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January 3, 1972

Let This Be a Lesson to You!

JAMA. 1972;219(1):81. doi:10.1001/jama.1972.03190270051013

So-called iatrogenic disease is unfortunately a medical commonplace. The physician, through his treatments, can bring about a condition which is harmful to the patient. The harm may vary from slight to severe, from transitory to fatal, or anything in between these extremes. At the present time the popular term for such harm is "side-effects," indicating the untoward results of well-intentioned therapy. But another and quite different medical commonplace I would call "iatrogenic non-disease," wherein the physician treats the patient for a condition which he has diagnosed but which doesn't exist. Whereas the iatrogenic disease results only from treatment, iatrogenic non-disease is logically prior to this and is created during the phase of diagnosis.

Diagnosis takes place through interpretation of symptoms and signs, including laboratory data; and if the data are misinterpreted, error can arise. Here, however, we must clearly distinguish between the cases in which the data are accurate but