Chalk Outline


I drew the chalk outline. I am not copyrighting it. Chalk Outline Symbol for Patient SafetyYou are free to use it to bring attention to patient safety in any way you want. If possible use light blue chalk in straight lines. The angularity not only makes it distinguishable from whales and porpoises, but also indicates that something terrible happened to this patient who was soft and round a short time ago.

Click here for stencils and instructions for putting the symbol on sidewalks

If someone tells you that you cannot draw a chalk outline on a public sidewalk to speak about patient safety, inform them that in the USA this is free expression and as such is protected by the first amendment (as long as it is chalk or something equally temporary). Issues similar to this have won in the Supreme Court of the United States in the recent past. It is protected speech and you have a right to do it even though they can make it costly to defend.

Their egos and reputations are not worth more than our lives.

Save the PatientsBe careful about identifying specific persons or institutions or they may sue you. Drawing it on a public sidewalk in front of one hospital where you were injured could cause problems for you. Drawing it in front of one where you did not have any problem should be safe. Drawing it in front of ten should be safer.

Unfortunately, not being able to identify where problems occur reduces the public debate to generalities. It's as though people going to restaurants were not allowed to tell anyone where they got food poisoning. If a lecher in a hospital intentionally harms you, you are not allowed to warn other patients about the predator. All you can do is put a symbol on your car or your web site or on a sidewalk that doesn't identify the location or perpetrator.

See Freedom of Speech for Patients

A possible sign for carrying in a march can be seen here.

Please don't use spray paint or anything permanent on a sidewalk or other public place. If it is permanent, it is graffiti and is more likely to alienate than to persuade (and might be illegal). Christo left his mammoth exhibit of 7,500 Gates in Central Park in Manhattan for less than three weeks because it is special and poignant if it is rare and of short duration. Chalk outlines still on the ground after 3 months annoy even other injured patients and may work against us. It is important not to be obnoxious to our own constituency.

4.1% of sentinel events in medicine are
assault/rape/homicide according to JCAHO

Another reason the symbol is a chalk outline is the total disregard of the medical profession of the crime rate in medicine. Some of the hundreds of thousands of patients who unnecessarily die each year (see Preventable Deaths) were killed intentionally. Not mercy killing - just murder. Even though there is a murder rate in medicine, as yet we have not seen one single patient safety initiative with even a mention of the crime rate in medicine or any thought of how to address it. Is there a darker moment for patient safety than health care workers intentionally injuring, or even killing, patients? Shouldn't we do something to keep medicine from sweeping awareness of it under the carpet?

Eight times as many Americans die unnecessarily in health care each year than died in the entire 30 years of America's involvement in the Vietnam War. Perhaps as a monument to them a few hundred thousand footprint-size chalk patient safety symbols should be placed on routes leading to state capitol buildings where they have passed liability limitations that protect the perpetrators even of murder in medicine (if you think that's confusing criminal and civil law, click here).



A more macabre symbol->