[HN Gopher] Iatrogenics: Why Intervention Often Leads to Worse O...
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Iatrogenics: Why Intervention Often Leads to Worse Outcomes
Author : rygxqpbsngav
Score : 76 points
Date : 2023-02-12 11:36 UTC (11 hours ago)
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(TXT) w3m dump (fs.blog)
| [deleted]
| MadSudaca wrote:
| 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.
| pixl97 wrote:
| The path to hell is lined with good intentions, but we must
| never forget it is paved with bad intentions.
| anonymouskimmer wrote:
| The sunk cost fallacy applies to both interventionism and
| noninterventionism. "An ounce of prevention is worth a pound of
| cure" is an idiom for a reason.
|
| What made interventions such as the Berlin Air Lift work is
| that they were stuck with until they were no longer needed. An
| unanticipatable effect of the Berlin Air Lift was the "Tear
| down this wall" speech and the end of the USSR.
| MadSudaca wrote:
| How do you know that was an unanticipated effect? Also, what
| about all other cases where interventionism didn't work, that
| is, made things worse? How can you tell a priori wether
| intervening will have good results? Moreover, if you're a
| decision-maker, will you bear any cost if your decision turns
| out wrong? If not, how is that supposed to be ethical?
| anonymouskimmer wrote:
| I'm just stating that lack of action is an action. I'm not
| arguing the points you're asking me questions about.
|
| > How do you know that was an unanticipated effect?
|
| Wanting to support Berlin so that the communist regime
| would eventually collapse might be a desired outcome, but
| the way it happened couldn't have been anticipated, it
| could at most be wished for. Wishfulness is the very thing
| the parent article is arguing against.
|
| > How can you tell a priori wether intervening will have
| good results?
|
| You try to learn history and figure out parameters for
| successful predictions?
|
| > Moreover, if you're a decision-maker, will you bear any
| cost if your decision turns out wrong? If not, how is that
| supposed to be ethical?
|
| I don't disagree? Ethics effects exist to encourage people
| to take precautions when it comes to the effects of their
| actions or inactions. There are obviously entrenched
| interests that push back against ethical consequences.
| empeyot wrote:
| Iatrogenesis (adj.: iatrogenic) is, I suspect, what the fist word
| should be.
| empthought wrote:
| 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.
|
| 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.
|
| "The key lesson here is that if we are to _act_ , we need a solid
| idea of not only the benefits of our _actions_ but also the harm
| we may cause--the second and subsequent order consequences." is
| more correct but doesn't serve this author's agenda.
| potatohead00 wrote:
| 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.
| ouid wrote:
| I read something recently here, comparing this phenomenon to the
| phenomenon of overfitting.
|
| 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.
|
| 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.
| M95D wrote:
| 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.
| readthenotes1 wrote:
| There is a fairly famous story in management of a guy in the
| 1960s who fought against building housing projects for the poor
| by tearing down neighborhoods and building big high rises.
|
| The idea was to give more people a better place to live.
|
| What the opponent said was you're going to concentrate a bunch
| of poor people in a building that neither we nor they will
| maintain, it will be far away from any jobs, and it will lead
| to more crime and more poverty.
|
| I don't think it takes much to say that people are short-
| sighted and some are only interested in their own personal
| short-term gain, certainly no metaphor or analogy is needed to
| state the obvious.
| zamfi wrote:
| This is a very interesting story, but I feel like I'm missing
| something -- any chance you could dig up a reference to this
| for us?
|
| Housing projects and private high rises seem like they would
| have similar problems...I'm not finding this easily, but
| confess I have no academic background in management!
| AlbertCory wrote:
| > any chance you could dig up a reference to this for us?
|
| you could search for Robert Taylor Homes in Chicago (torn
| down) or Pruitt-Igoe towers in St. Louis (torn down), for
| starters. Or the Cabrini-Green Homes in Chicago.
| zamfi wrote:
| Ah, thanks, yes I'm familiar with the legacies of torn-
| down public housing projects.
|
| It was the private ones and the implied comparison that I
| was after -- but now that I'm re-reading the parent post
| maybe there was no comparison, just a long sentence
| describing public housing projects _as_ torn-down
| neighborhoods with high-rises...
| manmal wrote:
| Isn't that what Adam Smith was all about? It's not a new idea
| at least.
| HPsquared wrote:
| See also, Le Chatelier's principle.
|
| It kind of makes sense, if a complex system has found some kind
| of steady state there must be some "restoring forces" at work
| to hold it there.
| kryogen1c wrote:
| > if a complex system has found some kind of steady state
| there must be some "restoring forces"
|
| I think this is one of those things that is True with a
| capital T.
|
| If you start with the premise that life is valuable, it is
| eventually derivable. Life tries to exist, and since
| existence is path-dependent making a change is likelier to be
| wrong than right.
| karrot-kake wrote:
| > making a change is likelier to be wrong than right.
|
| This agrees with the slightly-neutral theory of evolution.
| A given mutation is more likely to break something a little
| bit than improve that something a little bit.
| empthought wrote:
| I think you and the parent commenter are talking about the
| anthropic principle. It might be "derivable" but only in
| the particular situation in which we have found ourselves--
| and then it becomes less remarkable.
| kryogen1c wrote:
| > the anthropic principle
|
| How interesting. Can't exactly run a placebo controlled
| double blind experiment against the full state of the
| universe, hm?
|
| I've never thought about the universal preconditions that
| must be true for me to be thinking about them. This is
| shifting my whole worldview, thanks!
| empthought wrote:
| Glad to have spurred some thought... thanks for telling
| me!
| voldacar wrote:
| It is strictly true, in the sense that a _stable_
| equilibrium state is a potential well in a system 's phase
| space.
| photochemsyn wrote:
| Complex systems can have multiple different 'steady' states
| (many valleys in a complex mountain range of energy minima
| and maxima, in that sense), so while there may be local
| restoring forces, climbing out of one steady state and into
| another is extremely common.
| 4RealFreedom wrote:
| 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.
| Spooky23 wrote:
| No, lame duck administrations are when you're in office with a
| selected successor.
|
| Both of the laws referenced were very strategic laws that
| largely accomplished their purpose. The ACA in particular was
| designed to appeal to republicans first - it was in alignment
| with old guard GOP values. It patched some of the holes in
| healthcare (pre existing conditions, etc) and drove the
| economic activity that will drive future universal healthcare
| (the consolidation of providers into health networks) when
| political conditions allow.
|
| Overall US governance is deliberately designed to make doing
| something impossible. Think of any issue of the day that would
| benefit from Federal action. In general, nothing at all happens
| unless it's some spin on an existing law.
| 4RealFreedom wrote:
| I agree that I didn't use lame duck in the textbook
| definition but it does show the derogatory nature of not
| doing anything. Likewise congress would be called ineffective
| if they didn't pass laws. We often hear about gridlock when
| there's a balance of power with the 2 party system. I think
| saying 'deliberately designed to make doing something
| impossible' is an overstatement. Compromise is required. I
| see more and more that neither party wants to compromise,
| though. From my perspective, it's hard to talk about any
| Federal action that would be of benefit. Granted I'm jaded
| from seeing and being part of second order consequences. What
| kind of Federal action did you have in mind?
|
| Edit I didn't address one of your points. You said the laws
| largely accomplished their purpose. What did you see as their
| purpose?
| Spooky23 wrote:
| The Senate is a brake on change. In the most egregious
| example, the House passed anti-lynching legislation for 50
| years, which never made it out of Senate committee.
|
| Patriot act was ultimately designed to avoid the types of
| failures to coordinate that stopped the authorities from
| preventing 9/11 attacks. It was very successful at that
| aim, but created a bunch of other problems in the process.
| My statement isn't an endorsement of it.
|
| ACA reduced the number of uninsured individuals by 50%,
| eliminated a few key policy holes (ie pre-existing
| conditions) and slowed cost growth.
| 4RealFreedom wrote:
| How successful was the Patriot Act? Without measurable
| benefits we can't really say. For the ACA, the numbers
| I'm seeing are much less than 50%. From the Kaiser Family
| Foundation "While uninsured rates decreased across all
| income groups from 2013 to 2016, they declined most
| sharply for poor and near-poor people, dropping by 9.7
| percentage points and 11.4 percentage points,
| respectively." From that same source "In 2017, the
| uninsured rate reversed course and, for the first time
| since the passage of the ACA, rose significantly to
| 10.2%." You bring to the table an important point,
| though. We need measurable benefits. The fact that
| there's even guessing at the purpose of bills shows the
| flaw. We should require goals with every bill. Without
| that we just have bickering on specifics which, by
| design, have never been communicated. Politicians use
| this lack of information to their advantage.
|
| Edit - source - https://www.kff.org/report-section/the-
| uninsured-and-the-aca...
| m0llusk wrote:
| That misses a lot of context. The Affordable Care Act is
| considered by many to be an attempt to meet medical care needs
| with a market solution while most competing ideas go a
| completely different route such as Single Payer. It isn't just
| a patch to a system, but an attempt to fit some difficult
| constraints. Portraying extremely complex systems as simple may
| be the most common form of the first failing listed here.
| 4RealFreedom wrote:
| What context was missing? You can argue that the ACA has
| benefits or the US system is complicated but I did not
| simplify anything. From the article "Intervention--by people
| or governments--should only be used when the benefits visibly
| outweigh the negatives." My argument was 'damned if you do,
| damned if you don't' and politicians do not worry about the
| consequences of their actions.
| m0llusk wrote:
| You are asking a question yet seem committed to ideas and
| political views already. here is an attempt to answer:
|
| Through the Industrial Revolution medicine increased in
| scope and complexity and cost. By the 1970s people expected
| access to hospital care which was increasingly expensive to
| provide. Around the world most developed nations came up
| with some kind of universal insurance or single payer
| system to handle this. The US went with employer based care
| which limits who is covered and puts a burden on business.
|
| Ongoing calls for universal basic care threatened market
| based care in the US, so Mitt Romney came up with a plan to
| provide universal care through government regulated
| insurance markets. Obama tried to bring this plan to a
| Federal level but was stopped by a complex array of social
| and political forces. As a notable example of what
| happened, Frank Luntz who often has interesting ideas to
| contribute to this day insists that the ACA was not an
| insurance program even though providing health care through
| private insurance was the central concept.
|
| So now there are people who see the ACA as a compromised
| attempt to save market based insurance provided medical
| care and others who see it as some kind of strange
| intervention amounting to socialized medicine which oddly
| enough is exactly what it was designed to avoid. Where ACA
| was adopted it seems to be working reasonably well, and in
| Massachusetts where the original Romney plan was adopted
| everyone is insured and gets care through private insurance
| markets coordinated by the government.
|
| The really big irony here is that by compromising ACA and
| then not even adopting it in some states it is increasingly
| likely that some kind of Single Payer system will end up
| being adopted at a Federal level. In this sense those who
| attempted political intervention have generated the most
| harmful possible result. That is the increasingly likely
| possibility that the existing system of providing health
| care in the US through insurance markets will be completely
| swept away instead of being reformed as Mitt Romney and
| Barack Obama advocated.
| 4RealFreedom wrote:
| It seems like you're focused on the implementation of the
| ACA here. I used the ACA as an example of secondary
| consequences. My question of context was because that's
| literally what you said. I was wondering how context
| related to my post which I could have been more clear
| about. You seem to be saying that context is everything
| no matter the secondary consequences and go so far as to
| give more context. Many people characterized the ACA as a
| Trojan horse at the time. Was that it's purpose? That's
| maybe a more appropriate question to all this - why
| doesn't congress add purpose to bills? We need measurable
| benefits to weigh. By sidestepping that part of the
| process, it's a guessing game - all bills are just a mash
| of secondary consequences. That's convenient for
| politicians and political parties but not the people.
| littlestymaar wrote:
| 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"(r), then
| your intervention have a high risk of such failures, but
| otherwise the odds are low.
| jtc331 wrote:
| Given virtually all interventions have no control how do you
| know they're successful?
|
| Now it may well be that many interventions are successful. But
| your _assumption_ of your conclusion is actually the bias the
| article describes.
| throw_pm23 wrote:
| In the medical field, cases of interventions being harmful are
| not rare, and entire classes of interventions have been
| reconsidered in light of evidence.
| littlestymaar wrote:
| There's several billion medical intervention of all kinds
| every year, harmful interventions do exist but they are only
| a very tiny fraction of the total.
| throw_pm23 wrote:
| Yes, but there are _kinds of_ interventions which turned
| out to be systematically harmful. For instance, in most
| developed countries it was a policy to thoroughly wash
| newborns, until they realized it was harmful.
| DoreenMichele wrote:
| 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.
| fwungy wrote:
| Medicine has become monopolized, politicized, and
| propagandized. There are many treatments for modern ailments
| that is legally forbidden for doctors to recommend or
| prescribe, or will cause the doctor lose their license.
|
| Doctors operate under the Standard of Care rules. If the
| doctor does not follow SoC they open themselves to medical
| malpractice liability. Problem is that the SoC is imperfect,
| especially for less common afflictions. Doctors often know
| their prescriptions will not help their patients or even
| worsen conditions, but recommending non SoC treatments will
| potentially cost them the medical license that came to them
| at high cost and represents their livelihood.
|
| It can be argued that the SoC maximizes EV and minimizes cost
| across the population, however, even if that were true on day
| 1 of the implementation it would quickly degrade as
| bureaucratic lockin blunted the learning and innovation that
| doctors have historically used to advance knowledge.
| cpp_frog wrote:
| 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
| tonto wrote:
| see also: the noise/experimental music label (iatrogenesis
| tapes), created by brother of "casiotone for the painfully alone"
| [deleted]
| anonymouskimmer wrote:
| > 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?
|
| 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".
| QuadmasterXLII wrote:
| Somebody's mad that his taxes are paying for 5th grade teachers
| even though his kid's in 7th grade
| DoreenMichele wrote:
| 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 _The Hand Licking Incident_ ) did
| well on HN if you want to read a variation on this theme.
| m0llusk wrote:
| 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.
| Kamq wrote:
| This reminds me of Eisenhower's old quote to his advisors:
| "Let's make our mistakes slowly"
|
| Which, ironically enough, if you make changes slowly, and have
| a good way to back them out when they go wrong, you can change
| much faster. Mostly because you don't have people screaming
| about a change being the end of the world so hard that you need
| to go to war in order to change the smallest thing.
| CipherThrowaway wrote:
| 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.
|
| > Rarely do we even consider that the cost of doing something
| might outweigh the benefits.
|
| 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.
|
| > Intervention--by people or governments--should only be used
| when the benefits visibly outweigh the negatives.
|
| 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.
| marcosdumay wrote:
| > Cost vs benefit is the main thing that people consider when
| making decisions.
|
| I don't know what people you are talking about, but my
| experience is so different from this that I suspect your
| conclusion is purely platonic. You expect people to decide
| based on a cost/benefit analysis, or you hear people telling
| you they do.
|
| People almost never do a cost/benefit analysis. On the best
| cases, they analyze one of that pair.
| osigurdson wrote:
| I think they are saying that there are known costs and benefits
| but unknown costs are hard to quantify and unknown benefits are
| probably rare. Therefore the benefits need to be very material
| (several orders of magnitude as they state). Don't trade noise
| for noise.
| PragmaticPulp wrote:
| > > Rarely do we even consider that the cost of doing something
| might outweigh the benefits.
|
| > Cost vs benefit is the main thing that people consider when
| making decisions.
|
| This article also makes the mistake of equation "we", the
| average reader of the blog, with the doctors who are making
| prescribing decisions.
|
| Understanding the risks and side effects of prescribing a
| medication or procedure is core to the practice of medicine.
| It's integral to everything doctors do.
|
| The field of medicine is often criticized for not being
| aggressive enough with treatments, though these criticisms
| often come from people who only see the potential upside but
| not the risks. We saw this most recently with complaints about
| how long the FDA took to get vaccines out (which was actually
| lightning fast) or in how the field of medicine didn't rush to
| recommend theoretical COVID treatments based on small-scale
| studies and petri dish studies (which turned out to be the
| right choice, given that none of them replicated at scale in
| controlled studies).
|
| It's also the reason why the most _effective_ medication may
| not be the first-line treatment, because the first-line
| treatment is chosen as a tradeoff of risks versus benefits.
|
| Doctors know all of this. Unfortunately, doctors who decline to
| give patients the medications they think they need or recommend
| against surgical procedures patients think they want are
| subject to a lot of negative pressure in today's medical
| system. If someone goes into a doctor and demands antibiotics
| for their cold, the doctor must find a way to talk them down
| without risking another negative review which can impact their
| career and compensation in many systems. Some doctors just
| don't care enough, and will hand out prescriptions as asked.
| It's becoming a real problem now that medical systems have so
| many layers of middle management trying to put NPS scores and
| other feedback loops into the medical system, combined with
| social media pushing so many people to think they _know_ they
| need antibiotics or thyroid medicine or other treatments that
| come with more downsides than benefits.
| DVassallo wrote:
| Iatrogenics happens when the benefits are clear and the harms
| are hidden. So "rational" people tend to intervene because it
| would seem the benefits outweigh the costs.
| polskibus wrote:
| People use emotions and heuristics, not rational analysis when
| making most of their decisions. There is plenty plenty plenty
| of research on this.
| kaczordon wrote:
| And yet governments worldwide ignored the cost-benefit of
| lockdowns and removing kids from schools. Perhaps it's not such
| an obvious thing...
| vosper wrote:
| Or their cost-benefit analysis said that the cost of removing
| kids from schools was worth it.
|
| Do you have any evidence of ignored cost-benefit studies that
| were available at lockdown decision time (there wasn't much
| time for studies when these decisions needed to be made)?
| WillPostForFood wrote:
| _Or their cost-benefit analysis said that the cost of
| removing kids from schools was worth it._
|
| Cost is incurred by the children who have no voice, so zero
| cost to decision makers. Benefit is to one of the largest
| donor groups to politicians, so also large benefit to
| decision makers. Cost/benefit to society, population at
| large, the country? Seems to be willfully ignored.
| jtc331 wrote:
| Not having any studies to ignore is by definition not doing
| cost benefit analysis.
| dial9-1 wrote:
| your second paragraph kinda answers itself
| vosper wrote:
| My parent said cost-benefit was ignored, not that it
| wasn't considered.
| sebcat wrote:
| Does intervention lead to worse outcomes more often than not?
| photochemsyn wrote:
| 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.
|
| 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.
| barathr wrote:
| Someone needs to write an update to the classic book Medical
| Nemesis by Ivan Illich. A short review gives the flavor:
|
| https://jech.bmj.com/content/57/12/928
|
| https://en.wikipedia.org/wiki/Ivan_Illich#Medical_Nemesis
| cracrecry wrote:
| 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.
| hcayless wrote:
| I had an interesting experience as a child. I grew up in
| Barbados, where circumcision is not a common practice. In
| Biology class on day, the teacher talked about the practice,
| and basically everyone in the class went "Eww". I moved to the
| US the next year, and when the same topic came up in Biology,
| the teacher mentioned that in other countries, most men are
| uncircumcised. And the class went "Eww".
| anonymouskimmer wrote:
| Talk about private parts in a K-12 class and the response
| will universally be "eww". :)
| defen wrote:
| > 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.
|
| No, they won't, unless they really want to lose a slam-dunk
| lawsuit and possibly face criminal charges. Outside of a very
| limited set of circumstances, you can't just perform surgery on
| a person without their consent (or in this case, the proxy
| consent of the parents).
| fwungy wrote:
| The foreskins are used for expensive skin rejuvenation
| cosmetics and other high end products.
|
| Modern circumcision is evil. The foreskin is analogous to the
| clitorus. It is filled with nerve endings and keeps the head
| skin from keratinizing (hardening and losing sensitivity).
|
| Biblical circumcision was a notch in the foreskin. It was not
| the radical removal of it entirely.
| redeyedtreefrog wrote:
| Was hoping to find an intelligent and well researched article on
| medical interventions. Instead it's just some extremely hand wavy
| libertarian college essay.
| jwie wrote:
| You can't sell non-action.
|
| 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.
|
| We intervene because it allows us to sell product. There's no
| commission on discretion.
| akiselev wrote:
| Imagine a future where espionage between nation-states becomes
| impossible not because of omnipresent surveillance but because
| the multinational advertisers realize that spies have nearly
| unlimited disposable incomes backed by other nation states so
| they have the best click through ROI and thus get targeted by
| the most bizarre ads that civilians aren't.
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