Although it is certainly written by a human being, this article gives me a similar feeling to ChatGPT essays. The tone is compelling and plausible. But when I thought about it, I realized it didn't make much sense.<p>> Rarely do we even consider that the cost of doing something might outweigh the benefits.<p>Cost vs benefit is the main thing that people consider when making decisions. It's a core decision making framework taught as early as elementary school social studies. Institutional decision making is rife with processes for assessing risks and performing cost-benefit analysis.<p>> Intervention—by people or governments—should only be used when the benefits visibly outweigh the negatives.<p>This advice is the decision making equivalent of "just don't write code with bugs." Easily achievable but pretty useless and completely impractical. Real world decision making involves operating under uncertainty at almost all times. If it didn't, the topic wouldn't be worth writing articles about.
It takes homeostasis, a biological mechanism, and tries to suggest that it applies to politics and economy, too. What a strange ideea...
Yes, the decisions to intervene should be taken more carefully, but I don't think that interventions "often leads to worse outcomes". In fact, where I live, indecision and lack of interventions are a very big problem.
You can’t sell non-action.<p>It’s a broken window problem. It’s difficult to measure the value of leaving stuff alone. The line on the chart doesn’t go up.<p>We intervene because it allows us to sell product. There’s no commission on discretion.
The word “Intervention” is just fraught with unconscious bias and makes it seem like the intention that motivates an action is relevant when it is not. The characteristics noted in the essay apply to all actions.<p>No one would characterize the Industrial Revolution or adding lead to gasoline as “intervention” yet clearly the second-order thinking this article prescribes for “interventions” needed to be applied in those cases.<p>“The key lesson here is that if we are to <i>act</i>, we need a solid idea of not only the benefits of our <i>actions</i> but also the harm we may cause—the second and subsequent order consequences.” is more correct but doesn’t serve this author’s agenda.
Intervention wouldn't be so bad if it wasn't so hard to roll back on interventions set in motion that turned out to be a failure. When dealing with complex systems specially, our attempts to make things "better" often don't go so well.
I read something recently here, comparing this phenomenon to the phenomenon of overfitting.<p>The gist is that we want to leverage our ability to measure things that are easy to measure, which are correlated with things that are hard to measure, and then optimize for those things. The downside being that you will always implicitly be sacrificing the things you don't/can't measure, and these sacrifices tend to occur in greater marginal amounts as the low hanging fruit gets eaten.<p>There are obviously interventions which are so ill convceived that they have no place being implemented in the first place, but this mechanism applies to every intervention eventually.
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.<p>[0] <a href="https://www.youtube.com/watch?v=s5yVDVIvQL4">https://www.youtube.com/watch?v=s5yVDVIvQL4</a><p>[1] <a href="https://en.wikipedia.org/wiki/Mark_Spitznagel" rel="nofollow">https://en.wikipedia.org/wiki/Mark_Spitznagel</a>
I learned this big time as a parent: If the only solution you have is guaranteed to make it worse, it's better to stand there and watch it burn than to put out the fire with gasoline. The piece I wrote about it (titled <i>The Hand Licking Incident</i>) did well on HN if you want to read a variation on this theme.
Doctors are always thinking about the potential for harm in their therapies but you don't always have a lot of options. For example, amoxicillin is the standard of care for strep but some people are allergic. Azithromycin is also standard but overuse of macrolides is driving resistance in organisms that are already resistant to other antibiotics.<p>I understand the article is really trying to reach into medicine to find the reason to push back on other actions. If doctors recognize they can cause harm when they try to heal, so must other practitioners, presumably politicians, bureaucrats, engineers, marketers, activists, parents, etc.<p>It's not enough to identify the problem. We can bias for or against intervention. But neither bias is scientific or necessarily likely to produce a good outcome without externalities or adverse effects. Ideally we would try more things with small samples and also try to understand externalities, comparing that to other possible interventions or nonintervention. However, the status quo bias also has an implicit blind spot, which is assuming that things will remain the same. Unfortunately, conditions do change.<p>We also have a problem with the moral aspect of the question. Who has the right to intervene? Who has an obligation? Is it moral to decline to intervene? If you intervene for good reasons, but cause bad outcomes, is that a moral failing? Is one person's assessment of the outcome more morally correct than another's?
Someone needs to write an update to the classic book Medical Nemesis by Ivan Illich. A short review gives the flavor:<p><a href="https://jech.bmj.com/content/57/12/928" rel="nofollow">https://jech.bmj.com/content/57/12/928</a><p><a href="https://en.wikipedia.org/wiki/Ivan_Illich#Medical_Nemesis" rel="nofollow">https://en.wikipedia.org/wiki/Ivan_Illich#Medical_Nemesis</a>
> 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. Otherwise, how will we know when, despite our best intentions, we cause more harm than we do good?<p>I've watched enough time travel shows to know that we don't fully know the "benefits" of our intervention, in addition to the "harm".
American politics are riddled with examples - look at the Patriot Act and the Affordable Care Act. It seems to happen most with sweeping legislation. Of course, large legislation will have additional consequences because the point is it intervenes more. The flipside is that administrations that don't pass laws are referred to in derogatory ways - they are a lame duck. We've basically forced action, any action, no matter the consequences.
He talks about bloodletting but ignores the elephant in the room: circumcision.<p>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.<p>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.<p>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.<p>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.<p>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.<p>In France we had irradiated food for a long time. Crazy if they don't let you choose.<p>Today there are lots of things that could lead to secondary effects:<p>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.<p>But the most absurd of all is the Daylight Saving Time.<p>I believe the real culprit of that behavior is human hubris. People simplify the world, and under the simplification a new idea is fantastic.<p>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.
This misses the problem of scale. Often the only way to patch an existing system is to try small and localized changes and then propagate them slowly. Even correct changes may require unexpected related details to be in order for a successful result. Going slowly allows for analysis of related factors and anticipating range of variation.
Was hoping to find an intelligent and well researched article on medical interventions. Instead it's just some extremely hand wavy libertarian college essay.
this reminds me of the 'leading change' performance metric some mil leaders were (are?) evaluated on. the incentive is to be seen making changes, but there isn't anything about following up to ensure the change accomplished anything.
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.<p>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.
Homeopathy has been widely ridiculed as having no scientific basis, but in terms of outcomes, it might have been better than the heroic interventions of times past, such as bloodletting, mercuric chloride enemas, and whatnot.<p>Of course, there are no 'crystal signatures' in water and homeopathy has no more scientific basis than astrology does as an actual cure for anything - just a less bad approach compared to the above.