The Joint Commission established engagement of patients in safety as a National Patient Safety Goal in 2007. Organizations have made various efforts to include patients in safety programs, with mixed results. This thematic review uses the example of patients undergoing surgery to establish a framework for the roles patients can play in ensuring their own safety. In this framework, safety-related behaviors can be classified according to the type of error being prevented, the specific action the patient must undertake (e.g., asking questions), and the characteristics of the action. The article also discusses the barriers that can limit patient involvement. One of the study authors, Prof. Charles Vincent, previously authored a seminal article that was among the first to call for integrating patients into safety activities.