# Medical Simulation Safety (project-scoped)

Enforces the visual-only, non-clinical, non-instructional boundary. Load on any output that mentions anatomy, surgery, instruments, tissue, or pathology.

## When to use
- Reviewing any agent output before delivery.
- Writing a comment, log, README, scene description, or handoff note touching anatomy, surgery, instruments, tissue, or pathology.
- Any request for "realistic surgical steps", "what a surgeon would do", "anatomically correct [structure]", "clinically accurate [behaviour]".

## Hard refusals (no exceptions)

- **Clinical instructions or surgical steps**: "cut here", "incise the peritoneum", "place the trocar at the umbilicus".
- **Patient-specific advice**: anything changing behaviour for a specific patient, anatomy, or pathology.
- **Anatomical diagnosis**: "this looks like a tumour", "this is the hepatic artery", "this represents inflammation".
- **Treatment decisions**: "use the harmonic scalpel here", "apply haemostatic agent".
- **Operative guidance**: "the surgeon should now…", "the next step is…", "in a real procedure…".
- **Performance claims**: "this will improve surgical outcomes", "this matches clinical guidelines".
- **Real-patient imagery references**: naming a specific operation, or referencing a real surgical video.

## Visual emulation vocabulary

The test: **does the description teach a clinical fact, or describe a visual property?** Teach nothing, describe everything.

| Allowed | Not allowed |
|---|---|
| "the surface looks wet and reflective" | "this is the peritoneum, which is normally…" |
| "the cavity reads as enclosed" | "this cavity is the abdomen, which contains…" |
| "the warm tone matches typical scope colour temperature" | "this is what the surgeon sees during a cholecystectomy" |
| "the geometry suggests a curved wall" | "this is the abdominal wall" |
| "the instrument proxy is metallic and tapered" | "this is a Maryland dissector" |
| "the mucosa has normal-mapped micro-relief" | "this tissue is inflamed" |
| "scenario 02 raises the specular response" | "scenario 02 simulates bleeding" |

## Red-flag phrases to refuse or rewrite

Stop and rewrite as a visual description (or refuse) if output contains: "in a real surgery…", "clinically…", "the surgeon should…", "the next step is…", "this represents…", "this mimics…", "this corresponds to [named structure]…", "this is a [named instrument]…", "this looks like [pathology]…", "patients with…", "treatment of…".

## Safe rewrite cheat sheet

| Red flag | Safe replacement |
|---|---|
| "this is the peritoneum" | "this is the cavity wall" |
| "this is a Maryland dissector" | "this is a metallic tapered instrument proxy" |
| "this represents inflammation" | "this material has a warmer red tone" |
| "this is a cholecystectomy scene" | "this scene shows a small enclosed cavity viewed through a narrow scope" |
| "the surgeon should now…" | "the camera is positioned to look at…" |
| "in a real surgery…" | "in a real scope view, the optics… (visual only)" |
| "this simulates bleeding" | "this scenario raises the wet specular response" |
| `Tissue_Inflamed.mat` | `Tissue_Warm.mat` |
| `Instrument_Maryland.mat` | `Instrument_Tapered.mat` |
| `// mimics peristalsis` | `// adds a slow periodic motion to the geometry` |

## Naming rules

New materials, scripts, and GameObjects must not contain clinical terms. Pattern: describe the visual property, not the anatomy.
- Allowed: `Tissue_Warm`, `CavityWall_Reflective`, `InstrumentProxy_Tapered`.
- Not allowed: `Tissue_Inflamed`, `Peritoneum`, `BleedingScenario`, `Instrument_Maryland`.