41. The cost of mistakes: Penalties for surgical malpractice through the ages
Bibliographic record
Abstract
In recent years the United States has undergone what some have termed a malpractice “crisis”. It has affected Canada and other parts of the world to a lesser extent and has been the subject of much debate. Throughout history the idea of what constitutes negligent surgical care and its consequences has not been an immutable concept but rather has fluctuated between seemingly polar extremes. In ancient Mesopotamia, the Hammurabi code describes bountiful rewards for successful surgery contrasted with mutilation or death for failed attempts. In ancient Egypt we see the extremes of strict dogma, where acceptable practice was laid out by ancient priestly documents and those who strayed from their precise format could be met with deportation or beheading, a practice that discouraged developing treatment for those with a poor chance of survival. In stark contrast to these cultures the physician/surgeons of ancient Greece had almost complete impunity. After the monastic orders in Europe were banned from surgical practice in 1130 the uneducated barber surgeons dominated the field. The minority of educated surgeons pointed out many examples of negligence and improper care by this group. Capital punishment and mutilation of negligent surgeons became common once again in the crusader states, as public humiliation was added to the punishment. During the renaissance in Italy, the actions of a regulatory council levied stiff fines for surgeons who infringed on the practice of physicians while seemingly paying very little attention to examples of gross negligence and patient abuse. Finally in the modern era, surgery developed much more effective treatments for many conditions. Paradoxically as soon as a technique became better for a condition, accusations of negligence for treatment of that condition became common.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.048 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.007 | 0.005 |
| Insufficient payload (model declined to judge) | 0.032 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".