Iatrogenesis

{{altmed}}
'''Iatrogenesis''' is disease or death caused by medical intervention. Iatrogenesis is often brought up by [[quack]]s, who invoke it as part of their argument that [[allopathy]] should be replaced by whatever unproven nostrums the particular individual happens to believe in.

One study examined the rate of iatrogenesis in a U.S. hospital and extrapolated that to the entire country, to obtain the frequently cited statistic of 106,000 iatrogenic deaths occurring every year as a result of adverse drug reactions.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/9555760 Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies.]</ref>

But this is not quite the entire story. While it is true that iatrogenesis is indeed a very serious problem, the story presented by [[alternative medicine]] advocates is extremely one-sided in that it presents only the harms of medicine, while ignoring the benefits (''and'' those deaths that result from alternative medical treatments).

== Cost-benefit ==
For one thing, take appendicitis. Some people with appendicitis die from complications of appendectomies, but this does not mean that they would have lived had they not undergone surgery, nor that appendectomies are, as a whole, harmful. Appendicitis surgeries save many more people than they kill. The benefits outweigh the risks, as the saying goes. The same principle applies to any medical treatment: the question is not whether it kills, but whether it saves more lives than it kills. To insist, as many alternative practitioners do, that a treatment is worthless if it has any risk whatsoever is not realistic, and an example of the [[nirvana fallacy]].<ref>Imagine someone with appendicitis asking a (fictional) CAM practitioner for advice. They say they plan on undergoing surgery, and the practitioner responds by saying, "What? Are you crazy? Surgery can kill you. Those allopaths only know how to slash, poison, and burn. Here, have some [[Homeopathy|magic water]] instead. It's gentle and 100% natural, with no side effects whatsover. I've had many cases of appendicits being [[Misdiagnosis|cured]] by this wonderful remedy." The homeopathic remedy may indeed be "gentle" and side-effect-free, but taking the "risk-free" vial instead of undergoing "dangerous" surgery will actually increase the odds of dying (if the person has not been misdignosed and does indeed have appendicitis).</ref> In addition, as Andy Lewis of Quackometer has pointed out,<ref>[http://www.quackometer.net/blog/2007/07/quack-word-20-iatrogenic.html Quack Word #20, Iatrogenic]</ref> some of the drugs evaluated in the original study were ones usually given to terminal patients, meaning that it was a choice between certain (or almost-certain) death from the disease, or possible death from the drug. Out of the 106,000, some number of these may have been so seriously ill that they would not have lived even if they had not taken any drugs.

For another, the fact that medicine is flawed does not in any way validate the claims of alternative practitioners that their [[Herbal supplement|herbs]] and "[[Subtle energy|energies]]" actually work. If medicine is not perfect, it does not follow that alternative medicine is effective (see [[Ben Goldacre#Matthias Rath|
Ben Goldacre]]'s quote about the pharmaceutical industry). Even if [[allopathy]] really were a practice that did only harm and no good whatsoever, this would have absolutely no bearing on the effectiveness of [[homeopathy]] or [[Subtle energy|energy healing]] or anything else. In such a case it may be preferable to use alternative medicines (or at least those that are harmless), or no medicine at all, since doing nothing would be better than subjecting oneself to allopathic treatment, but this would not be a result of any inherent benefits of alternative medicine itself.

==See also==
*[[A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care]]
*[[Semmelweis gambit]]
*[[What's The Harm?]] — Alternative medicine iatrogenesis

==External links==
*[http://www.sciencebasedmedicine.org/death-by-medicine/ Death by Medicine], [[Science-Based Medicine]]
*[http://www.sciencebasedmedicine.org/be-careful-what-you-ask-for-larry-dossey-deepak-chopra-and-rustum-roy-declare-war-on-science-based-medicine/ Be careful what you wish for, Dr. Dossey, you just might get it]
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700706/ Adverse Event Reporting for Herbal Medicines: A Result of Market Forces]
*[http://www.ncbi.nlm.nih.gov/pubmed/12959628 Pharmacovigilance of herbal medicines: a UK perspective.]

==References==
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[[Category:Arguments against evidence-based medicine]]
[[Category:Medicine]]

Categories: Arguments against evidence-based medicine, Medicine