The optimal role of patients in improving safety has yet to be determined. Although patients are being encouraged to ask questions and engage in safety programs, the extent to which patients are willing and able to do so is controversial. This qualitative study, conducted at a cancer center in Denmark, examined the perspectives of patients and health care professionals regarding patient engagement in safety efforts and strikes an important cautionary note. Despite the high-risk nature of oncology care, patients did not identify their safety as a main concern. While patients were observed engaging in safety behaviors—for example, questioning the dose of a new medication—most patients felt that ensuring safety was primarily the clinician's responsibility and expressed concern that more active involvement in safety could result in their being labeled "difficult" and could potentially impair their relationship with the care team. Given these findings, promotion of patient engagement in safety efforts runs the risk of merely shifting responsibility for safety from professionals to patients.