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
- 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
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
Hammurabi's Code Contained
about 250 laws 33
"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)