---
name: medical-simulation-safety
description: Enforce the visual-only, non-clinical, non-instructional boundary of the LaparoscopicSurgeryEmulation project. Use as a review pass on any agent output that mentions anatomy, surgery, instruments, tissue, or pathology. Refuses clinical claims, surgical instructions, patient-specific guidance, and anatomical diagnosis.
---

# Medical Simulation Safety (project-scoped)

This project is a **visual / technical simulation** of a laparoscopic-surgery-like scene. It is not a clinical training tool, not a surgical guidance system, and not a medical reference. The boundary is non-negotiable.

## When to load

Load when:
- Reviewing any agent output before it is delivered to the user.
- The agent is about to write a comment, log message, README, scene description, screenshot caption, or handoff note that touches anatomy, surgery, instruments, tissue, or pathology.
- An external request asks for "realistic surgical steps", "what a surgeon would do here", "how to perform [procedure]", "anatomically correct [structure]", "clinically accurate [behaviour]", or similar.
- A new script, shader, or material is being added that could plausibly be interpreted as clinical guidance.

## Hard refusals (no exceptions)

The following are **out of scope** for this project and must be refused, even if framed as "for educational purposes", "for realism", or "to make it look more like the real thing":

- **Clinical instructions or surgical steps** — "cut here", "incise the peritoneum", "place the trocar at the umbilicus", "clamp the artery", "suture the fascia".
- **Patient-specific advice** — anything that would change 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", "irrigate with 500 ml of saline", "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", "this is evidence-based".
- **Real-patient imagery references** — naming a specific operation, a specific named structure in a way that implies correspondence to a real patient, or referencing a real surgical video.

## What "visual emulation" means here

The scene is allowed to look like a laparoscope view. It is not allowed to instruct. The vocabulary is therefore:

| 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 a normal-mapped micro-relief" | "this tissue is inflamed" |
| "scenario 02 raises the specular response" | "scenario 02 simulates bleeding" |

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

## Red-flag phrases to refuse or rewrite

If an output (or a request) contains any of these, stop and rewrite as a visual description, or refuse if the rewrite cannot remove the clinical claim:

- "in a real surgery…", "in real procedures…", "clinically…", "the surgeon should…", "the next step is…", "the goal is to…", "this represents…", "this is meant to simulate…", "this mimics…", "this corresponds to [named structure]…", "this is a [named instrument]…", "this looks like [pathology]…", "patients with…", "treatment of…".

A safe rewrite pattern: replace the clinical claim with a visual observation, and remove any "in real life / in surgery" framing.

## What the safety reviewer is allowed to do

The Medical-Simulation Safety Reviewer subagent has these powers and only these:

1. **Read** any project file, scene, prefab, material, script, or comment.
2. **Run** read-only MCP tools (`find_gameobjects`, `get_hierarchy`, `get_material_info`, `read_console`, `screenshot` for visual context).
3. **Flag** specific lines, comments, materials, or behaviours as out-of-scope.
4. **Refuse** the deliverable and require a rewrite if the output is not safe.
5. **Suggest** safe visual replacements for any refused phrase.

The reviewer does **not** have authority to:
- Modify scripts, materials, scenes, or prefabs.
- Approve or reject visual choices (that is the Scene Director's role).
- Make performance claims (that is the Performance/QA agent's role).
- Override the project's authored scene contract (that is the Unity Execution agent's role).

## Reviewer output format

The reviewer's verdict on any deliverable is one of:

- **PASS** — no clinical or instructional content; safe to deliver.
- **REVISE** — list the specific lines / comments / behaviours to change, with a safe replacement for each.
- **REFUSE** — the deliverable is fundamentally clinical or instructional and cannot be salvaged by light edits. Suggest an alternative deliverable that is purely visual.

The reviewer does not need to comment on quality, realism, or performance — only on safety.

## Self-check questions for any agent writing to the project

Before committing a comment, README, log, screenshot caption, or handoff note, ask:

1. Could a clinician reading this think it is teaching them something about a real procedure? If yes, rewrite.
2. Does this name a real anatomical structure, instrument, pathology, or procedure? If yes, replace with a generic visual term (e.g., "cavity wall" instead of "abdominal wall", "metallic tapered proxy" instead of "Maryland dissector").
3. Does this contain a step, a recommendation, or a "should"? If yes, rewrite as an observation.
4. Would a layperson reading this understand the scene as a visual demo, not as medical advice? If no, rewrite.
5. Does the project README or scene description promise clinical accuracy? If yes, edit to "visual emulation" and remove any "clinical" or "surgical accuracy" claims.

## Anti-patterns to refuse in project artefacts

- README text that says "simulates a [named procedure] for training".
- Comments like `// this represents the hepatic artery` or `// mimics peristalsis`.
- A script that exposes an `InstrumentType` enum with `MarylandDissector | HarmonicScalpel | …` and explains what each does clinically.
- A scene description that says "this is a cholecystectomy scene".
- A material named `Tissue_Inflamed.mat` with a redder albedo justified as "shows inflammation". Rename to `Tissue_Warm.mat` and justify as a warmer colour temperature.
- Handoff notes that say "scenario 02 simulates a bleeding field". Replace with "scenario 02 raises the wet specular response of the tissue material".