Well Intentioned Harms

Iatrogenics is when a treatment causes more harm than benefit. As iatros means healer in Greek, the word means “caused by the healer” or “brought by the healer.” Healer, in this sense, need not mean a doctor, but anyone intervening to solve a problem. For example, it could be a thought leader, a CEO, a government, or a coalition of the willing. Nassim #Taleb calls these people interventionistas.

Often these people come armed with solutions to solve the first-order consequences of a decision but create worse second and subsequent-order consequences. Luckily, for them, at least, they’re never around to see the train wreck they created.

Today we use the phrase iatrogenics to refer to any effect resulting from intervention in excess of gain. Some examples are easier to recognize than others. For example, when the negative effects are immediate and visible and appear to be a direct cause-effect, we can reasonably conclude that the intervention caused a negative effect. However, if the negative effects are delayed or could be explained by multiple causes, we are less likely to conclude the intervention caused them.

More controversial example of such phenomena would be military interventions in the Middle East. In these cases, linkages are clouded by narratives, moral arguments, and clear cause and impact. And when the linkages between cause and effect are murky, the very people who caused the harm are often the people rewarded for improving the situation.

The key lesson here is that if we are to intervene, we need a solid idea of not only the benefits of our interventions but also the harm we may cause—the second and subsequent order consequences.

Think about how a typical meeting starts. In response to a new product from a competitor, for example, the first question people usually ask is, “What are we going to do about this?” The hidden assumption that goes unexplored is that you need to do something. Rarely do we even consider that the cost of doing something might outweigh the benefits.

And the optics of doing nothing are not without consequences. It will appear to your boss that you’re not doing anything. You have an incentive to be seen as doing something even if the costs of taking action are high.