I’m in the middle of writing a paper about this, but there is much to be learned by engineering-driven organizations from what has happened at NASA with both Challenger and Columbia. Cass Sunstein (cited by Clay Shirky) rightly points to stiffling of dissent, but to my mind that is really just a subset of a broader issue — normalization of deviance in risky cultures — first (and best) identified by Diane Vaughan in her excellent 1997 book “The Challenger Launch Decision: Risky Technology, Culture, and Deviance at NASA“.
She describes normalization of deviance here in a book chapter about parallels between Challenger and Columbia:
“In all official engineering analyses and launch recommendations prior to the accidents, evidence that the design was not performing as expected was reinterpreted as acceptable and non-deviant, which diminished perceptions of risk throughout the agency.”
For those of you in large engineering-driven organizations, this should sound harrowingly familiar.