To give an example of how disastrously incompetence can interact with the lack of personal accountability in medicine, a recent horrifying case I found was this one:
According to the hospital, Matsui has been involved in a number of medical accidents during surgeries he performed over a period of around six months since joining the hospital in 2019, resulting in the deaths of two patients and leaving six others with disabilities.
Matsui was subsequently banned from performing surgery by the hospital and resigned in 2021.
January 22nd: Dr. Chiba’s heart sinks when he learns that Matsui has pressured yet another patient into surgery. The patient is 74-year-old Mrs. Fukunaga, and the procedure is a laminoplasty—the same one that left Mrs. Saito paralyzed from the neck down 3 months ago. ‘Please let Matsui learn from his mistakes,’ Chiba pleads. Knowing that Matsui’s grasp of anatomy is tenuous at best, Chiba tries to tell Matsui exactly what he needs to do. ‘Drill here,’ Chiba says, pointing at a vertebra. Matsui drills, but the patient starts bleeding, constantly bleeding. He calls for more suction, but it’s no use; blood is now seeping from everywhere. Matsui is confronted by his greatest weakness: the inability to staunch bleeding, the one skill that every surgeon needs. The operating field is a sea of red. As sweat rolls down his face, Matsui is in complete despair. He knows he has to continue the surgery, so the only thing he can do is pick a spot and drill.
A sickening silence. Even Matsui can feel that something is wrong because his drill hits something that is definitely not bone. Dr. Chiba looks over and lets out a little whimper. Matsui has made the exact same mistake as last time: he’s drilled into the spinal cord, and this time the damage is so bad that the patient’s nerves look like a ball of yarn. There’s actually video footage of this surgery. Yes, it really looks like a ball of yarn, and no, you really don’t want to watch it, trust me. The footage ends with Matsui literally just stuffing the nerves back into the hole he drilled and hoping for the best. This was Matsui’s most serious surgical error yet, and it would later come back to haunt him. But for now, all he got was a slap on the wrist. A month later, he was back at it. He was going to perform another brain tumor removal—the very first procedure he failed at Ako.
One aspect I found interesting: Japan’s defamation laws are so severe that the hospital staff whistleblowers had to resort to drawing a serialized manga about a “fictional” incompetent neurosurgeon to signal the alarm.
That’s pretty messed up. This thread is a good examination of the flaws of blame vs blamelessness.
I wonder if we could somehow promote the idea that “outing yourself as incompetent or malevolent” is heroic and venerable. Like with penetration testers, if you could, as an incompetent or malevolent actor, get yourself into a position of trust, then you have found a flaw in the system. If people got big payouts and maybe a little fame if they wanted it for saying. “Oh hey, I’m in this important role, and I’m a total fuck up. I need to be removed from this role”, that might promote them doing so, even if they are malevolent but especially if they are incompetent.
Possible flaws are that this would incentivize people to defect sometimes, pretending to be incompetent or malevolent, which is a form of malevolence, but this could get out of control. Also people would be more incentivized to try to get into roles they shouldn’t be in, but as with crypto, I’d rather have lots of people trying to break the system to demonstrate it’s strength than security through obscurity.
To give an example of how disastrously incompetence can interact with the lack of personal accountability in medicine, a recent horrifying case I found was this one:
Doctor indicted without being charged for professional negligence resulting in injury
This youtube video goes over the case. An excerpt:
One aspect I found interesting: Japan’s defamation laws are so severe that the hospital staff whistleblowers had to resort to drawing a serialized manga about a “fictional” incompetent neurosurgeon to signal the alarm.
That’s pretty messed up. This thread is a good examination of the flaws of blame vs blamelessness.
I wonder if we could somehow promote the idea that “outing yourself as incompetent or malevolent” is heroic and venerable. Like with penetration testers, if you could, as an incompetent or malevolent actor, get yourself into a position of trust, then you have found a flaw in the system. If people got big payouts and maybe a little fame if they wanted it for saying. “Oh hey, I’m in this important role, and I’m a total fuck up. I need to be removed from this role”, that might promote them doing so, even if they are malevolent but especially if they are incompetent.
Possible flaws are that this would incentivize people to defect sometimes, pretending to be incompetent or malevolent, which is a form of malevolence, but this could get out of control. Also people would be more incentivized to try to get into roles they shouldn’t be in, but as with crypto, I’d rather have lots of people trying to break the system to demonstrate it’s strength than security through obscurity.