throwawaynotmd

It’s not enough to say it’s harmful. How is it harmful? A blood test, for example, cannot be inherently harmful. (Okay, no more harmful than drawing blood). So it must be about what people then decide to do based on that test. That’s what my post is about.

We have a more detailed exchange going on elsewhere in this thread, with my latest comment, addressing your more detailed points, here: https://news.ycombinator.com/item?id=27630947

I should say, if you know ex ante that certain results are not worth acting on, then when you actually get those results ex post, you should ignore them just the same. So actually running a test cannot formally be the problem.

>Many times the patient will push them for further tests and treatment (or the doctors will advocate for it to ease the mind of the patient) which leads to potential harm from unnecessary treatments.

>People will ask to be treated anyway, and iatrogenics will rear its ugly head.

I just want to say that you are in agreement with my position here.

Your point about psychological problems is interesting, but as long as people know what they’re signing up for, it’s okay. Some people aren’t prone to anxiety. Why should they pay the price because other people are? Part of my original point was that implicit in your argument is that people capable of handling it should be denied something because more people incapable of handling it can’t be stopped from hurting themselves. I think many people do not agree with that moral reasoning, so medical people hide it behind objective looking statistics.

And as for cost, I don’t take any arguments from medical people about cost seriously. The reason why costs are so high is because doctors and the medical field as a whole run a massive protectionist racket to keep the supply of medical professionals low.

How fresh of them to say that because they’ve limited the supply of medical resources to enrich themselves, patients must pay by having less access to care.

The argument you’re making has always bothered me because it’s hiding the ball.

If finding something that otherwise carries no symptoms is best left untreated, then the fact that you found it should make no difference to the decision. The doctor should say that the best course of action is to do nothing. More information can never be harmful. If you know information is best not acted on in the abstract, then you also know you should not act on it in particular.

So what you really mean but have left unspoken is one of two things.

First, that doctors are untrustworthy people who make recommendations and decisions based on concerns other than their patient’s wellbeing, such as covering their asses from lawsuits or making more money.

But rather than fix that, you would rather keep patients more ignorant and away from the doctor in the first place. Which actively harms people who do have honest doctors. That is, your approach of not testing hurts people with honest doctors to protect people with dishonest doctors.

Or second, if you take dumb patients as the problem, you are willing to hurt people with good decision making ability (who would heed their good doctor’s advice to leave the possible ailment untreated) so you can protect people with bad decision making.

Because many times, these tests will uncover things that obviously need treatment. They will save many lives. But because more stupid people will hurt themselves, then no one should have access to them.

The political and moral assumptions built into these positions are immense and yet the medical field tucks those away and pretends that this is just a purely scientific truth, that someone running more harmless tests is actually inherently harmful.

That is a lie! And a very nasty one at that.