This post is the latest installment of our “Monday Reflections” feature, in which a different Just Security editor examines the big stories from the previous week or looks ahead to key developments on the horizon.

It was almost a case study in worst case scenarios involving the American military and civilian casualties. A US AC-130 gunship reportedly poured fire into the only working trauma hospital in a city under siege. Rather than killing militants who were targeting Americans or Afghans, the strike reportedly killed and wounded dozens of patients and staff belonging to one of the world’s most famous and respected NGOs, Doctors Without Borders (also known by its French name, Médecins Sans Frontières).

Over the last few days, the discussion has been dominated by the tragedy and concern about potential war crimes and violations of international humanitarian law. But there is another important lesson here: Even the most precise weapons make mistakes. Whether those weapons are used in airstrikes like the one in Kunduz, or in targeted killings around the world.

The weekend’s airstrikes make it clear that errors happen, and the government has stated that it will launch an investigation into what occurred. But other “precision” programs — particularly targeted killings — are conducted almost entirely in secret and lack enough public oversight. It’s past time for a full review of these programs.

Multiple outlets have reported that Saturday morning’s airstrike in Kunduz, Afghanistan was carried out by an AC-130. Such planes are flown by members of the US Air Force’s Special Operations Command (AFSOC), the same organization that carries out targeted killings with Predator and Reaper drones on behalf of the US’s Joint Special Operations Command (JSOC). Going by nicknames like Spooky, Spectre, and Stinger they are converted C-130 cargo planes outfitted with powerful night-vision cameras and other sensors and armed with machine guns, cannons, howitzers, and occasionally small bombs and missiles. Flying mostly at night, they are prized for their ability to circle targets for hours, staring down and monitoring both friendly troops and enemies before using their guns to level a building to or even pick off individuals. These aircraft and the crews that fly them, those who peer at the images gathered by their sensors and fire the weapons, are supposed to be among the best in the world at knowing what’s going on beneath them. They are so good that they are often used to watch over convoys or remote American outposts.

Per Médecins Sans Frontières (emphasis mine):

From 2:08 AM until 3:15 AM local time today, MSF’s trauma hospital in Kunduz was hit by a series of aerial bombing raids at approximately 15 minute intervals. The main central hospital building, housing the intensive care unit, emergency rooms, and physiotherapy ward, was repeatedly hit very precisely during each aerial raid, while surrounding buildings were left mostly untouched.

The aircrew that attacked the hospital wasn’t sitting thousands of miles away from the target, watching through what’s often called a “soda straw” view beamed to them from a drone’s cameras. They likely weren’t much more than ten thousand feet, if that, from their target. The gunship’s crew was looking down on the city and reportedly in contact with American troops on the ground (though questions remain about how close those Americans were to the hospital and the actual fighting in Kunduz). The hospital was supposed to be well known to all as a Doctors Without Borders facility and the organization insists that Taliban forces were not using it as a fighting position.

It’s precisely for these reasons that the strike on Saturday morning is emblematic of a larger problem. Even the very best aircrews, using the most precise weapons, communicating with highly-trained troops on the ground sometimes get things catastrophically wrong. Unlike this strike, which was conducted as part of a very public operation and will be the subject of a “transparent” investigation, too many similar incidents have been the result of secretive operations with limited public oversight.

AFSOC’s gunships and drones are routinely deployed around the world, hunting suspected terrorists in targeted killings and attacking insurgents in battlefield strikes like the one this past weekend. They often hit their marks, but they also kill others who happen to be nearby. Meanwhile, the US government still insists that the targeted killing program is a surgical tool that eliminates threats while keeping civilian casualties to a minimum. It does this despite serious questions about its claims of low civilian casualties, and relying on controversial standards of evidence to decide who is a target and who isn’t and then to verify who was killed. For every genuinely dangerous person killed, the strikes that go wrong inevitably fuel resentment toward the US, giving extremists a propaganda victory and recruiting tool. But the US government refuses to adequately discuss targeted killings and their effectiveness, instead keeping them cloistered inside the CIA and JSOC, the most secretive wing of the military.

But the hospital strike shows that AFSOC, like everyone, makes mistakes. Sometimes, big ones. Such mistakes will occur as long as aircraft are dropping ordnance “in anger” (as the military often describes the use of weapons in combat). But instead of just being dismissed as inevitable and tragic collateral damage, the mistakes that occur under the aegis of the CIA and JSOC are too often under-acknowledged (when they are acknowledged at all) by those making them. And these mistakes do serious harm, not just to the innocents killed and injured, but to the US’s long-term security interests. These harms must be weighed against the benefit of killing those who are the intended targets.

Perhaps Saturday’s strike will be the tipping point where we demand more accountability for and understanding of civilian casualties from American airstrikes. Perhaps it won’t be dismissed as an unfortunate but routine tragedy of war. Perhaps the independent investigation Doctors Without Borders is rightly demanding will materialize, and better yet, expand into AFSOC’s and through it JSOC’s overall targeted killing program.