Wikipedia:Articles for deletion/Medical harm


 * The following discussion is an archived debate of the proposed deletion of the article below. Please do not modify it. Subsequent comments should be made on the appropriate discussion page (such as the article's talk page or in a deletion review).  No further edits should be made to this page.

The result was delete and redirect to Medical error. Content deleted before redirect as a POV essay. § FreeRangeFrog croak 01:56, 16 June 2014 (UTC)

Medical harm

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This article is written as an essay and violates WP:NPOV and WP:OR. It is based on a claim that the term "medical harm" came into use in the medical community after a 1991 article in the New England Journal of Medicine. This is not true. The correct term is Iatrogenesis and Medical error and WP already has those articles. This article is almost entirely an essay and editorializes the author's view of the topic with sources that don't support everything being claimed. I considered a merge, but there doesn't appear to be anything useful to merge especially as the sources don't always support the claims. SW3 5DL (talk) 14:26, 9 June 2014 (UTC)
 * Delete as per nominator. Merging seems impractical. Essay-ish. Original research. Lacks secondary sources.--Tomwsulcer (talk) 16:07, 9 June 2014 (UTC)
 * Note: This debate has been included in the list of Medicine-related deletion discussions. S.G.(GH) ping! 16:33, 9 June 2014 (UTC)


 * I have no objection to deleting this content, but I think "medical harm" is a plausible search term. In any case we shouldn't leave it as a redlink.  After deletion, we should create a redirect to iatrogenesis.— S Marshall  T/C 17:03, 9 June 2014 (UTC)
 * Yes, that's fine. SW3 5DL (talk) 18:51, 9 June 2014 (UTC)


 * Keep Merge somewhere, not sure where I have a lot of uncertainty about the right terms for this concept, and perhaps this article should be merged, somewhere else, but "medical harm" might not the same as a "medical error" - I am not sure. I tried to differentiate some terms in this table.

I think there are ought to be some Wikipedia article for "bad things associated with health care", but in the academic literature I find no overarching term. It may or may not be the case that iatrogenesis is the same as either "medical error" or any other layman term. says that the terms are the same, and it seems plausible, but I find no sources to verify this. In contrast, the content currently in the article for iatrogenesis seems to me to go far beyond merely medical error and into the space of harm resulting from unerring treatment, which made me wonder if iatrogenesis is the same as "bad things associated with health care", which might be the same as "medical harm". I am really confused at how to coordinate these articles.  Blue Rasberry  (talk)  20:03, 9 June 2014 (UTC)
 * Delete, or Redirect to Iatrogenesis. (Changing to Medical error, see below) This is an essay, not an article. To answer Blue Rasberry, my understanding is that iatrogenesis is any kind of bad health outcome that results from medical treatment - whether from an error, a side effect, or an unavoidable result of the treatment or advice given (for example, iatrogenic hypothyroidism after surgical removal of the thyroid). I don't think "debt" or "social stigma" or "abuse" should be considered "medical harm" in any case; they are not medical outcomes, and they can happen in an interaction with any type of service provider. (For example, seeing a lawyer can also cause debt, stigma, and abuse; should there be an article on "bad things associated with legal care"?) BTW I notice that our article defines "Iatrogenesis" as preventable harm resulting from medical treatment, but then goes on in the lead to say that it can also include results of treatment which are not preventable, such as scars from surgery. Maybe the word "preventable" should be removed, but that's another discussion for another place.  --MelanieN (talk) 20:32, 9 June 2014 (UTC)
 * Comment: Blue Rasberry's chart above is grossly in error and POV/OR in itself. Medical errors/iatrogenesis do cause harm. The wrong medication given to a patient can cause harm. The wrong name on a surgery schedule can cause harm. Yes, medical errors cause harm. These are not different concepts. Iatrogenesis and Medical error are also called 'adverse events.' Yes, they are the same thing. Check the medical literature again. Read the journal articles.


 * In addition, Blue Rasberry fails to see that the current article Medical harm is nothing more than an essay and violates WP:NPOV and WP:OR. It should be deleted. SW3 5DL (talk) 20:57, 9 June 2014 (UTC)

Below are a few sources:
 * Opoids, iatrogenic harm and disclosure of medical error
 * Iatrogenic disease in the elderly
 * Reducing the frequency of errors in medicine
 * Reducing medication errors in the Neonatal intensive care unit
 * Iatrogenesis and Medical Error – The Case for Medical Malpractice Litigation
 * Dr. Arnold Relman, former editor of the New England Journal of Medicine: on Becoming a Patient

SW3 5DL (talk) 21:25, 9 June 2014 (UTC)
 * Just to quibble a little: IMO iatrogenesis is NOT synonymous with "medical error". Iatrogenesis is broader and includes all adverse outcomes caused by treatment. You can have iatrogenic conditions even where there was no error, such as side effects of a drug. --MelanieN (talk) 21:39, 9 June 2014 (UTC)
 * No, they are the same. They are both 'from the healer.' And side effects from a drug are not in themselves errors. The risk of side-effects are weighed against the benefits. Chemotherapy will make your hair fall out. AND it can also cause you to lose your hair permanently or if you hair comes back it will not come back the same. But the risk of hair loss does not outweigh the benefit of the chemo killing the cancer. SW3 5DL (talk) 21:48, 9 June 2014 (UTC)
 * You make my point exactly: they are NOT the same. "Iatrogenic" is not synonymous with medical error. Iatrogenic hair loss is "from the healer", but it is not due to an error. All conditions caused by medical error are iatrogenic, but not all iatrogenic conditions are caused by error. To put it another way, medical error is a subset of iatrogenic conditions. --MelanieN (talk) 21:54, 9 June 2014 (UTC)

I do not need to be convinced of anything; I admit outright that I have no idea what terms to use for any of this. I am just trying to learn your perspective. Does this seem right to you?

Thanks.

You are also correct that the content in the medical harm article is awful and that it is an essay.  Blue Rasberry  (talk)  14:49, 10 June 2014 (UTC)
 * Your question was addressed to SW3 5DL, not me, but I will just say that I do NOT agree with this chart because I do not agree that "medical harm", "medical error", and "iatrogenesis" are synonymous. Why are we debating this anyhow? We seem to be agreed that the article under discussion does not belong here; are we looking for a redirect target, or what? --MelanieN (talk) 14:54, 10 June 2014 (UTC)
 * I do not agree that this article should be deleted, just that all or almost all the content in it is very bad right now. There still could be an article called "medical harm" if that is a real thing that is not either or both "medical error" or "iatrogenesis". What do you think the difference is between the three? Is medical harm the same as either of those other two things?   Blue Rasberry   (talk)  16:14, 10 June 2014 (UTC)
 * For starters, "debt," "stigma", and "abuse" do not belong in this discussion at all. Those seem to be your own addition to the conversation. They are not mentioned in the article under discussion; they are non-medical outcomes; and they are things that can happen in a variety of contexts and are not unique to medical situations. The definition you are proposing here is way too broad IMO, and it is not supported in the literature. What references I could find at Google Scholar seem to use "medical harm" as synonymous with "medical error". So this term could be redirected to "medical error" (earlier I suggested a redirect to Iatrogenesis, but based on my literature search just now, usage of this term seems to be limited to medical error and does not include all forms of iatrogenec illness). But IMO the term "medical harm" is not sufficiently well defined as a distinct entity (apart from medical error) to be worthy of a standalone article. --MelanieN (talk) 17:09, 10 June 2014 (UTC)
 * Okay, so it seems that you "do not agree that "medical harm", "medical error", and "iatrogenesis" are synonymous", and you also think that there is no such term as "medical harm" and that those words are not distinct from "medical error". It seems that you think "Iatrogenesis" and "Medical error" should be separate articles, but I am still unclear on what you feel is the difference between these two. SW3 5DL gave good sources providing supporting evidence that these concepts are the same.
 * You are correct, I just personally and without support from literature thought that there might be a term for "Undesirable health care outcomes" and that medical harm might be it. I agree with you there are no sources defining medical harm in that way. Do you feel that I understand what you have said? Thanks for talking this through with me.  Blue Rasberry   (talk)  17:29, 10 June 2014 (UTC)
 * Thanks, Blue Rasberry. Yes, I think you have understood me very well and I thank you for your openness to discussion and evidence. As for whether Iatrogenesis is the same thing as Medical error or not, it isn't necessary to resolve that at this discussion - if we are agreed that "Medical error" would be a good redirect target for this term. --MelanieN (talk) 17:38, 10 June 2014 (UTC)


 * Comment Speaking of the literature - as nominator notes, the article claims the term "medical harm" came into use as a result of a 1991 NEJM article. But that journal article, or at least its abstract, does not seem to use the term "medical harm" at all. It uses the term "adverse events"; it also mentions "medical injury" once, in the context of malpractice litigation. This is further evidence that this article is not based on sources, but is the author's opinion or synthesis.--MelanieN (talk) 17:23, 10 June 2014 (UTC)
 * Merge somewhere, not sure where I changed my position. This article should be merged and become a redirect to some other article. I am not sure what, but either Iatrogenesis or Medical error seem like candidates. There is disagreement about whether those two are the same.  Blue Rasberry   (talk)  17:31, 10 June 2014 (UTC)
 * Merge to medical error Okay, the current thought is that "medical harm" means "medical error", and that medical error is the much more established term. We do not really have good literature saying that, but we have some so-so literature which supports that idea, and it seems intuitively sufficient to everyone here I think. An outstanding issue for elsewhere is whether medical error and iatrogenesis are the same, but that is a different discussion.  Blue Rasberry   (talk)  19:27, 10 June 2014 (UTC)
 * No it can't merge. It's an absolute invention by the editor who created it. User:MelanieN has got it right when she noted the claim to the term "Medical harm" coming about after the NEJM article is false. I noted the exact same thing which is why I nominated it for deletion. The article should be deleted and the term 'medical harm' can redirect to 'medical error,' though IMO 'medical harm' implies an intended act of harm. Iatrogenesis/medical error are acts of omission not deliberate acts of commission. They are the result of a failure to follow a protocol, a missed directive, the wrong order, etc. But certainly not intentional as that term seems to imply. SW3 5DL (talk) 21:55, 10 June 2014 (UTC)


 * Delete, redirect to "iatrogenesis/medical error" It has not been established that "medical harm" is a term used in any consistent way.  Blue Rasberry   (talk)  14:35, 11 June 2014 (UTC)
 * Merge and keep redirect. At the least the figures in the prevalence section seem referenced & are significant. Nom is perhaps not being entirely objective here - there is salvage. Wiki CRUK John (talk) 11:36, 12 June 2014 (UTC)
 * Comment A thorough and objective reading of the article and an examination of all the sources, as I've done, will show this article is essentially a WP:HOAX. The article creator references a website several times that, in itself isn't RS, and doesn't mention 'medical harm.' Nor do any of the sources. The author has written an article entirely from his POV. He appears to have added in sources for the medically recognized term 'adverse events' which do not use the phrase 'medical harm' nor do they claim medical harm. The claim of 'medical harm' is entirely the POV of article's creator. SW3 5DL (talk) 14:30, 12 June 2014 (UTC)
 * I'm inclined to agree that there is nothing worth merging here (although I don't see any justification for calling it a hoax). Even sources that at first glance seem solid, turn out to be POV and not peer-reviewed - for example the JAMA reference which is really a "commentary". The one solid reference is the NAS report "To Err is Human", and it is already cited in the Medical Error article. --MelanieN (talk) 15:20, 12 June 2014 (UTC)
 * The definition of WP:Hoax is an attempt to make something that is false appear real. That appears to be the case here. The term 'medical harm' in itself is not a neutral term. It implies intention. To take that term, which doesn't even have currency in the medical or lay literature, and then give it the appearance of a valid article by applying sources to it does suggest hoax. SW3 5DL (talk) 16:44, 12 June 2014 (UTC)


 * Delete and redirect to medical error. This is an effort to put a new label on an old bottle. bd2412  T 19:27, 12 June 2014 (UTC)
 * The above discussion is preserved as an archive of the debate. Please do not modify it. Subsequent comments should be made on the appropriate discussion page (such as the article's talk page or in a deletion review). No further edits should be made to this page.