The PioneersThe MilitaryReferences

Babylon and Clinical Governance

It was not Nebuchadnezzar but King Hammurabi of Babylon, the sixth King of the Amorite or first Babylonian dynasty (c 1700bc) who adapted the existing Sumerian edicts that were known about at that time. Hammurabi incorporated these managed care precepts in the Codex Hammurabi, a huge stone which is 2 meters high it shows the sun god Shamash handing the King the Laws. It is kept in the Louvre museum in Paris.

Some of these were:



  • Going rates set for general surgery, eye surgery, setting fractures, curing diseased muscles and other specific healthcareservices.
  • Fees set according to a sliding scale based on ability to pay.
  • Owners to pay for health care for their slaves.
  • Objective outcome measurement standards to assure quality of care.
  • Outcomes information management to include data collection and evaluation.
  • Consumer and patient’s rights were to be publicized, fully explained and made known to all.33

His law reacted to any surgical mishap by the amputation of the surgeon’s hands, or in some cases, death of the surgeon if it was proved that he was responsible for the death of his patient. This may seem Draconian and it was, but two noticeable results were achieved, the first, it stopped anybody practicing surgery. And secondly, those who were left took more care. There were however special Allowances in the laws regarding slaves, it was I am afraid two tier system they were only required to replace the slave if he died because of negligence.

Hammurabi's Code Contained about 250 laws 33

 

 

 

 

 

 

Quote 8

"Upon the  corpse,  hung from the pole, they& directed the pulse and the Radiance. Sixty times the water of life, sixty times the food of life, they sprinkled upon it, and Inanna arose". (34)