Iatrogenics in High Places
Iatrogenics is harm caused by an intervention intended to help. Taleb extends the medical term to social systems, arguing that frequent intervention combined with limited understanding can overlook a system’s capacity to adapt.
THE IDEA
Iatrogenics in High Places
Two areas have been particularly infected with absence of awareness of iatrogenics: socioeconomic life and (as we just saw in the story of Semmelweis) the human body, matters in which we have historically combined a low degree of competence with a high rate of intervention and a disrespect for spontaneous operation and healing—let alone growth and improvement.
As we saw in Chapter 3, there is a distinction between organisms (biological or nonbiological) and machines. People with an engineering-oriented mind will tend to look at everything around as an engineering problem. This is a very good thing in engineering, but when dealing with cats, it is a much better idea to hire veterinarians than circuits engineers—or even better, let your animal heal by itself.
Table 3 provides a glimpse of these attempts to “improve matters” across domains and their effects. Note the obvious: in all cases they correspond to the denial of antifragility.
Click here for a larger image of this table.
![images/Tale_9780679645276_epub_078_r1.jpg] ![images/Tale_9780679645276_epub_079_r1.jpg] ![images/Tale_9780679645276_epub_080_r1.jpg] ![images/Tale_9780679645276_epub_081_r1.jpg] ![images/Tale_9780679645276_epub_082_r1.jpg] ![images/Tale_9780679645276_epub_083_r1.jpg] ![images/Tale_9780679645276_epub_084_r1.jpg] ![images/Tale_9780679645276_epub_085_r1.jpg] ![images/Tale_9780679645276_epub_086_r1.jpg] ![images/Tale_9780679645276_epub_087_r1.jpg] ![images/Tale_9780679645276_epub_088_r1.jpg] ![images/Tale_9780679645276_epub_089_r1.jpg]
When to use it
Evaluating the risks of aggressive medical treatments versus watchful waiting.
Assessing economic policies that attempt to stabilize markets but may increase systemic fragility.
Deciding whether to micromanage a project team or allow autonomous problem-solving.
Identifying when personal coaching or advice might do more harm than good.
FROM THEORY TO EVERYDAY LIFE
In practice
Unnecessary Antibiotics for Viral Infections
A doctor prescribes antibiotics for a common cold (a viral infection) to satisfy a patient's demand for treatment. The antibiotics cause side effects like diarrhea and contribute to antibiotic resistance, causing more harm than the self-limiting illness.
A MOMENT TO REFLECT
Put it to work.
Can you recall a time when an intervention in your life or work caused unintended harm that outweighed the benefits?
How can you distinguish between situations that require active intervention and those best left to self-healing or natural processes?
In what areas of society (e.g., healthcare, education, government policy) do you see iatrogenics occurring due to over-intervention?
CONTINUE THE CONVERSATION
Source texts
- Antifragile (Nassim Nicholas Taleb)