Iatrogenics: Why Intervention Often Leads to Worse Outcomes

He talks about bloodletting but ignores the elephant in the room: circumcision.

You go to the US and you have to be careful if you have a boy because they will circumcise your child without asking for permission.

If you ask Americans they will tell you that it is an hygienic, prophylactic measure, but the real reason is that it became fashion to copy the British royal family that did it, and after that they just continued the tradition.

People support it not because they "don't have skin in the game" but because they have. Because the majority of them were already circumcised and there is no way back,or experience the alternative, so they want to believe there is a real reason for that, instead of the bogus Royal thing.

I asked a lot of people there and they painted a terrible world if you dare not to do that. I come from a country in which 90% are not circumcised and the image they had about the alternate reality was surreal and made no sense.

Another thing that Americans do is boiling eggs requirement, for "hygienic" reasons, destroying natural antioxidants, or natural antibiotics and antifungi so eggs could be way more dangerous than natural ones after time.

In France we had irradiated food for a long time. Crazy if they don't let you choose.

Today there are lots of things that could lead to secondary effects:

You have forced Water fluoridation. You have forced GMO food you could no opt out. Forced electromagnetic signals everywhere you can not opt out. Forced flame retardant in foams, sofas and bed mattresses. Forced COVID vaccination.

But the most absurd of all is the Daylight Saving Time.

I believe the real culprit of that behavior is human hubris. People simplify the world, and under the simplification a new idea is fantastic.

So for example you take the statistics and see smokers usually burn their houses while they smoke in bed and something happen, and forcing everybody to use flame retardants will save the risk of those people, but you can not see the new dead people that you create after they get cancer that will never smoke in bed.

Related to N. N. Taleb, his colleague and CIO of Black Swan fund Universa Investments Mark Spitznagel [1] discusses iatrogenics in the context of hedge funds in a recent interview [0], at 18:20.

[0] https://www.youtube.com/watch?v=s5yVDVIvQL4

[1] https://en.wikipedia.org/wiki/Mark_Spitznagel

While conservatives love the stories of interventions failing with second order effects being worse than the initial situation, in practice these are only rare instances among plenty of successful intervention we don't even think about.

The main factor leading to a disaster is usually the desire to make grandiose interventions (instead of steadily increasing ones that have proven successful at small scale) and refusal to listen to early signs of something going wrong. That is, if you're Mao Zedong or any kind of dictators with a “brilliant plan”®, then your intervention have a high risk of such failures, but otherwise the odds are low.

In the medical field, cases of interventions being harmful are not rare, and entire classes of interventions have been reconsidered in light of evidence.

In my experience, bad mental models in medicine lead to all kinds of horrors for entire classes of patients. If they decide to call it a genetic disorder, they throw their hands in the air and give up on actually making you better and trot out phrases designed to politely break you of demanding such, like "the normal progression...", a phrase intended to make you accept that you will get steadily worse, you hurtling towards your death is nothing to be concerned about and please stop annoying your doctor by expecting real help.