1) No, machine learning perfoms better than typical "risk scores" such as the RCRI (it was not tested against doctors clinical judgement)

2) Even so...so what? What we don't have is any reliable way to reduce surgical complications when the benefit outweighs the risk when the risk is elevated

For 2) I guess that if you know you will die with high probability, you will search for ( if at all possible) an alternative treatment ( which might have side effects but at least you’re alive ) ?