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Due to the controversy surrounding assisted suicide, I am removing it from the list of iatrogenic circumstances, but leaving the brief mention in the text of that section. Daries 17:26, 30 March 2006 (UTC)
At the moment the article is purely about clinical iatrogenesis. I removed an article about social iatrogenesis because it was unsourced and vaguely biased against DSM, which is not the subject here.
Where are the really relevant sources? I'd like to see Ivan Illich and his cultural iatrogenesis here. JFW | T@lk 01:46, 3 May 2006 (UTC)
Without the word "unintended" in the definition, it should not be merged with the word "error." Sighalot ( talk) 12:40, 25 June 2014 (UTC)
Why are iatrogenic deaths not mentioned in the List of causes of death by rate article? Acetone, 8 November 2006
I apologize if I am not doing this correctly but this is my first time to contribute. I am bothered by a reference in this article to Complementary and Alternative medicine as being the same: Further, iatrogenic illness or death is not restricted to Western medicine: alternative medicine (sometimes referred to as complementary medicine) may be considered an equal source of iatrogenesis for the same reasons.
NIH's National Center for Complementary and Alternative Medicine differentiates the two as distinct from each other stating the Complementary medicine is used "together with conventional medicine" and Alternative medicine is used "in place of." Examples cited are aromatherapy for the former and "a special diet to treat cancer instead of undergoing surgery, radtiation...recommended by a conventional doctor" for the latter. Based on this distinction, it appears that complementary medicine should be removed from the citation that coincides with alternative medicine.
It is still possible that complementary therapists may cause iatrogenesis, but I would think it would be as a therapist working with conventional medical practitioner and therefore part of the previous reference in the article as "as a result of actions by others". Thanks for your consideration of this comment. Jgcarney 17:05, 1 March 2007 (UTC)
In this list, I changed "minimizing the possibility of negative drug effects" to "failure to minimize the possibility of negative drug effects"; I'm guessing at what the original writer meant, but if anybody knows different please say so. —Preceding unsigned comment added by 193.172.19.20 ( talk) 13:35, 15 October 2007 (UTC)
I added 'anxiety and annoyance' to the initial list of sources, since it is -extremely- common (even normative) for people to have higher blood pressure and heart rate and other stress-related effects in the presence of authority structures, medical personnel, or other context where individuals have others exert control over them. Experienced medical technicians are well aware that people might show hypertensive blood pressure who show no signs of hypertension outside the clinic. —Preceding unsigned comment added by 216.55.170.9 ( talk) 07:22, 25 April 2011 (UTC)
Would the deaths caused by fake medicine mentioned in Glycerin#Danger_of_contamination_with_diethylene_glycol be considered a kind of iatrogenesis? -- 68.0.124.33 ( talk) 06:24, 26 January 2008 (UTC)
From decade to decade, the emphasis and frequency of certain mental illness diagnoses varies considerably. For example, obsessive compulsive disorder was a more frequent diagnosis a decade ago, and bi-polar disorder is more popular now. There is no real epidemiological justification for these wide variations and unnecessarily designating a person as mentally ill is clearly an iatrogenic source of emotional stress, identical to a physician telling you that you have cancer, when you do not. Homebuilding 70.130.44.250 ( talk) 14:38, 6 September 2008 (UTC)
I have added refs to the section, deleted OR, made the language more NPOV and fixed a wikilink. ResearchEditor ( talk) 21:44, 27 April 2008 (UTC)
paragraph before ResearchEditor's edits:
An iatrogenic artifact is a disease made up by doctors, often a diagnostic trend or fad that has become or is expected to become obsolete or discredited. Examples of diseases considered or accused of being iatrogenic artifacts include nymphomania, hystero-epilepsy, repressed memory, autogynephilia, and multiple personality disorder. In many cases, it has been shown that "experts" who believe in the disease are able to observe or even induce symptoms matching the disease's description in suggestible patients. Behavioral disorders are particularly susceptible to artifacts. For example, in the false memories syndrome: thousands of psychotherapists have attempted to recover memories of early childhood abuse from their clients. The techniques, practices and exercises used in these attempts are often referred to as Recovered Memory Therapy and sometimes resulted in allegations of abuse being made by individuals against family members. Many of these individuals severed all connection with their parents, hundreds of whom were convicted of these "crimes" and imprisoned.
ResearchEditor ( talk) 03:35, 29 April 2008 (UTC)
paragraph after ResearchEditor's original edits:
An iatrogenic artifact is a disease believed to be made up by doctors. It may be a diagnostic trend or fad some believe to be obsolete or discredited. Examples of diseases accused of being iatrogenic artifacts include nymphomania, hystero-epilepsy, repressed memory, autogynephilia, and multiple personality disorder. Some researchers believe that the iatrogenic origins of multiple personality disorder have not been proven. [1] [2] [3] [4] One study found no empirical evidence for the idea that "most patients recover memories of childhood sexual abuse because their therapist had suggested to them that they were abused as children" [5] and studies have consistently demonstrated that amnesia can occur in survivors of trauma. [6] [7] [8] [9] [10] It has been suggested that treaters who believe in the disease may be able to observe or even induce symptoms matching the disease's description in suggestible patients. In the false memory syndrome, psychotherapists have been accused of attempting to recover memories of early childhood abuse from their clients. The techniques, practices and exercises used in these attempts have been referred to as Recovered Memory Therapy and sometimes resulted in allegations of abuse being made by individuals against family members. Some of these individuals severed all connection with their parents, some of whom were convicted of crimes and imprisoned. Stephanie Dallam states that "the 'False Memory Syndrome' is a controversial theoretical construct based entirely on the reports of parents who claim to be falsely accused of incestuous abuse...The current empirical evidence suggests that the existence of such a syndrome must be rejected. False memory advocates have failed to adequately define or document the existence of a specific syndrome...This does not imply, however, that memory is infallible or that all people who are accused of sexual abuse are guilty." [11] The term "Recovered memory therapy" (RMT) was coined by affiliates of the False Memory Syndrome Foundation in the early 1990s, [12] It is not listed in DSM-IV or used by any mainstream formal psychotherapy modality. [12] Some believe that there is insufficient evidence that false memories can be created in therapy. [13]
ResearchEditor ( talk) 03:35, 29 April 2008 (UTC)
(undent)I've raised this issue on JAR's talk page, he said he'd try to get to it. Can we agree to leave it until he gets to it? If he doesn't manage to within, say a week, (he's really doing us a favour here, since this is pretty far out of his normal interest) then we can discuss possibly including DID and how it should look. The problem is there's a lot of potentially iatrogenic psychological disorders, but this is a page about iatrogenesis in general - it's shouldn't be bloated by a single section that goes in to far too much detail about one area that's equivocal. Let's revisit on the 8th, agreed? WLU ( talk) 14:57, 1 May 2008 (UTC)
Agreed. (So far JAR's edits look good.) ResearchEditor ( talk) 01:49, 2 May 2008 (UTC)
OK, here's a suggestion for the section. I have references for the list of conditions, but I didn't want to do the work of formatting them if this version is not going to be used. I tried to keep this simple and direct, to avoid getting into the controversies. If there is a controversy about iatrogenisis re a particular condition, it would be better to explore that in the article about that condition. Also, I did not mention FMS at all in the list, because that's not a diagnosed condition, and also - if it's mentioned, then the whole NPOV response is needed and the whole section will go off-topic. So I recommend that FMS be left off the list. I also didn't mention Repressed Memory. That one could be added I suppose, but again, it's not something that's "diagnosed", and also I don't have a reference for that one. But with Repressed Memory, unlike FMS, I don't think it would cause a big controversy to include it.
I have no idea if this is what you're looking for... but here it is:
In psychology, iatrogenisis can occur when behavior symptoms are misdiagnosed or are identified and named as a condition that does not actually exist; or when a diagnosis, medication or other treatment or intervention causes or worsens a condition rather than improving the symptoms. Conditions that have been hypothesized to be associated with iatrogenisis include bipolar disorder, dissociative identity disorder, somatoform disorder, fibromyalgia, chronic fatigue syndrome, posttraumatic stress disorder, substance abuse, adolescent antisocial personality disorder, and others. The degree of association of any particular condition with iatrogenisis is unclear and in some cases controversial; research has not yet shown definitive results. A historical example of a condition formerly considered to be a disease that has since been shown to be an iatrogenic artifact is hystero-epilepsy; symptoms disappeared when the treatments were discontinued. [14] [15]
-- Jack-A-Roe ( talk) 08:25, 3 May 2008 (UTC)
In psychology, iatrogenisis can occur due to misdiagnosis (including diagnosis with a false condition as was the case of hystero-epilepsy [14] [16]) or when medical or psychotherapeutic treatment causes or worsens symptoms. Conditions hypothesized to be partially or completely iatrogenic include bipolar disorder, dissociative identity disorder, somatoform disorder, fibromyalgia, chronic fatigue syndrome, posttraumatic stress disorder, substance abuse and adolescent antisocial personality disorder, though research is unequivocal for each condition.
In psychology, iatrogenesis can occur due to misdiagnosis. Conditions that have been hypothesized to be associated with iatrogenesis include bipolar disorder, dissociative identity disorder, somatoform disorder, fibromyalgia, chronic fatigue syndrome, posttraumatic stress disorder, substance abuse, adolescent antisocial personality disorder and others. The degree of association of any particular condition with iatrogenesis is unclear and in some cases controversial. A historical example of a condition formerly considered to be a disease that has since been shown to be an iatrogenic artifact is hystero-epilepsy; symptoms disappeared when the treatments were discontinued. [14] [17]
Here are the references that led me to the list of conditions in the draft paragraph. They are not unilateral, some of these support iatrogenesis for a particular condition and some oppose, but they all mention it as a consideration. Also, in some, medications are involved, but regard other treatment interventions. If you don't think they apply, feel free to modify the conditions list one way or the other.
Some of the articles are long, so it might be a good method to use your browser find-command to search for "iatro" in the text - to cover locate forms of the word. For the ones that are Google Books links, the Google in-book search box on the right hand side of the page works in most browsers though some have trouble with it - also in Google Books it only searches for whole words, so it might be necessary to search for both iatrogenic and iatrogenesis. Here's the list:
[7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17]
Some of those references could also be useful in the articles about each of the listed conditions.
As much as I'd like to complete the work on this, I don't have time to choose and format the references so I need to leave that to the two of you. If you end up not using some of these references or omitting some of the conditions, that's fine - use your best judgement, I'm not attached to the results. If you'd like my feedback on the next version of the paragraph, please let me know. -- Jack-A-Roe ( talk) 19:00, 4 May 2008 (UTC)
ResearchEditor ( talk) 04:04, 5 May 2008 (UTC)In psychology, iatrogenesis can occur due to misdiagnosis (including diagnosis with a false condition as was the case of hystero-epilepsy [14]) Conditions hypothesized to be partially or completely iatrogenic include bipolar disorder [18], dissociative identity disorder [19] [14] , fibromyalgia [20], somatoform disorder [21], chronic fatigue syndrome [21], posttraumatic stress disorder [22], substance abuse [23], antisocial youths [24] and others [25] though research is unequivocal for each condition. The degree of association of any particular condition with iatrogenesis is unclear and in some cases controversial.
To be perfectly honest - re the current article it occurs to me (not that my opinion counts) that regarding PTSD. By the way many articles refer to it (including this one) - logically it should have a different 'name' for those 'affected' by incidents termed 'disasters' - eg those situations where people may be affected by a large scale situation (where many people are involved). Post Disaster Trauma (whatever you like) for example - the current reference for Iatrogenesis (PTSD) being based entirely on a telephone survey for 9/11, several years after the event. Worthless! Ergo you have two seperate diagnoses for two completely different (though perhaps on the surface the same). Yet another catch-all 'named' illness (which by all accounts and purposes, personal (traumatic) incidents are completely different from those suffered in group shock. Using PTSD as a catch-all is a bit like suggesting everyone with a runny nose has a 'cold'. The point being it is far more likely that clinicians may be lazy and just group a host of people to have PTSD (if they exhibit any behaviour different from the norm (perhaps not even that)) after hearing the patient was involved in a well known 'disaster' scenario. Therefore PTSD is not iatrogenic, but repeated, high-profile, misdiagnosis may cause it to appear so. Unless more (realistic) research can prove otherwise. Original diagnoses are not the problem, medical mispractice is. MagicalThinking ( talk) 12:14, 3 October 2012 (UTC)
I wonder if homosexuality would fit into the page - it was pathologized in the first two (three?) DSMs, if sources turn up it'd be interesting as an addition. WLU ( talk) 23:15, 27 April 2008 (UTC)
Iatrogenic disorder and iatrogenic artifact both exist, both are stubs, and both duplicate content. Could/should they be merged? I think the page is short enough to handle them, particularly given the duplication of content. WLU ( talk) 14:22, 28 April 2008 (UTC)
Good idea. I've done the merges. If anyone notices anything from the other articles I missed that need to be included, please do so. -- Jack-A-Roe ( talk) 04:04, 29 April 2008 (UTC)
I have restored this section, because appears to be sourced and was deleted without sufficient reason. ResearchEditor ( talk) 03:10, 28 May 2008 (UTC)
I have deleted a statement without a source. ResearchEditor ( talk) 02:40, 2 June 2008 (UTC)
A glaring omission from this article are deaths caused by unnecessary medical procedures, something that the medical literature distinguishes from simple negligence. // Internet Esquire ( talk) 06:31, 19 October 2008 (UTC)
I think it is glaring. And I doubt that it fits under the term iatrogenesis let alone under medical error. For instance, if someone gets roaring drunk, drives 90 mph, crashes into a school bus and kills a dozen children, the intention may not have been to kill a dozen children, but it is difficult to dismiss it as an error or an unintended outcome. The terms iatrogenesis (as currently defined) and medical error do not cover a large swath of what harms patients.
Does Netesq really need sources to back up examples like inebriated surgeons? Incompetent practitioners who are allowed to keep practicing for political reasons? Nurses and doctors who cannot be persuaded to maintain hand hygiene standards? Along with issues like the covering up of problems rather than reporting them resulting in continuing harm that could have been prevented? And selling unnecessary treatments to make money? The intention might not have been to cause financial or physical harm, just like the driver did not get drunk with the intention of killing a dozen children, but such things cannot be dismissed as mere errors or unintended outcomes. If you don't wash your hands and someone dies, you cannot dismiss it with "Whoops." You unnecessarily exposed others to risk just as though driving drunk.
I did not come up with the term medical harm, and did not especially like it, but I suspect that it was an attempt to fill an omission that is glaring - harm caused to patients that cannot be dismissed as unintended or as mere errors. The omission that Netesq calls glaring might be that there is no word to cover these problems in medicine, unless someone can point us to something else in Wikipedia that does.-- Sighalot ( talk) 19:23, 17 June 2014 (UTC)
What I believe is needed first is not a set of definitions specifying each type of bad outcome, but a single term for all of it, so that the field is not referred to merely as Errors. I have searched for such a term for over ten years. It has been a continual topic of discussion during that time with others also in need of such a term. Various combinations of other words have stood in for such a word. If there were support for "patient harm" as the label, then we would embrace that. But there does not appear to be an appropriate term in existence.
Do you think that it might be time that we act like Virchow and produce an appropriate word ourselves? He first named Lukemia "White Blood" for that problem, not unlike using the words "Medical Harm" for this problem. White Blood didn't work out well either so he made it more academic sounding by using the Greek word for "white," leukos, and called it leukemia. That had a profound impact on the future of understanding the disease.
Isn't it time we do the same thing for this problem? I have proposed using the word Nequamitis (neck' wahm itis). Nequam is Latin for worthless, good for nothing, or bad. "Itis" is, of course, a suffix derived from Greek meaning inflammation. When care injures patients at the least it is worthless. With the amount of injury the field of medicine dispenses, I believe it is not inappropriate to regard the body of medicine as having an affliction that could be called Nequamitis, or some similar word. This kind of language may be conducive to productive thought in a field that has diagnosing and curing afflictions as part of its job description. Reducing errors that are thought to be systems problems isn't what caregivers are trained for. But diagnosing and curing is.
The word Nequamitis cannot be cited anywhere other than one website as far as I know. And it could be that in our lifetimes it would get no traction, but perhaps eventually one or two people would mention it in papers and then, finally, there would be the references the profession seems to need before it will allow a term to be used. Without such a term we will be forced to continue to watch the issue discussed as though the only problem is a small number of errors that probably are unavoidable and certainly are not anyone's fault - not a recipe for finding problems and solving them.
Any thoughts? Sighalot ( talk) 03:50, 19 June 2014 (UTC)
The following reference has been cited in facebook discussions from time to time during the last year. Would it be of any use to this end? http://patient-safety.com/errors-medical.html Sighalot ( talk) 17:35, 19 June 2014 (UTC)
I am very glad you are asking this question. I have been thinking about it. I cannot recall having seen such an article. I will ask around. Let me make sure I am asking the question correctly when I do. Is this it: "Looking for an academic paper that lists all the things in health care that are bad and that says that it would be good if health care would seek to promote the opposite of them." Sighalot ( talk) 11:13, 23 June 2014 (UTC)
I wonder if any noticed source 1 links to a nutritionist health web site, and not, say, a medical paper that actually states the 250,000 deaths a year number. —Preceding unsigned comment added by 71.240.240.118 ( talk) 13:08, 9 December 2008 (UTC)
The means by which a medical personage derives a continued income by intentionally inflicting repeated and constant illness upon an unwilling individual, and then treats the illness and any possible derivative illnesses, such that the treatment may prolong the originally inflicted illness, to then be treated for further profit. See also: carrion feeder, Physician, American. 98.16.0.188 ( talk) 12:31, 13 September 2009 (UTC)
The section dealing with this subject talks solely about 'transitional' economies and not about the debate regarding for example developed world health care systems despite the fact that the cost of medicine in the developed world is often multiple orders of magnitude higher then in the developing world.-- Senor Freebie ( talk) 15:09, 19 October 2009 (UTC)
I changed the line "In the United States, from 120,000 to 225,000 deaths per year may be attributed in some part to iatrogenesis." to "In the United States, an estimated 44,000 to 98,000 deaths per year may be attributed in some part to iatrogenesis." after reading the source for the statement. I.E. "Information concerning the deficiencies of US medical care has been accumulating. The fact that more than 40 million people have no health insurance is well known. The high cost of the health care system is considered to be a deficit, but seems to be tolerated under the assumption that better health results from more expensive care, despite evidence from a few studies indicating that as many as 20% to 30% of patients receive contraindicated care.1 In addition, with the release of the Institute of Medicine (IOM) report "To Err Is Human,"2 millions of Americans learned, for the first time, that an estimated 44,000 to 98,000 among them die each year as a result of medical errors." As we can see the source doesn't give any indication of the 120,000 to 225,000 deaths claimed. Further sorry didn't realize wikipedia logged me out. Donhoraldo ( talk) 16:15, 16 September 2010 (UTC)
e-Iatrogenesis (or technological iatrogenesis) emerged as a growing theme at last weeks Medinfo conference. Roughly defined as "patient harm caused at least in part by the application of health information technology" according to Weiner et al (2007). Suspected to be a factor in approximately 25 percent of medication errors. bibliography. Should this be included?— Rod talk 08:07, 22 September 2010 (UTC)
"# Illegible handwriting on a paper prescription replaced by a mistyped e-script
None of thees are unique to e-Iatrogenesis in nature but it dose show some trend. Donhoraldo ( talk) 18:43, 24 September 2010 (UTC)
This section has a fairly major problem, it makes extensive factual claims involving "studies" that aren't cited, and proceeds to list fairly controversial and debatable conclusions regarding iatrogenics as a leading cause of death in the USA. This all needs sourcing, or it will end up being redacted, I believe. -- Pstanton ( talk) 08:31, 19 October 2010 (UTC)
Why are there citations about statements by Gary Null. Does this really count as a reliable and legitimate source of information?-- 75.64.73.238 ( talk) 06:13, 15 May 2011 (UTC)
Well, it's probably a reference to this self-published online 2-part item Death By Medicine by those same authors, the factual veracity of which is probably open to question as it is not published in a regular peer-reviewed medical journal. FWIW. Peter morrell 13:45, 15 May 2011 (UTC)
This meta-study was published by the Nutrition Institute of America, a nonprofit organization that has sponsored independent research for 30 years, and requires that all data be validated by published, peer-reviewed scientific studies. It's authors are Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD. It is the only such meta-study, corroborates the well-documented work of Ivan Illich in his 1974 book Medical Nemesis, and should be included here. -- Riversong ( talk) 18:17, 6 October 2012 (UTC)
"Conditions hypothesized as partially or completely iatrogenic include bipolar disorder,[5] dissociative identity disorder,[4][6] | issue = 6 | page = 43 |pmid=9270707 | pages = 161–2, 165–6, 171–2 passim }} </ref> somatoform disorder,[7] chronic fatigue syndrome,[7] posttraumatic stress disorder,[8] substance abuse,[9] antisocial youths[10] and others,[11] though research is equivocal for each condition."
In regards to the final sentence. I'm not exactly sure if research on any psychological condition is unequivocal. Perhaps they are highly researched but I think unequivocal should be removed. 24.115.19.178 ( talk) 19:27, 7 January 2012 (UTC)
Susan Cain mentions anecdotally, that introversion in children might be treated (wrongly) with drugs due to concern by misguided, extroverted parents. I would like to see this added to the psych section if there are additional sources. Viriditas ( talk) 03:22, 28 November 2012 (UTC)
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