through continuous improvement, unconscious habitudes and plastic brains. Thank you for supplying me with a continued flow of essential self aware posts and articles. 🙏🙏
Thank you Trevor for sharing your approach to self and quality improvement. All roads lead to human action and decisions, and it's the only thing we can control about ourselves.
Thank you Nathalie 🙏🙏
I agree. Individual responsibility will always be necessary as a central part of relationships, because we live the systems in relationships and common places, not in a vacuum.
On the other hand, systems approach is used because it makes sense (particularly if it's used with prudence): if systems influence and structure the lives of millions of people, then we can look at a system and see behaviours and repeated problems that typically emerge within that system. Then, if we want different "wide" outcomes, we can try a different system to prevent having the outcomes we don't want anymore.
A good example is that criminality arises where socioeconomic inequality is high (as in countries like Haiti, or El Salvador some years ago), while criminality is low in prosperous countries. Not only in countries, but also in the cities and neighbourhoods that fill those descriptions within a same country. This suggests that socioeconomic inequality (more on the side of poverty than wealth as crime is concentrated in poor areas, but also in wealth to an extent) correlates to risk factors for criminality: high stress, family dysfunction, lack of education, mental health problems, etc.
It doesn't make criminality less horrible, but it makes the wide context understandable in order to prevent future generations of criminals: the most peaceful countries are the most prosperous AND less inequal (this difference is relevant), and I believe they have other factors in common as well: they tend to be geographically small and neutral in wars (in practice, and even officially like Switzerland), etc.
(In brief words: individual responsibility, naming the specific people for their actions, is for the present and forever, and systems approach are for future outcomes and generations... and at the same time a system that gives general wellness can increase covert aggression, for which we still need moral development and enforced individual responsibility as you said).
Thanks for your thoughtful comments The Stone.
I agree that systems analysis has predictive value. When patterns repeat across populations, it makes sense to examine the conditions that increase the probability of certain outcomes. Poverty, instability, and chronic stress do correlate with higher rates of crime, which is observable.
I am careful though about how quickly structural explanation becomes moral explanation.
Context can increase risk but it doesn't enact behaviour. Two people can experience the same structural constraints and make very different choices. Systems shape probabilities and individuals generate actions.
I also think it’s important to distinguish between designing for material stability and designing for moral constraint. A society can be prosperous and still cultivate covert aggression, status anxiety, or scapegoating under more civilised language. Stability reduces some harms but it doesn't eliminate human incentives regarding power, competition, and protection.
So I see it less as present versus future and more as two simultaneous layers. Structural conditions influence what becomes common and responsibility determines what becomes tolerated.
If we change systems without strengthening behavioural constraint, harm mutates rather than disappears.
Good point all around; systems are ultimately made by people, but people who are often no longer part of those systems. What we usually end up with is a system utilized and lived in by other people with individual personalities and level of virtue. Even the best engineered system can be hijacked, and even the most dysfunctional system can be improved. However, I'd offer that the latter needs to be approached with an attitude not of "how does this oppress me?" rather than "how can this be tweaked better?"
You raise an interesting point about who designs systems vs who is actually using them. Designers are not always users, and that's where some fail to fulfil its purpose, and fulfils a harmful purpose instead.
The focus on stregnths has been lost in so many conversations about improvement and change. Focusing on what's already working and what can be improved through tweaks is how we do improvement work rather than reducing problems. The problem based focus is such a trap especially because people reduce complex systems to issues vs seeing it as an ecosystem with risk and protective factors.
This is interesting thinking about it in terms of systems.
A few thoughts come to mind …
1.) When it comes to work, our family we can’t always change the system. But we can change how we respond to it.
2.) The system is likely never going to change so we have to find a system we can live with.
3.) Generally speaking, the more you try to fight a system the more upset you will make yourself. So refer back to point #1.
This doesn’t mean that we should tolerate abuse, illegal behavior, sustained harassment, etc. But generally systems are what they are so the faster we can recognize them and learn to navigate them in a healthy way the more successful we are likely to be :)
Very wise perspective. Knowing where we can reasonably exert control and what we might have to change to better navigate a system can improve our state of wellbeing. People live to fight and battle and wear themselves out.
.. just realised I’d commented earlier yet one of your thoughts brought me back and spurred further thought..,
i think you have it bang on Nathalie. My perspectives are IT ( over 37 years) and multiple clients, sectors, geographies and demographics and it’s not only the system software which i have blamed its the surrounding operations and organisational structural infrastructures too. It’s the self protecting system of regulation from malpractice and maladministration and the faulty immune system around audit, security and accessibility. I’ve written about these system failures and so have PMs in ‘lessons learned’ quad zillions of times. I include applications, operations, and unintegrated siloes; analysis, design, implementation, testing, service management, programme and project management, release management, requirements, development, architects, quality assurance, change management, security, bid management and cultural ethics. This is the miscarriage of justice which is covered up by legal illusion.
But what about harm to people?
When I realised something felt badly wrong around 2014, my technical quests for fulfilment and change through techcentric bias were simply not working, I reverted to my younger persona once again perhaps favouring art over science, refocusing on feedback and assertiveness. I realised this was an important part of my identity to reignite. It was the start of a journey to a full awakening in June 2022 about bullying, gaslighting, devastating illness and betrayal. So yes I think with the DEIB, culture warrens, cul de sacs journeyed, the grievances and appeals journeyed the 9 stages of healing from trauma largely travelled, its feelings, emotions and people that lead with the nervous system, the prefrontal cortex crucially the key variable. True discernment to select great leaders can only be sought and found through connection to the body, feelings, emotions, homeostasis and great leaders will work with their real identity on show with a healthy central nervous system too. 🙏
I think this is going to be another crucial article for me to chew over a great deal. Thankyou 🙏
Trevor, I appreciate the depth of your reflection and the breadth of experience you’re drawing from.
Your point about regulatory immune systems is interesting. In many institutions, audit, compliance, and governance mechanisms are designed to prevent visible malpractice, yet they can also become self-protective layers that insulate the organisation from scrutiny. Harm becomes procedural rather than accidental when protection of the structure overrides protection of people.
You ask what about harm to people, which is my concern too. Systems might be technical or regulatory, but injury is enacted relationally through repeated behaviour that's tolerated, coordinated and covertly legitimised.
Where I would place the emphasis is less on nervous system states and more on restraint, accountability, and incentive design. Emotional regulation matters, but without consequences and role clarity, even well-regulated individuals will adapt to what is rewarded.
You might be interested in what I have to say about neuroreductionism as problematic framing: https://www.hackingnarcissism.com/p/neuroreductionism
Thank you for engaging so thoughtfully and your tremendous support Trevor.
Excellent thank you so much, this is all very exciting forward thinking and movement. Somatic healing and vagus nerve has been an incredible discovery for me since Andrea Edmondson talked about it at a bullying conference I attended in 2023. It has taken me two years to start to absorb it into my own soma and I’m still at base camp of that climb. ( it’s getting better when I practice, it’s no different from trying to perfect and hone my squash shots) I wish I’d known this stuff at 21 and not 61, ho hum never too late. My doctors prescribed sleeping pills ( zoplicone and Tamazepam) in 2005 ( which had horrible side effects meaning I battled through the days for years and years) and the later SSRIs ( how many millions of prescriptions in the uk alone) to keep me going on a sleep deprived half life were treating my symptoms of an impacted nervous system where I too often powered through an indisputable physiological sick stomach, tight chest (that could not properly breathe in and out) and insomnia ( foggy head) repressing, suppressing and numbing. It is no way to live. Operating sometimes on no sleep was like torture at times, always thinking I had to keep it quiet for fear of showing weakness and being stigmatised with man’s mental health. I also had to ensure my family and children were supported with my income. My wife worked incredibly hard too as a teacher.Thank God I met a wonderful loving trusted relation on linked in who taught me how to feel and notice my body again in 2022 through 2025, when encountering horrendous situations at Fujitsu on the Post Office account and other clients. She helped me to save myself through reconnecting me with my body and reintegrating my healthy I. She helped me to rediscover my identity of unity and loving others. So I think that somatic exercises could have saved me 20 years of lower grade living and helped me operate ( lead) at a higher level perhaps . I agree there is a danger of vagus nerve pop culture and vagus nerve hacking. So I don’t think it’s about pop culture it’s about having experienced a recurring living hell for decades ( survival mode) which led to me having suicidal thoughts on a number of occasions and led to me falling asleep at the wheel crashing into a parked HGV and miraculously surviving in 2019. I don’t want my children or the next generation to have to suffer what I went through, a living hell. Looking forward to reading this next recommended read. Thank you so much. Keep doing what you are doing. 👏👏🙏
I've been guilty of "blaming the system [as] a stopping point rather than a starting question." Wanting to change a faulty system isn't enough. It's important to figure out where and how it went wrong, figure out the "hidden assumptions," the unintended goals, and the corresponding incentivized behaviors. If those aren't addressed, the new system will keep producing these, which seems to be the case with what you're describing in the world of the PMC.
But it's not because a system incentivizes damaging behaviors that the actors acting accordingly shouldn't be held responsible for then. Intent has no bearing on the damage done and the corresponding responsibility. After all, "I was just following orders" isn't an admissible defense.
Systems are resistant to change, sure. But it's still possible to change them. Speaking up, calling out, sowing seeds of doubt, anything to break the illusion of a unified majority supporting the system. If you feel there's something wrong, rest assured that you're not alone in feeling that. It's scary to be the kid calling out that the emperor is naked. But as soon as someone says it, the illusion is broken.
A broken system probably has goals that drifted, or goals that inadvertently incentivizes unwanted behaviors. For (a simplified) example, if members of the PMC feel their positions are precarious, one of their goals will be survival, to hold on to their position. This incentivizes stamping out the competition and can lead to scapegoating.
Any ideas how different goals or purposes could shift such behaviors?
Alexandre, I agree that incentives and hidden assumptions matter. Tha's why I hesitate to call these systems broken.
Most large institutions have two enduring priorities: preserve legitimacy/reputation and generate enough revenue to sustain themselves. Everything else is subordinate to those goals.
From that vantage point, what looks like dysfunction often isn’t malfunction because it's alignment. Reputation management, procedural insulation, status protection, and elimination of perceived risk all serve those primary goals. Stated goals and actual operating goals can be worlds apart.
That doesn't remove individual responsibility but there's always a point at which someone chooses whether to restrain themselves or to comply.
Where I’m more cautious is around the idea that systems readily shift once illusions are broken. They change rapidly when efficiency, profit, or liability are at stake. They're far slower to change where moral constraint threatens internal hierarchies or reputational control.
If goals were to shift meaningfully, the system would need to prioritise behaviour constraint over image protection. That would require leaders willing to take on short-term reputational instability to protect long-term integrity in an environment that doesn't scapegoat them for doing so.
So I believe change is possible. It's just not the dominant organising principle most of the time.
If someone uses a system to try to assassinate you then the system is exploitable even if they are at fault and will die sooner rather than later.
That's true too.
Unless the system was a murder machine from the start 🤔
Another great article, thank you Nathalie!
I read it right after watching this eye opening vid featuring a street interview by Peter Boghossian, so very timely and relevant!
https://x.com/WTSmith17/status/2020186638404710486?s=20
Thank you Yuliana for the sharing the link. Peter Boghossian has the patience of a saint with some of these people. It helps that he holds a strong belief that you can reason with anyone.
You're welcome!
Indeed, I am not one of the patient saints who possess the artful skill of planting seeds of doubt and contemplation, but luckily there are a few of them walking amongst us. It's hard for me to believe that absolutely anyone can be reasoned with, I think there has to be an opening for listening at the very least.
This was a next-level examination, as well as fascinating and thought provoking.
I appreciate you letting me know. Thank you!
Totally agree, and I see this played in the practice of medicine, with "moral injury" claimed as a universal consequence of everything wrong in the healthcare system. The individual's capacity to shape themselves and the world around them matters; though of course there are limits. My work (esp in my own Substack) is on how to find that balance as individuals. Change does not always have to come from above.
Moral injury has replaced burnout in physician wellbeing discourse. I pushed back a lot (I used to a lot of work with physician wellbeing) on its use because they downplay the aspect of them causing harm to another person and focus more on their victimhood of working in a demoralising system. It enables them to maintain their innocence and noble professional self-image without reckoning with their actual violation of principles that led them to injure another person. This is often discussed in the context of doctor-patient relationship when we also know that relational aggression is rife among the profession that can eat away at one's conscience.
Your mission to help pull physicians into a more balanced view of themselves within systems is commendable. I hope you can build a solid community here.
Blaming the system is a dodge to put distance between you and your guilt. It is an attempt to blame others for your sin. It changes the morality of actions into social issues to dilute the impact on the conscience. And it doesn’t work, ultimately.
I think that's mostly true with a few exceptions. The mental health system in the US is known for exerting brutal force on some people in a crisis by police. There are some dangerous people but there are also non-dangerous, unarmed people who are harmed or killed because of the way the system is designed and agents are trained to respond.