> Everyone makes mistakes.

Amen. And avoiding a culture of blame (taking inspiration from the NTSB) makes it much more straightforward to put systemic measures in place which reduce the impact of those mistakes. People still make mistakes at the same rate, but more mistakes get trapped and more negative outcomes can be avoided.

The vitriol of this discussion shows just how difficult it is to establish such a culture. People really want to see mistakes as evidence of moral inferiority.