[littlestymaar]

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.

[DoreenMichele]

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]

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.

[throw_pm23]

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]

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]

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.

[littlestymaar]

True, but if you look at the entire collection of kinds of intervention you'll find that the harmful kinds are also a small fraction of them.

[jtc331]

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.

[littlestymaar]

> Given virtually all interventions have no control how do you know they’re successful?

Nobody ever ran a controlled trial on parachutes, how can we do know that they work?

Controlled trial aren't the alpha and omega of knowledge. They are powerful tools, but they also have a fairly narrow scope of applicability (and they are also a quite recent addition to the collection of scientific tools).