Safety investigations designed to find 'systemic' failures almost always end up blaming individuals because humans are easier for bureaucracies to process than complex structures.
April 1, 2026
Original Paper
Responsibility Convergence in Organizational Investigations: Structural Dynamics of Blame in Root Cause Analysis
SSRN · 6372301
The Takeaway
We assume modern root-cause analyses are objective searches for truth, but this research shows a 'responsibility convergence' where organizations consistently settle on human error as the cause. This happens because individuals are 'administratively legible' anchors that allow a case to be closed, whereas fixing a distributed sociotechnical system is seen as unactionable.
From the abstract
Organizational investigations such as root cause analysis (RCA) are intended to identify systemic causes of failure and support organizational learning. Yet across regulated and safety-critical environments, investigative conclusions recurrently stabilize responsibility at identifiable individuals despite formal commitments to system-oriented explanation. This persistent actor-centered pattern presents a theoretical puzzle: why do investigative systems designed to diffuse responsibility across s