Will this cause harm?

I have been reading Nassim Nicholas Taleb’s brilliantly tangential book Antifragile: Things that Gain from Disorder.

A concept and mental model he shares is iatrogenics. This is a medical term that refers to “harmful unintended side effects”.

In Antifragile, he writes:

In the case of tonsillectomies, the harm to the children undergoing unnecessary treatment is coupled with the trumpeted gain for some others. The name for such net loss, the (usually bitten or delayed) damage from treatment in excess of the benefits, is iatrogenics.

Iatro– means “a physician; medicine; healing,” from Greek iatros “healer, physician”. –genic means “producing, pertaining to generation.” So harm caused by a healer.

While some have advocated using ‘iatrogenesis’ to refer to all ‘events caused by the health care delivery team’, whether ‘positive or negative’, consensus limits use of ‘iatrogenesis’ to adverse effects, possibly including, broadly, all adverse unforeseen outcomes resulting from medication or other medical treatment or intervention.


Taleb extends this concept beyond medicine and it has helped me think about the total impact of any intervention.

When we intervene without a full appreciation of the potential positive and negative effects, Taleb describes this practice as  “naive interventionism”.

What does this look like in other fields like education?

In schools these interventions might be a simple timetable change from one year to the next. You may be experiencing that now – as the the new academic year in Australia has just started. Perhaps you are only just realising the negative impact of that extended first session or the longer lunchtime.

Perhaps something more significant like streaming in primary maths classes causes obvious missed opportunities for building relationships – perhaps the negative impact outweighs the positive. We are causing more harm than good – this is iatrogenics.

I experienced many primary schools in the UK with complex intervention programmes for students I taught in my classes. I don’t remember ever fully evaluating the negative side effects of those interventions and how they were delivered.

Taleb suggests any intervention will have iatrogenics – the question for leaders is whether we are even aware of them?

It is easy to begin to use the mental model of iatrogenics in your development planning – all we have to do is ask ourselves a few questions:

  • “Will this cause harm?”
  • “How might we understand the negative impact of this idea?”
  • “What can we do to minimise the negative impact?”
  • “How will we know if the negative impact of this outweighs the positive?”
  • “What would happen if we did nothing?”


Photo by Kelly Sikkema on Unsplash

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