[vanderZwan]

You know, I'm wondering: could part of Dijkstra's reputed arrogance be due to a cultural difference? I'm Dutch, and bluntly calling out flaws in each other's work is not considered all that rude over here; it's almost the opposite: not calling someone out on their flaws implies we either consider them a lost cause or not worth the hassle of educating.

I almost got fired from a teaching position in Sweden because I told my 3rd year bachelor students that many did not bother to add their names or the assignment number, or using paragraphs and in some cases even basic interpunction on their assignments. And that this was well below the level required to to pass secondary school, and that I expect better from them.

This was apparently too confrontational, and a few upset students later I got chewed out and almost fired. Meanwhile, from my point of view, I was just doing my job and already sugarcoating it by Dutch standards.

Having said that, yes, even by Dutch standards I would say that Dijkstra liked to troll people a bit.

PS: I really like the following insight from Dijkstra's review: But whereas machines must be able to execute programs (without understanding them), people must be able to understand them (without executing them).

[bmer]

Full disclosure:

a) Dijkstra is a bit of a personal "hero" of mine (hero in quotation marks, because I don't like to think of myself as a hero worshipper), because it was due to him I learned of textbooks written by guys like Eric Hehner and Roland Backhouse, which ended up changing my life significantly.

b) I do not really grasp the technical issues being discussed in the correspondences between Dijkstra and Backus

Given this disclosure:

Regardless of the cultural issues (which I suspect you are right about), I found Backus' first response to Dijkstra full of ad hominems, and very light on technical rebuttals. If we subtract out the ad hominems, I suspect the technical rebuttals would take less than a page (which is a significant reduction, considering that the full letter is 4 (typewritten!) pages).

Calling Dijkstra arrogant seems to have been a popular insult (as Backus himself admits), so I wonder if Backus was simply jumping onto the bandwagon as a defensive reaction to the arguments presented in EWD 692.

I think Dijkstra's responses were indeed trollish. I wish he wouldn't have said anything further after he noticed the gratuitous personal attacks against his character in Backus' response, but he couldn't help but say something back. Oh well.

Can you comment on this observation?

[c3534l]

I personally found Backus to be way more of a dick in these letters, though I did gloss over some parts. It's strange how different people can get very different things from these letters. Maybe they just didn't have personalities that meshed well. I don't think it's cultural: I'm American and I find Dijkstra's demeanor to be perfectly acceptable, if a little a colorful. Although, in the same vein, people often don't like Linus Torvalds for many of the same reasons.

[tps5]

I found Dijkstra's letters appalling. Writing - utterly without shame - that his negative response to Backus' paper was disingenuous and served a "political" purpose is utterly despicable to me.

I don't know how you can defend that.

[_prototype_]

Dijkstra was very rude

[Bromskloss]

> textbooks written by guys like Eric Hehner and Roland Backhouse

Would you like to say something about those?

[bmer]

E. Hehner has a course called "Formal Methods for Software Design", which he presents completely openly online (including video lectures, a textbook, solutions, and so on): http://www.cs.toronto.edu/~hehner/FMSD/

I really liked it.

I also liked R. Backhouse's approach to it, encapsulated in two books:

1) less playful: http://www.amazon.com/Program-Construction-Calculating-Imple...

2) more playful: http://www.amazon.com/Algorithmic-Problem-Solving-Roland-Bac...

If you are looking for motivation, you might also like: http://research.microsoft.com/en-us/um/people/lamport/pubs/p...

-----------------

I found Dijkstra's stuff to be easier to read after I had read books by Hehner/Backhouse, even though chronologically, Dijkstra came first.

[Cyph0n]

Thank you for linking that course. I've always been interested in formal methods and verification of correctness.

[bmer]

No problem. You'll notice as you go through the links that none are about verification of correctness. Rather, they are about "correct by construction".

[nickpsecurity]

Hehner's work is on my reading list. The reviews on Backhouse's links aren't promising.

[bmer]

I have learned not to put much weight in Amazon reviews for technical literature. Borrow a copy of the books from a library (my city library actually had access to a digital version of Backhouse's latest book, and you could always Yarr! yourself a copy) and check them out, before shelling out the cash :)

[nickpsecurity]

Well, the one reviewer said it was only a start toward a method for practical software with practical part maxing out at a sorting algorithm. Is that true or do you have examples of realistic stuff covered by book?

[vanderZwan]

You're right that the technical rebuttals are fairly slim, but the rest of the exchange, which is all about political play and saving face[0], isn't pointless.

The whole argument Dijkstra makes boils down to "if everyone was as technically competent as you and I, then I wouldn't need to do this. But the sad truth is that the incompetent are not only the majority, they decide what gets funded and researched, so I have to." I think he is right about that, and probably even acted correctly on it, but even so: positioning himself like he's taking on a sacrificial trollish saviour role and just doing this to save programming research is pretty arrogant, so Backus is right as well!

And that's just the politics of it, saving public face hasn't even entered the equation here. Don't forget, Backus' reputation also directly affects the respect and by extension funding that he receives for research that he wants to do. With that in mind I can very easily see how Backus must have been furious after reading EWD692, especially considering that it contained a few insinuations about him, which again I would partially account to Dutch culture, which (used to) have a severe case of tall poppy syndrome[1]. But from Backus' point of view, if they had been friends and colleagues before, it might have felt like backstabbing, both politically and as friends.

So I think I understand Backus' ad hominems - I suspect he was sincere about trying to criticise Dijkstra from the position as a long-time friend; his writing style boiling down to: "Look, I respect you and all, but I have to point out that you're being a dick; oh and have a taste of your own medicine on the side, because two can play that game."

Of course, it looks like he played right into the hands of Dijkstra, because Dijkstra doesn't appear to be as emotionally invested in saving public face, and seems to rather enjoy puzzling Backus a bit longer.

In general, I think it speaks for both of them that they managed to resolve these differences to what appears to be mutual satisfaction!

[0] https://en.wikipedia.org/wiki/Face_(sociological_concept)

[1] https://en.wikipedia.org/wiki/Tall_poppy_syndrome

[Ericson2314]

Hah, I'd say that both Dijkstra and Backus are "heros" for me---scare quotes for the exact same reason. I'm mainly interested in ideology/vision in reading about the early pioneers, and I find theirs more interesting than, let's say, Knuth's.

[tluyben2]

I am Dutch, my father studied under Dijkstra (TUE) and I studied under some of Dijkstra's prodigies. The humor Dijkstra uses is very Dutch to me and to me it's hilarious. His hard stabs were considered good practice in a lot of professional Dutch high end careers in the 70s/80s/90s but I believe it became less common. We have less issues telling like it is even if it hurts people in general, but when I still worked in NL this was definitely dying out.

That said; I admire Dijkstra for having such strong opinions and striving to create solid software no matter what. He was used to write software for machines that didn't exist yet[1] and I for one wish I had the time/budget to write software proofs. Especially with the modern tools (not the ones I learnt using from Dijkstra's works, but that was a good theoretical foundation which gave me understanding) we have now it's very possible but only for very expensive systems with very generous deadlines. I could say we will not deliver without that but I would be living under a bridge...

[1] https://www.cs.utexas.edu/users/EWD/transcriptions/EWD13xx/E...

[eternalban]

> I'm Dutch, and bluntly calling out flaws in each other's work is not considered all that rude over here;

quote: “Object-oriented programming is an exceptionally bad idea which could only have originated in California.” – Edsger Dijkstra

Backus, on the other hand, is a genuinely lovely man. If you haven't read/seen his interview with CHM [1], then I urge you to do so. (Pay attention to his closing remarks!)

[1]: http://www.computerhistory.org/fellowawards/hall/bios/John,B...

[Typhon]

I could never find a reliable source for this oft-quoted remark about Object-Oriented Programming. As far as I know, Dijkstra never said this, not in this exact phrasing anyway.

[erikbye]

Also, why would he say that when he knew, very well, that OOP was invented in Norway?

http://coldcomfortgames.com/blog/object-oriented-programming...

https://www.quora.com/Why-did-Dijkstra-say-that-%E2%80%9CObj...

It seems no one is able to find the source of the quote, it's in fact much more likely he did not say anything like that, and that the quote is a fabrication.

[Typhon]

What he did say : « I don’t think object-oriented programming is a structuring paradigm that meets my standards of elegance » (https://www.cs.utexas.edu/users/EWD/transcriptions/EWD12xx/E...)

I guess some decided that Dijkstra didn't have enough inflammatory quotes attached to his name and fabricated the other one.

[eternalban]

http://harmful.cat-v.org/software/OO_programming/

[erikbye]

That's not a reliable source, and it does not specify source of the quote.

[B1FF_PSUVM]

> Object-oriented programming is an exceptionally bad idea

'Truths as hard as fists', is one way I've seen it put in another language (sortof).

> which could only have originated in California

Flattery will get you anywhere. UTexas, in this case ...

[bloaf]

>Reason is always a kind of brute force; those who appeal to the head rather than the heart, however pallid and polite, are necessarily men of violence. We speak of ‘touching’ a man’s heart, but we can do nothing to his head but hit it.

G. K. Chesterton

[Retra]

While I would agree with that in principle, I think the word "violence" is being stretched a bit. Being unforgiving, stubborn, demanding, hard-hearted, or anything adherence to logic might be claimed to imbue are not acts of violence, even if they are emotionally hurtful to others.

[Jtsummers]

Emotional harm is still violence. it is not a strictly physical phenomenon.

[Retra]

Emotional harm can be violent if it is forcibly inflicted on someone. If they volunteer themselves to be emotionally harmed of their own volition, this is hardly violence.

Rational thought is not violent, no matter how much it pains you to hear what it concludes. Disagreeing with someone is not violence, even if they can't bear to suffer it.

[Pica_soO]

I was molested by the universe, ever since i was evicted from the save space of the womb. ;)

I would feel so ashamed, for soiling myself with self-pity in public and to perceive the distance others take from me as a success of my output.

[michaelmrose]

That's not what that word means.

[oldmanjay]

Was there a meeting where someone took the explicit decision to have followers repeat this lie until other people believed it, or do people like you take it upon yourselves to repeat this lie out of the basic evil in your heart?

[dctoedt]

> UTexas, in this case

Got a reference for that? The Wikipedia discussion suggests otherwise: https://en.wikipedia.org/wiki/Object-oriented_programming#Hi...

[bendbro]

I think he's saying that by attacking California schools, the University of Texas was more likely to take Dijkstra in.

[Bromskloss]

Is the interview to be found on that page? I'm afraid I don't see it.

[eternalban]

https://www.youtube.com/watch?v=dDsWTyLEgbk

[ktRolster]

You know, I'm wondering: could part of Dijkstra's reputed arrogance be due to a cultural difference?

Dijkstra got a lot of attention from his essay, "Goto Considered Harmful." Even though he did not come up with that title, he learned from it that a hyperbolic saying can grab attention, and be used for good.

So thereafter, he spent a while when he would say things in the most flame-bait way possible, to gain attention, because it worked.

[jamesblonde]

I'm a lecturer in Sweden, and i know how you feel :) To quote some students on a list "What's this nonsense with independent thinking? Nobody ever told us we had to do that."

[vanderZwan]

Ouch. As if it's a chore instead of a privilege to get to do so!

Well, luckily my story had a happy ending: my colleagues (who were checking the assignments with me) stood up for me, and after the course other students defended me by saying "finally, a teacher willing to call out the freeloaders! It's so demotivating to see them get away with not doing anything while I put in so much effort and get nothing in response."

The reason my former boss had reacted like an overprotective mother was because the complaining students had made me look like someone who motivated through bullying, intimidation and fear. He takes his responsibilities of creating a safe space for students to learn and overcome their insecurities very seriously, and I respect that. Meanwhile, I have high expectations of my students precisely because I believe they are capable of so much more than they give themselves credit for, and he now understands and respects that, and has given me some pointers in how to get that across in ways that Swedes aren't allergic to. So we resolved our issues too.

But yeah, that was a pretty strong culture clash; in the end it was educational for everyone involved I think.

[shiggerino]

I can concur. The Swedes have turned into an absolute disgrace. Constant late-coming, talking and other distracting behaviour. They have become a nation of low moral fibre, pure and simple. I say become, because I refuse to believe this was the modus operandi of the likes of Linnaeus, Arrhenius, Berzelius, Celsius, etc.

I'm going through the motions myself, at an institution that shall remain nameless, knowing how kindly they take to criticism here.

[Qantourisc]

Belgium here: it's a bit the same. However HOW you say it matters to. First times you are expected to say it "without" emotion, like not being angry. Consequential times incrementally go nuts :D

[agumonkey]

Culture shock / Calibration. Similar to Russian approach on social politeness. Or the lack there of. They don't smile unless they have a real reason to be happy. For westerners they appears cold hearted.

Autistic persons are a bit like that too. They have a very simple optimization scheme, so pointing at suboptimal things directly is seen as a gift when most people will have a broad view on being told, shame, disrespect etc etc.

[Ma8ee]

Many, far from all, Swedish students are way to pampered with. I was call Gestapo because I pointed out that it isn't acceptable behavior to be 40 minutes late to the lab session and not having read the instructions beforehand.

But it is definitely also a cultural thing. The contrast became very obvious when we had Russians in the seminars. The Swede says things like "I don't think I really understand how you mean, could you maybe elaborate that point a little bit further". The Russians: "You are wrong and it's very obvious to even a high school student what your mistake is. And besides, all this has already been done in the Soviet Union 40 years ago."

[cafard]

I have heard of the cultural difference you refer to--my son worked in the Netherlands for some months. Yet I don't think that is all of it. Is it simple frankness to say that the use of Fortran damages the brain?

I do think that a good deal of the internet--the great unwashed both correspondents refer to--remember Dijkstra the insult comic better than Dijkstra the pioneer of computing. It doesn't improve discourse on the internet, I guess, or worsen it much either. I don't think it just to Dijkstra's reputation, though that is no responsibility of mine.

In his biography of Alexander the Great, Peter Green quotes the Athenian Demades's reproach to Philip:"King Philip," he said, "Fortune has cast you as Agamemnon; but you seem determined to act the part of Thersites."

[tangled_zans]

> I'm Dutch, and bluntly calling out flaws in each other's work is not considered all that rude over here; it's almost the opposite: not calling someone out on their flaws implies we either consider them a lost cause or not worth the hassle of educating.

Woah, I do that too! Maybe I should move to Netherlands.

[internaut]

I've always liked the Dutch for this reason.

If it isn't possible to work with somebody while disagreeing with them, then you're the problem. If you spend long enough talking to anybody you'll eventually come across disagreements.

Many people take disagreements too personally.

I was just yesterday talking to a paramedic. I mentioned to him the article I saw on HN about medical error being the 3rd highest cause of death next to cancer and heart disease.

He immediately started to attack me, exclaiming how I was not an authority in this area so how would I know what I was talking about and therefore had no right to talk about something like this.

I explained I was not the source of the information, and that large numbers of people inside and outside the medical profession are concerned that a great deal of medical research isn't reproducible and in any case if car accidents don't even touch the number of medical fatalities occurring then it's a problem since car accidents are so problematical it's one of the leading reasons we're trying to automate them.

He blew his top. Ad homs everywhere.

Later I took to the Net to see if I was correct in my impression. Turns out my 'Master of Paramedics who read lots of journals' can't have been paying much attention because the British Medical Journal and Lancet are in lockstep with everything I had been saying. In fact I was probably far too kind judging from what the leading lights of the medical profession are saying themselves.

I expect he would accuse me of being arrogant.

I've said it before but tribalism is very powerful. It is far more dangerous to Science than Religion and it definitely gets in the way of technological change.

[sukilot]

I don't know what your friend said, but the "errors are #3 killer" is a twisted fact. It comes from assigning "error" at the cause of death of every injury or illness that might have been non-fatal if every perfect test, advance in practice, technology, and mode of care were applied. It isn't a measure of how many otherwise healthy people were killed by errors that introduced new complications.

One of highlighted examples from an abstract of a major study was an "error" where a doctor didn't tell a kid with diagnosed heart disease that strenuous exercise would be dangerous, and the kid died after collapsing during a run.

[ScottBurson]

There's an interesting summary of the debate about this study on Medscape [0].

Failing to tell a patient that strenuous exercise might be fatal sounds like an error to me!

As it happens, my maternal grandmother was killed by a medical error (before I was born). She went in for some kind of routine surgery and didn't make it. Decades later, when the doctor involved died, among his effects were found a letter he had written to another doctor, explaining that he had made a stupid mistake that killed her. (I don't know any more details.)

Does that mean I believe the "#3 killer" claim? Not necessarily. But I'd bet that the problem is worse than most medical professionals would expect, and that there remains considerable room for improvement.

[0] http://www.medscape.com/viewarticle/863788

[eruditely]

tell us more about your grandmother's story.

[ScottBurson]

I don't know anything else about it, except I can add that it would have been about 1952, in Alabama.

[internaut]

Ack, I thought you were talking to me. Sorry!

[internaut]

It happened with my father's birth I think. He was the oldest of seven children like typical Catholic families of the time. As a child I knew she walked kind of funny but I put it down to her being an old lady (she wasn't but to a child's eyes it's different). As with something you're familiar with you don't question it. Later my father joined a cult and developed an acrimonious relationship with my grandfather who believed the cult was trying to steal his property and so he disinherited my father. We moved away while I was still very young and so I didn't see my grandmother for a time. In my late teens my father and grandfather became more friendly and we visited occasionally.

My grandmother was becoming ill, first diabetes, then Alzheimers. Around this time I learned from my mother than the doctors in the Bons (as we called the Cork Hospital) had performed a Symphysiotomy. My mother described it as a butcher shop involving hacking and sawing. I think a radio show prompted her outburst on the topic, although she and my grandmother didn't get along she obviously felt deep revulsion about the affair. As with most of the women I don't think they asked for permission, they just wheeled them into surgery. I think what galled my grandparents the most is that they perceived the Bons to be a much superior hospital to all the others. It was private. It had reputable doctors. It was Catholic. They were farmers so this would have been a considered expense for them. I'm confident they didn't want to talk about it, it was probably too much.

In this diagram on the wiki you can see what happened: https://en.wikipedia.org/wiki/Symphysiotomy#/media/File:Skel...

The part marked '5' was severed using something like a wood saw or circular saw. Saying they broke the pelvis isn't an exaggeration.

The accounts from the wiki are grotesque. Catherine McKeever, a private patient at the Lourdes Hospital, Drogheda in 1969, told the Committee that she did not realise what had happened: 'I saw him [the doctor] with an instrument which I thought was a bit brace because my father was a wood turner. I felt a crack … Nobody answered me or said anything'. Margaret Conlan, who was operated upon in 1962 in St Finbarr's Hospital, Cork, testified that she had never been told anything about it: 'My baby’s head was perforated and the baby died… I did not find out [about the symphysiotomy] until I read it in the newspaper'.

It seems the practice was done to encourage more children. I'm not familiar with Catholic dogma so I don't understand why doctors would foist on their patients. Today I wonder today how the Muslim and African doctors are getting away with FGM in Irish and English hospitals, so in a way the barbarism continues. Don't trust religious fanatics or doctors and especially not both.

The problem is that they both tend to come well dressed and respected by their communities. Taking them down makes you the bad guy, not them.

[internaut]

> Does that mean I believe the "#3 killer" claim? Not necessarily. But I'd bet that the problem is worse than most medical professionals would expect, and that there remains considerable room for improvement.

Yes exactly, that's my position.

I feel that doctors are overworked generally, don't sleep very much so it's not surprising they don't have the time for introspection on this subject. The error rate is probably largely caused by economic factors like the perpetual labour shortage (in Ireland/UK at least).

On a personal level my grandmother had her pelvis snapped by doctors.

http://www.irishcentral.com/news/irish-woman-awarded-600000-...

In my own experience with a (not life threatening) medical procedure I went to three different doctors asking for help. None was given. They ignored my requests for analysis and a solution. I didn't even know what was wrong.

Finally I went online, found out what the problem was about, found out what the solution could be for it, and then I literally took a flight to England to get an experienced medical practitioner to sort it out which he did very professionally for a reasonable fee.

After this I complained to the medical ombudsman. Only then did they get into a flutter after literally years of waiting for them to solve the problem. A solution was provided that I no longer needed and I told them so. In fact I had already told them so but they weren't paying much attention. Pretty sure I could have sued them into the ground for malpractice.

I work with a coworker who broke his ankle falling down from a ladder. A horrible injury that shattered. That didn't even turn out to be the real problem though because after going into the hospital a doctor didn't wash his hands, and put them into the wound, infecting it with MRSA. My coworker who was awake, literally asked him to wash his hands right there and the doctor said "No, it's Ok".

I'm just one guy in his twenties and I can think of 3 cases like this. That is not good!

Lastly on an optimistic note my uncle fell off a roof he was working on with roof tiling. He fell two stories and behind him a trolley containing roof tiles slipped down and onto his back, almost snapping his spine in two.

The doctors fixed him up with steel plates, taking them out years later. Now he walks around like nothing happened (still on roofs!) but it's an amazing feat of medical attention to detail that this is true given his spinal column was almost severed.

[internaut]

Yes I realize that. The BMJ paper is using hyperbole to prove a point (just like Dijkstra's GOTO considered harmful). It's not really the #3 killer but to be honest it should not be in the top ten of things likely to kill you or even close to it.

The medical profession, much like the teaching profession has a nasty habit of victim blaming if things go wrong when it can get away with it. They need humbling because they are too confident. They are highly resistant to this because it diminishes their status and few people enjoy a loss of confidence even if introspection is required for improvement. Computer people tend to take this for granted because we're in a feedback loop with the compiler that tells us constantly when we're in the wrong. That we're fucking idiots all the time isn't news to us. It is news to some other professions that don't have such a tight feedback loop between success and failure.

It is true for example that people don't take their medicine on a timely basis but frustration of dealing with people has bled into other areas and that is unhealthy.

[nonbel]

>"That we're fucking idiots all the time isn't news to us. It is news to some other professions that don't have such a tight feedback loop between success and failure."

This is great, there is nothing like thinking "wtf is wrong, someone changed some library last update and that is the cause", then hours later realizing you are a moron.

How exactly can this happen in medicine without severe social consequences?

[internaut]

Instead of library updates imagine half the doctors and nurses don't speak English with a high degree of fluency and don't come from the native culture. That is so obviously a problem for communicating subtleties that it's infuriating that it has to be explicitly pointed out.

Speaking of reform. I think the only answer is closing the gap between action and success/failure i.e. a tighter feedback loop.

Some futuristic thinking is required.

For surgery I would propose a VR sim in which they performed the same surgery again and again, with the details/features changing all the time. Then at a high level of proficiency I would copy the real movements to a machine copying the surgeons actions on a real patient with the feedback visual presenting itself to the surgeon as part of the sim.

- This helps homogenize surgeons movements.

- Increases confidence of a successful operation.

- Allows for high level practiced skill rapidly.

- Removes them from the theater directly to prevent disease.

- Calms the nerves so the surgeon is able to work without fear.

- System gets better over time with more data.

For diagnostics I would record the patient's voice describing her symptoms with a visual of the person. I would then pattern match for related conditions in my database that appear to resemble the symptoms. The system has some degree of common sense as it is a traditional expert system. Audio/Video inputs would be used to make requests e.g. can I see your arm that is paining you for more detailed visual analysis using machine learning. Vocal analysis for other detectable disease. Finally a list of options would be offered up to the doctor as plausible possibilities. In the beginning these would be offered up after the doctor made an independent diagnosis and a second opinion would also be made. This is to give feedback accuracy to the diagnosis system. Later on the 'obvious cases' would be presented to a doctor in real time as the patient began describing his or her symptoms. This would be presented either as a list or perhaps more appropriately as a mind map.

- Acts as a medical record.

- Logic behind choices can be retroactively justified.

- General practitioners can see patients faster because they won't need as many notes.

- Patients will be more confident in their diagnosis with a digital second opinion.

- Prescriptions can be autofilled to prevent error.

- System gets better over time with more data.

Now it is important to note I have no idea what I'm talking about. This took literally 30 seconds to come up with. So why hasn't something radically better already been done? I say it is very simple. It is not allowed. It is defacto illegal to do any of the above. You can't even digitize medical records properly. That is frightening.

The only way this is going to work is if we

- Provide services where they are impossible e.g. third world.

- Only provide this technology to private healthcare. Possibly even on Seasteads to avoid anti-tech litigation.

- The government creates a SMZ (Special Medical Zone) outside of the medical establishment's reach.

In addition to this you'd have to make the general public aware of how bad their healthcare really is. That's the only way to get "Tech companies screw 3rd world with experimental medicine" stories from whoever will be the next Gawker off your backs because the established order is going to do everything it can to blacken your name.

[nonbel]

>"Now it is important to note I have no idea what I'm talking about. This took literally 30 seconds to come up with."

I think you have some great ideas.

>"So why hasn't something radically better already been done?...In addition to this you'd have to make the general public aware of how bad their healthcare really is."

Maybe at this point the consequences would be worse than the current problem, at least in the short term.

[frank_jaeger]

A doctor failed to tell a CHILD about an appropriate level of activity for his condition, and you honestly have the gall to put quotes around that error?

[kazinator]

That child could have easily died running involuntarily from bullies or dogs. Or from having his heart race due to anything else: being startled, nervous, or excited on a first date or whatever.

He didn't die while undergoing a medical procedure; he died of a bad ticker.

The medical establishment didn't cause his heart ailment, it just neglected to inform him. That is unfortunate, but it is somehow not the in the same category as, say, being treated for a broken leg, and given a fatal overdose of some painkiller.

Honest accounting for deaths due to medical error must only count situations when someone dies of something irrelevant, not directly connected to the condition for which they are treated. (Certainly not of the condition for which they are treated, especially if that kind of condition itself carries a reasonable probability of causing death!) That cause of death which occurs must not be a recognized risk factor in that kind of treatment (when that treatment is correct).

The key reasoning is that without any medical intervention at all, the child would also have likely died, and of the same thing.

If we count as a "death due to medical error" a situation in which medicine merely failed to prevent a death, that has to be very well justified. This means that it was very probable that if the mistake had not been made, the patient would have made a full recovery: their condition would have cleared away to the point of that condition no longer being a death risk, and that this positive outcome is virtually guaranteed in such cases when the correct treatment is applied.

The advice not to ever strain yourself physically for the rest of your life or get excited is not a treatment which results in the condition being cured. The condition remains in place, along with the risk of dying.

[kazinator]

The dude is a paramedic. His job is to drive like a madman through red lights to emergency situations to frantically try to save someone, not to weigh the merits of research.