Iatrogenics

Iatrogenics. That’s a fancy word that I came across in Antifragile by Taleb. Iatrogenics refers to a situation when intervention causes more harm than good. A more straightforward term for this is “naive interventionism”. Alright, perhaps that’s not easier as well.

There are several examples of situations when naive intervention backfires. In Antifragile, Taleb gives this example:

In the case of tonsillectomies, the harm to the children undergoing unnecessary treatment is coupled with the trumpeted gain for some others. The name for such net loss, the (usually bitten or delayed) damage from treatment in excess of the benefits, is iatrogenics.

The medical field abounds with such examples. Doctors prescribe unnecessary treatments and surgeries, and in some cases, we are upset if the doctor suggests nothing. But it is not limited to the medical field. In software engineering, we are always trying to add new features to alleviate and improve existing software. The government is also constantly proposing policies.

The primary cause for this is that we are biased towards action (also see “additive cognitive bias”). And we fall victim to confirmation bias and so forget to reason about the downsides of doing something.

So how do we avoid the downsides of naive interventionism?

Here are some ways:

Think through the consequences. You are probably forgetting the second and other higher-order consequences.
If someone suggests an intervention, check to see if they have skin in the game. If the person suggesting the intervention doesn’t have to suffer any of the consequences, it is likely they may not have thought through the negative consequences.
Use systems thinking, and in particular, the iceberg model can help.

When presented with a problem, the iceberg model suggests that what you see is just the tip of an iceberg, and you need to look under the surface to see what else is happening. When an employee doesn’t perform well, there is probably other things happening in the employee’s life that might be causing the employee to underperform. Without knowing the real reason, your intervention may not be a good solution for the employee or for the company.

Next time someone suggests something, check to see if doing nothing is a better strategy.