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<ul id="toc-Iatrogenic_avenues-sublist" class="vector-toc-list"> <li id="toc-Risk_associated_with_medical_interventions" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Risk_associated_with_medical_interventions"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Risk associated with medical interventions</span> </div> </a> <ul id="toc-Risk_associated_with_medical_interventions-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medical_errors" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medical_errors"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Medical errors</span> </div> </a> <ul id="toc-Medical_errors-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Causes_and_consequences" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Causes_and_consequences"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Causes and consequences</span> </div> </a> <button aria-controls="toc-Causes_and_consequences-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Causes and consequences subsection</span> </button> <ul id="toc-Causes_and_consequences-sublist" class="vector-toc-list"> <li id="toc-Medical_error_and_negligence" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medical_error_and_negligence"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Medical error and negligence</span> </div> </a> <ul id="toc-Medical_error_and_negligence-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Adverse_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Adverse_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Adverse effects</span> </div> </a> <ul id="toc-Adverse_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Psychiatry" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Psychiatry"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Psychiatry</span> </div> </a> <ul id="toc-Psychiatry-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Iatrogenic_poverty" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Iatrogenic_poverty"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Iatrogenic poverty</span> </div> </a> <ul id="toc-Iatrogenic_poverty-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Social_and_cultural_iatrogenesis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Social_and_cultural_iatrogenesis"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.5</span> <span>Social and cultural iatrogenesis</span> </div> </a> <ul id="toc-Social_and_cultural_iatrogenesis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav 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class="firstHeading mw-first-heading"><span class="mw-page-title-main">Iatrogenesis</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 31 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-31" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">31 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D8%B4%D9%83%D9%84%D8%A9_%D8%B9%D9%84%D8%A7%D8%AC%D9%8A%D8%A9_%D8%A7%D9%84%D9%85%D9%86%D8%B4%D8%A3" title="مشكلة علاجية المنشأ – Arabic" lang="ar" hreflang="ar" data-title="مشكلة علاجية المنشأ" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Yatrogen" title="Yatrogen – Azerbaijani" lang="az" hreflang="az" data-title="Yatrogen" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%AF%D1%82%D1%80%D0%BE%D0%B3%D0%B5%D0%BD%D0%B8%D1%8F" title="Ятрогения – Bulgarian" lang="bg" hreflang="bg" data-title="Ятрогения" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Iatrog%C3%A8nia" title="Iatrogènia – Catalan" lang="ca" hreflang="ca" data-title="Iatrogènia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Iatrogen" title="Iatrogen – German" lang="de" hreflang="de" data-title="Iatrogen" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Iatrogenia" title="Iatrogenia – Spanish" lang="es" hreflang="es" data-title="Iatrogenia" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Iatrogenesi" title="Iatrogenesi – Basque" lang="eu" hreflang="eu" data-title="Iatrogenesi" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%85%D8%B4%DA%A9%D9%84%D8%A7%D8%AA_%D8%AF%D8%B1%D9%85%D8%A7%D9%86%E2%80%8C%D8%B2%D8%A7%D8%AF" title="مشکلات درمان‌زاد – Persian" lang="fa" hreflang="fa" data-title="مشکلات درمان‌زاد" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Iatrog%C3%A9n%C3%A8se" title="Iatrogénèse – French" lang="fr" hreflang="fr" data-title="Iatrogénèse" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Iatraigineas" title="Iatraigineas – Irish" lang="ga" hreflang="ga" data-title="Iatraigineas" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9D%98%EC%9B%90%EC%84%B1" title="의원성 – Korean" lang="ko" hreflang="ko" data-title="의원성" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Iatrogenik" title="Iatrogenik – Indonesian" lang="id" hreflang="id" data-title="Iatrogenik" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Iatrogenesi" title="Iatrogenesi – Italian" lang="it" hreflang="it" data-title="Iatrogenesi" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%99%D7%90%D7%98%D7%A8%D7%95%D7%92%D7%A0%D7%99" title="יאטרוגני – Hebrew" lang="he" hreflang="he" data-title="יאטרוגני" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%AF%D1%82%D1%80%D0%BE%D0%B3%D0%B5%D0%BD%D0%B8%D1%8F" title="Ятрогения – Kazakh" lang="kk" hreflang="kk" data-title="Ятрогения" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Iatrogeen" title="Iatrogeen – Dutch" lang="nl" hreflang="nl" data-title="Iatrogeen" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%8C%BB%E5%8E%9F%E7%97%85" title="医原病 – Japanese" lang="ja" hreflang="ja" data-title="医原病" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Iatrogen" title="Iatrogen – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Iatrogen" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Jatrogenia" title="Jatrogenia – Polish" lang="pl" hreflang="pl" data-title="Jatrogenia" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Iatrogenia" title="Iatrogenia – Portuguese" lang="pt" hreflang="pt" data-title="Iatrogenia" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Iatrogenie" title="Iatrogenie – Romanian" lang="ro" hreflang="ro" data-title="Iatrogenie" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%AF%D1%82%D1%80%D0%BE%D0%B3%D0%B5%D0%BD%D0%B8%D1%8F" title="Ятрогения – Russian" lang="ru" hreflang="ru" data-title="Ятрогения" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Iatrog%C3%A9nne_po%C5%A1kodenie" title="Iatrogénne poškodenie – Slovak" lang="sk" hreflang="sk" data-title="Iatrogénne poškodenie" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%88%D0%B0%D1%82%D1%80%D0%BE%D0%B3%D0%B5%D0%BD%D0%B0_%D0%B1%D0%BE%D0%BB%D0%B5%D1%81%D1%82" title="Јатрогена болест – Serbian" lang="sr" hreflang="sr" data-title="Јатрогена болест" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Jatrogena_bolest" title="Jatrogena bolest – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Jatrogena bolest" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Iatrogeneesi" title="Iatrogeneesi – Finnish" lang="fi" hreflang="fi" data-title="Iatrogeneesi" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Iatrogen" title="Iatrogen – Swedish" lang="sv" hreflang="sv" data-title="Iatrogen" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%82%E0%B8%A3%E0%B8%84%E0%B8%AB%E0%B8%A1%E0%B8%AD%E0%B8%97%E0%B8%B3" title="โรคหมอทำ – Thai" lang="th" hreflang="th" data-title="โรคหมอทำ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/%C4%B0yatrojenez" title="İyatrojenez – Turkish" lang="tr" hreflang="tr" data-title="İyatrojenez" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%AF%D1%82%D1%80%D0%BE%D0%B3%D0%B5%D0%BD%D1%96%D1%8F" title="Ятрогенія – Ukrainian" lang="uk" hreflang="uk" data-title="Ятрогенія" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li 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class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"><span class="mw-redirectedfrom">(Redirected from <a href="/w/index.php?title=Iatrogenic&redirect=no" class="mw-redirect" title="Iatrogenic">Iatrogenic</a>)</span></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Causation of harm by any medical activity</div> <p class="mw-empty-elt"> </p> <figure class="mw-halign-right" typeof="mw:File/Frame"><a href="/wiki/File:Iatros.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/3/31/Iatros.jpg" decoding="async" width="257" height="261" class="mw-file-element" data-file-width="257" data-file-height="261" /></a><figcaption>Ancient Greek painting in a vase, showing a physician (<span title="Ancient Greek (to 1453)-language romanization"><i lang="grc-Latn">iatros</i></span>) <a href="/wiki/Bloodletting" title="Bloodletting">bleeding</a> a patient</figcaption></figure> <p><b>Iatrogenesis</b> is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence.<sup id="cite_ref-:0_1-0" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> First used in this sense in 1924,<sup id="cite_ref-:0_1-1" class="reference"><a href="#cite_note-:0-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> the term was introduced to <a href="/wiki/Sociology_of_medicine" class="mw-redirect" title="Sociology of medicine">sociology</a> in 1976 by <a href="/wiki/Ivan_Illich" title="Ivan Illich">Ivan Illich</a>, alleging that industrialized societies impair quality of life by <a href="/wiki/Overmedicalization" class="mw-redirect" title="Overmedicalization">overmedicalizing</a> life.<sup id="cite_ref-:1_4-0" class="reference"><a href="#cite_note-:1-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Iatrogenesis may thus include mental suffering via medical beliefs or a practitioner's statements.<sup id="cite_ref-:1_4-1" class="reference"><a href="#cite_note-:1-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Some iatrogenic events are obvious, like <a href="/wiki/Amputation" title="Amputation">amputation</a> of the wrong limb, whereas others, like <a href="/wiki/Drug_interaction" title="Drug interaction">drug interactions</a>, can evade recognition. In a 2013 estimate, about 20 million negative effects from treatment had occurred globally.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> In 2013, an estimated 142,000 persons died from adverse effects of medical treatment, up from an estimated 94,000 in 1990.<sup id="cite_ref-GDB2013_8-0" class="reference"><a href="#cite_note-GDB2013-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Iatrogenic_avenues">Iatrogenic avenues</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=1" title="Edit section: Iatrogenic avenues"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Risk_associated_with_medical_interventions">Risk associated with medical interventions</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=2" title="Edit section: Risk associated with medical interventions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Adverse_effect" title="Adverse effect">Adverse effects</a> of prescription drugs or vaccines</li> <li>Overuse of drugs (causing, for example, <a href="/wiki/Antibiotic_resistance" class="mw-redirect" title="Antibiotic resistance">antibiotic resistance</a> in <a href="/wiki/Bacteria" title="Bacteria">bacteria</a>)</li> <li>Prescription <a href="/wiki/Drug_interaction" title="Drug interaction">drug interaction</a></li></ul> <div class="mw-heading mw-heading3"><h3 id="Medical_errors">Medical errors</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=3" title="Edit section: Medical errors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Incorrect <a href="/wiki/Medical_prescription" title="Medical prescription">prescription</a>, perhaps due to illegible <a href="/wiki/Handwriting" title="Handwriting">handwriting</a> or computer <a href="/wiki/Typos" class="mw-redirect" title="Typos">typos</a></li> <li>Faulty procedures, techniques, information, methods, or equipment</li> <li><a href="/wiki/Negligence" title="Negligence">Negligence</a></li> <li><a href="/wiki/Hospital-acquired_infection" title="Hospital-acquired infection">Hospital-acquired infections</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Causes_and_consequences">Causes and consequences</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=4" title="Edit section: Causes and consequences"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Medical_error_and_negligence">Medical error and negligence</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=5" title="Edit section: Medical error and negligence"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Iatrogenic conditions need not result from <a href="/wiki/Medical_error" title="Medical error">medical errors</a>, such as mistakes made in <a href="/wiki/Surgery" title="Surgery">surgery</a>, or the prescription or dispensing of the wrong therapy, such as a <a href="/wiki/Medication" title="Medication">drug</a>. In fact, intrinsic and sometimes <a href="/wiki/Adverse_effect_(medicine)" class="mw-redirect" title="Adverse effect (medicine)">adverse effects</a> of a medical treatment are iatrogenic. For example, <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a> and <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>—necessarily aggressive for therapeutic effect – frequently produce such iatrogenic effects as <a href="/wiki/Hair_loss" title="Hair loss">hair loss</a>, <a href="/wiki/Hemolytic_anemia" title="Hemolytic anemia">hemolytic anemia</a>, <a href="/wiki/Diabetes_insipidus" title="Diabetes insipidus">diabetes insipidus</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Brain_damage" class="mw-redirect" title="Brain damage">brain damage</a>, <a href="/wiki/Lymphedema" title="Lymphedema">lymphedema</a>, infertility, etc. The loss of function resulting from the required removal of a diseased organ is iatrogenic, as in the case of <a href="/wiki/Diabetes" title="Diabetes">diabetes</a> consequential to the removal of all or part of the <a href="/wiki/Pancreas" title="Pancreas">pancreas</a>. </p><p>The incidence of iatrogenesis may be misleading in some cases. For example, a ruptured <a href="/wiki/Aortic_aneurysm" title="Aortic aneurysm">aortic aneurysm</a> is fatal in most cases; the survival rate for treatment of a ruptured aortic aneurysm is under 25%. Patients who die during or after an operation will still be considered iatrogenic deaths, but the procedure itself remains a better bet than the probability of death if left untreated. </p><p>Other situations may involve actual <a href="/wiki/Negligence" title="Negligence">negligence</a> or faulty procedures, such as when <a href="/wiki/Pharmacotherapy" title="Pharmacotherapy">pharmacotherapists</a> produce handwritten prescriptions for drugs. </p><p>Another situation may involve negligence where patients are brushed off and not given proper care due to providers holding prejudice for reasons such as sexual orientation, ethnicity, religion, immigration status, etc. This can cause mistrust between patients and providers, leading to patients to not go in for treatment, resulting in more deaths. </p> <div class="mw-heading mw-heading3"><h3 id="Adverse_effects">Adverse effects</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=6" title="Edit section: Adverse effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Adverse reactions, such as <a href="/wiki/Allergy" title="Allergy">allergic reactions</a> to drugs, even when unexpected by pharmacotherapists, are also classified as iatrogenic. </p><p>The evolution of <a href="/wiki/Antibiotic_resistance" class="mw-redirect" title="Antibiotic resistance">antibiotic resistance</a> in <a href="/wiki/Bacteria" title="Bacteria">bacteria</a> is iatrogenic as well.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Bacterial strains resistant to antibiotics have evolved in response to the over prescription of <a href="/wiki/Antibiotic" title="Antibiotic">antibiotic</a> drugs.<sup id="cite_ref-Llor_Bjerrum_pp._229–241_10-0" class="reference"><a href="#cite_note-Llor_Bjerrum_pp._229–241-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>Certain drugs and vaccines are toxic in their own right in therapeutic doses because of their mechanism of action. <a href="/wiki/Alkylating_antineoplastic_agent" title="Alkylating antineoplastic agent">Alkylating antineoplastic agents</a>, for example, cause <a href="/wiki/DNA_damage" class="mw-redirect" title="DNA damage">DNA damage</a>, which is more harmful to cancer cells than regular cells. However, <a href="/wiki/Alkylation" title="Alkylation">alkylation</a> causes severe side-effects and is actually <a href="/wiki/Carcinogenic" class="mw-redirect" title="Carcinogenic">carcinogenic</a> in its own right, with potential to lead to the development of secondary tumors. In a similar manner, <a href="/wiki/Arsenic" title="Arsenic">arsenic</a>-based medications like <a href="/wiki/Melarsoprol" title="Melarsoprol">melarsoprol</a>, used to treat <a href="/wiki/Trypanosomiasis" title="Trypanosomiasis">trypanosomiasis</a>, can cause <a href="/wiki/Arsenic_poisoning" title="Arsenic poisoning">arsenic poisoning</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (July 2023)">medical citation needed</span></a></i>]</sup> Furthermore, <a href="/wiki/Aminoglycoside" title="Aminoglycoside">aminoglycoside</a> <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> can be toxic to the <a href="/wiki/Kidney" title="Kidney">kidneys</a>; these are prescribed only in severe infections where the risk of <a href="/wiki/Nephrotoxicity" title="Nephrotoxicity">nephrotoxicity</a> is preferable to the consequences of the infection.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>Adverse effects can appear mechanically. The design of some surgical instruments may be decades old, hence certain adverse effects (such as tissue trauma) may never have been properly characterized.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Psychiatry">Psychiatry</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=7" title="Edit section: Psychiatry"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In psychiatry, iatrogenesis can occur due to <a href="/wiki/Medical_error" title="Medical error">misdiagnosis</a>. This includes diagnosis with a false condition, as was the case of <a href="/wiki/Hystero-epilepsy" class="mw-redirect" title="Hystero-epilepsy">hystero-epilepsy</a><sup id="cite_ref-spanos_12-0" class="reference"><a href="#cite_note-spanos-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup>. A potentially iatrogenic circumstance is misdiagnosis of <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a> for another disorder, especially in pediatric patients considered to have major depressive disorder and prescribed stimulants or antidepressants.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> Other conditions such as <a href="/wiki/Somatoform_disorder" class="mw-redirect" title="Somatoform disorder">somatoform disorder</a> are theorized to have significant sociocultural and iatrogenic components.<sup id="cite_ref-Abbey1993_14-0" class="reference"><a href="#cite_note-Abbey1993-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Myalgic_encephalomyelitis/chronic_fatigue_syndrome" title="Myalgic encephalomyelitis/chronic fatigue syndrome">Chronic Fatigue Syndrome/Myalgic Encephalomyelitis</a> was historically viewed as a psychiatric/somatoform condition, and the now-outdated treatment of Graded Exercise Therapy is known to have caused iatrogenic harm.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Likewise, many neurological conditions, including <a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">multiple sclerosis</a>, are frequently misdiagnosed as <a href="/wiki/Functional_neurologic_disorder" title="Functional neurologic disorder">functional neurologic disorder</a>,<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> a diagnosis tied to several pathways of iatrogenic harm including stigma, dismissal of patients' own experience, disregard of genuine neurological disorders, and even direct harm from interactions with clinicians.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">Post-traumatic stress disorder</a> is hypothesized to be prone to iatrogenic complications based on treatment modality.<sup id="cite_ref-Boscarino_21-0" class="reference"><a href="#cite_note-Boscarino-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Certain antipsychotics have been shown to reduce brain volumes in animals and in humans over long-term use.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Some populations may be at risk of misdiagnosis, including those identified as having <a href="/wiki/Substance_abuse_disorders" class="mw-redirect" title="Substance abuse disorders">substance abuse disorders</a>.<sup id="cite_ref-Moos2005_24-0" class="reference"><a href="#cite_note-Moos2005-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> At the other end of the spectrum, <a href="/wiki/Dissociative_identity_disorder" title="Dissociative identity disorder">dissociative identity disorder</a> is considered by a minority of theorists to be a wholly iatrogenic disorder with the bulk of diagnoses arising from a tiny fraction of practitioners.<sup id="cite_ref-spanos_12-1" class="reference"><a href="#cite_note-spanos-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Braun1989_25-0" class="reference"><a href="#cite_note-Braun1989-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p><p>The degree of association of any particular condition with iatrogenesis is unclear and in some cases controversial. The over-diagnosis of psychiatric conditions (with the assignment of mental illness terminology) may relate primarily to clinician dependence on subjective criteria.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> The assignment of pathological nomenclature is rarely a benign process and can easily rise<sup class="noprint Inline-Template" style="margin-left:0.1em; white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Please_clarify" title="Wikipedia:Please clarify"><span title="How "easily"? (October 2020)">clarification needed</span></a></i>]</sup> to the level of emotional iatrogenesis, especially when no alternatives outside of the diagnostic naming process have been considered. Many former patients come to the conclusion that their difficulties are largely the result of the power relationships inherent in psychiatric treatment, which has led to the rise of the <a href="/wiki/Anti-psychiatry" title="Anti-psychiatry">anti-psychiatry</a> movement.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Iatrogenic_poverty">Iatrogenic poverty</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=8" title="Edit section: Iatrogenic poverty"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Meessen et al. used the term "iatrogenic poverty" to describe impoverishment induced by medical care.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Impoverishment is described for households exposed to catastrophic health expenditure<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> or to hardship financing.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Every year, worldwide, over 100,000 households fall into <a href="/wiki/Poverty#Health_care" title="Poverty">poverty</a> due to health care expenses. A study reported that in the United States in 2001, illness and <a href="/wiki/Medical_debt" title="Medical debt">medical debt</a> caused half of all personal <a href="/wiki/Bankruptcy_in_the_United_States" title="Bankruptcy in the United States">bankruptcies</a>.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> Especially in countries in <a href="/wiki/Transition_economy" title="Transition economy">economic transition</a>, the <a href="/wiki/Willingness_to_pay" title="Willingness to pay">willingness to pay</a> for <a href="/wiki/Health_care" title="Health care">health care</a> is increasing, and the supply side does not stay behind and develops very fast. But the regulatory and protective capacity in those countries is often lagging behind. Patients easily fall into a vicious cycle of illness, ineffective therapies, consumption of savings, indebtedness, sale of productive assets, and eventually poverty. </p> <div class="mw-heading mw-heading3"><h3 id="Social_and_cultural_iatrogenesis">Social and cultural iatrogenesis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=9" title="Edit section: Social and cultural iatrogenesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The 20th-century social critic <a href="/wiki/Ivan_Illich" title="Ivan Illich">Ivan Illich</a> broadened the concept of medical iatrogenesis in his 1974 book <i>Medical Nemesis: The Expropriation of Health</i><sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> by defining it at three levels. </p> <ul><li>First, clinical iatrogenesis is the injury done to patients by ineffective, unsafe, and erroneous treatments as described above. In this regard, he described the need for <a href="/wiki/Evidence-based_medicine" title="Evidence-based medicine">evidence-based medicine</a> 20 years before the <i>term</i> was coined<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> (the <i>concept</i> itself had been known and followed for centuries).</li> <li>Second, at another level social iatrogenesis is the <a href="/wiki/Medicalization" title="Medicalization">medicalization</a> of life in which medical professionals, pharmaceutical companies, and medical device companies have a vested interest in sponsoring sickness by creating unrealistic health demands that require more treatments or treating non-diseases that are part of the normal human experience, such as age-related declines. In this way, aspects of medical practice and medical industries can produce social harm in which society members ultimately become less healthy or excessively dependent on institutional care. He argued that medical education of physicians contributes to medicalization of society because they are trained predominantly for diagnosing and treating illness, therefore they focus on disease rather than on health. Iatrogenic poverty (above) can be considered a specific manifestation of social iatrogenesis.</li> <li>Third, cultural iatrogenesis refers to the destruction of traditional ways of dealing with, and making sense of, death, suffering, and sickness. In this way the medicalization of life leads to cultural harm as society members lose their autonomous coping skills. It is worth noting that in these critiques "Illich does not reject all benefits of modern society but rejects those that involve unwarranted dependency and exploitation."<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=10" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Globally it is estimated that 142,000 people died in 2013 from adverse effects of medical treatment, an increase of 51 percent from 94,000 in 1990.<sup id="cite_ref-GDB2013_8-1" class="reference"><a href="#cite_note-GDB2013-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> In the United States, estimated deaths per year include: <sup id="cite_ref-starfield_36-0" class="reference"><a href="#cite_note-starfield-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </p> <ul><li>12,000 due to unnecessary surgery</li> <li>7,000 due to medication errors in hospitals</li> <li>20,000 due to other errors in hospitals</li> <li>80,000 due to <a href="/wiki/Nosocomial" class="mw-redirect" title="Nosocomial">nosocomial</a> infections in hospitals</li> <li>106,000 due to non-error, negative effects of drugs</li></ul> <p>Based on these figures, iatrogenesis may cause as many as 225,000 deaths per year in the United States (excluding recognizable error). An earlier <a href="/wiki/Institute_of_Medicine" class="mw-redirect" title="Institute of Medicine">Institute of Medicine</a> report estimated 230,000 to 284,000 iatrogenic deaths annually.<sup id="cite_ref-starfield_36-1" class="reference"><a href="#cite_note-starfield-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=11" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Yearly_mortality_rates_1784-1849.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cf/Yearly_mortality_rates_1784-1849.png/290px-Yearly_mortality_rates_1784-1849.png" decoding="async" width="290" height="171" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cf/Yearly_mortality_rates_1784-1849.png/435px-Yearly_mortality_rates_1784-1849.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cf/Yearly_mortality_rates_1784-1849.png/580px-Yearly_mortality_rates_1784-1849.png 2x" data-file-width="1240" data-file-height="731" /></a><figcaption>Evidence demonstrating the advent of <a href="/wiki/Pathological_anatomy" class="mw-redirect" title="Pathological anatomy">pathological anatomy</a> in 1823 Vienna (left vertical line) correlated with incidence of fatal childbed fever. The onset of chlorine handwash in 1847 is noted (right vertical line). For comparison, rates for Dublin maternity hospital, which had no pathological anatomy (<a href="/wiki/Historical_mortality_rates_of_puerperal_fever#Yearly_mortality_rates_for_birth_giving_women_1784–1849" title="Historical mortality rates of puerperal fever">view rates</a>). <a href="/wiki/Ignaz_Semmelweis" title="Ignaz Semmelweis">Semmelweis</a> 1861.</figcaption></figure> <p>The term "<a href="https://en.wiktionary.org/wiki/en:iatrogenesis#English" class="extiw" title="wikt:en:iatrogenesis">iatrogenesis</a>" means <i>brought forth by a healer</i>, from the <a href="/wiki/Greek_language" title="Greek language">Greek</a> <span title="Ancient Greek (to 1453)-language romanization"><i lang="grc-Latn">iatros</i></span> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc"><a href="https://en.wiktionary.org/wiki/en:%E1%BC%B0%CE%B1%CF%84%CF%81%CF%8C%CF%82#Ancient_Greek" class="extiw" title="wikt:en:ἰατρός">ἰατρός</a></span></span>, "healer") and <span title="Ancient Greek (to 1453)-language romanization"><i lang="grc-Latn">genesis</i></span> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc"><a href="https://en.wiktionary.org/wiki/en:%CE%B3%CE%AD%CE%BD%CE%B5%CF%83%CE%B9%CF%82#Ancient_Greek" class="extiw" title="wikt:en:γένεσις">γένεσις</a></span></span>, "origin"); as such, in its earlier forms, it could refer to good or bad effects. </p><p>Since at least the time of <a href="/wiki/Hippocrates" title="Hippocrates">Hippocrates</a>, people have recognized the potentially damaging effects of medical intervention. "First do no harm" (<i><a href="/wiki/Primum_non_nocere" title="Primum non nocere">primum non nocere</a></i>) is a primary Hippocratic mandate in modern <a href="/wiki/Bioethics" title="Bioethics">medical ethics</a>. Iatrogenic illness or death caused purposefully or by avoidable error or negligence on the healer's part became a punishable offense in many civilizations.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p><p>The transfer of pathogens from the autopsy room to maternity patients, leading to shocking <a href="/wiki/Historical_mortality_rates_of_puerperal_fever" title="Historical mortality rates of puerperal fever">historical mortality rates of puerperal fever</a> (also known as "childbed fever") at maternity institutions in the 19th century, was a major iatrogenic catastrophe of the era. The infection mechanism was first identified by <a href="/wiki/Ignaz_Semmelweis" title="Ignaz Semmelweis">Ignaz Semmelweis</a>.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p>With the development of <a href="/wiki/Scientific_medicine" class="mw-redirect" title="Scientific medicine">scientific medicine</a> in the 20th century, it could be expected that iatrogenic illness or death might be more easily avoided.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2024)">citation needed</span></a></i>]</sup> <a href="/wiki/Antiseptic" title="Antiseptic">Antiseptics</a>, <a href="/wiki/Anesthesia" title="Anesthesia">anesthesia</a>, <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a>, better surgical techniques, <a href="/wiki/Evidence_based_medicine" class="mw-redirect" title="Evidence based medicine">evidence-based</a> <a href="/wiki/Guideline_(medical)" class="mw-redirect" title="Guideline (medical)">protocols</a> and <a href="/wiki/Best_practices" class="mw-redirect" title="Best practices">best practices</a> continue to be developed to decrease iatrogenic side effects and <a href="/wiki/Death" title="Death">mortality</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2023)">citation needed</span></a></i>]</sup> </p> <div style="clear:both;" class=""></div> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=12" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 20em;"> <ul><li><a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">Adverse drug reaction</a></li> <li><i><a href="/wiki/Antifragile_(book)" title="Antifragile (book)">Antifragile</a></i></li> <li><a href="/wiki/Bioethics" title="Bioethics">Bioethics</a></li> <li><a href="/wiki/Bloodletting" title="Bloodletting">Bloodletting</a></li> <li><a href="/wiki/Cascade_effect" title="Cascade effect">Cascade effect</a></li> <li><a href="/wiki/Classification_of_Pharmaco-Therapeutic_Referrals" title="Classification of Pharmaco-Therapeutic Referrals">Classification of Pharmaco-Therapeutic Referrals</a></li> <li><i><a href="/wiki/Fatal_Care:_Survive_in_the_U.S._Health_System" class="mw-redirect" title="Fatal Care: Survive in the U.S. Health System">Fatal Care: Survive in the U.S. Health System</a></i></li> <li><a href="/wiki/Hospital-acquired_infection" title="Hospital-acquired infection">Hospital-acquired infection</a></li> <li><i><a href="/wiki/Journal_of_Negative_Results_in_Biomedicine" title="Journal of Negative Results in Biomedicine">Journal of Negative Results in Biomedicine</a></i></li> <li><a href="/wiki/List_of_medicine_contamination_incidents" title="List of medicine contamination incidents">List of medicine contamination incidents</a></li> <li><a href="/wiki/Medical_malpractice" title="Medical malpractice">Medical malpractice</a></li> <li><a href="/wiki/Medicalization" title="Medicalization">Medicalization</a></li> <li><a href="/wiki/Nassim_Nicholas_Taleb" title="Nassim Nicholas Taleb">Nassim Nicholas Taleb</a></li> <li><a href="/wiki/Nocebo" title="Nocebo">Nocebo</a></li> <li><a href="/wiki/Paradoxical_reaction" title="Paradoxical reaction">Paradoxical reaction</a></li> <li><a href="/wiki/Patient_safety" title="Patient safety">Patient safety</a></li> <li><a href="/wiki/Placebo" title="Placebo">Placebo</a></li> <li><a href="/wiki/Polypharmacy" title="Polypharmacy">Polypharmacy</a></li> <li><a href="/wiki/Pressure_ulcer" title="Pressure ulcer">Pressure ulcer</a></li> <li><a href="/wiki/Quaternary_prevention" title="Quaternary prevention">Quaternary prevention</a></li> <li><a href="/wiki/Risk%E2%80%93benefit_ratio" title="Risk–benefit ratio">Risk–benefit ratio</a></li> <li><a href="/wiki/Sentinel_event" title="Sentinel event">Sentinel event</a></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=13" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width" style="column-width: 30em;"> <ol class="references"> <li id="cite_note-:0-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_1-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">"<a href="https://www.merriam-webster.com/dictionary/iatrogenic" class="extiw" title="mwod:iatrogenic">Iatrogenic</a>", <i>Merriam-Webster.com</i>, <a href="/wiki/Merriam-Webster" title="Merriam-Webster">Merriam-Webster</a>, Inc., accessed 27 Jun 2020.</span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation journal cs1">"John O. Barr & Timothy L. Kauffman, "Iatrogenesis in older adults", in Timothy L. Kauffman, Ron Scott, John O. Barr & Michael L. Moran, eds., <i>A Comprehensive Guide to Geriatric Rehabilitation</i>, 3rd edn. (Edinburgh: Churchill Livingstone/Elsevier, 2014)". <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FB978-0-7020-4588-2.00056-5">10.1016/B978-0-7020-4588-2.00056-5</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=John+O.+Barr+%26+Timothy+L.+Kauffman%2C+%22Iatrogenesis+in+older+adults%22%2C+in+Timothy+L.+Kauffman%2C+Ron+Scott%2C+John+O.+Barr+%26+Michael+L.+Moran%2C+eds.%2C+A+Comprehensive+Guide+to+Geriatric+Rehabilitation%2C+3rd+edn.+%28Edinburgh%3A+Churchill+Livingstone%2FElsevier%2C+2014%29&rft_id=info%3Adoi%2F10.1016%2FB978-0-7020-4588-2.00056-5&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIatrogenesis" class="Z3988"></span> <span class="cs1-visible-error citation-comment"><code class="cs1-code">{{<a href="/wiki/Template:Cite_journal" title="Template:Cite journal">cite journal</a>}}</code>: </span><span class="cs1-visible-error citation-comment">Cite journal requires <code class="cs1-code">|journal=</code> (<a href="/wiki/Help:CS1_errors#missing_periodical" title="Help:CS1 errors">help</a>)</span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.addictionhelper.com/advice/intervention-mistakes-avoid/">"Intervention Mistakes and How to Avoid Them"</a>. <i>Addiction Helper</i>. 11 December 2014<span class="reference-accessdate">. Retrieved <span class="nowrap">3 February</span> 2021</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Addiction+Helper&rft.atitle=Intervention+Mistakes+and+How+to+Avoid+Them&rft.date=2014-12-11&rft_id=https%3A%2F%2Fwww.addictionhelper.com%2Fadvice%2Fintervention-mistakes-avoid%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIatrogenesis" class="Z3988"></span></span> </li> <li id="cite_note-:1-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-:1_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:1_4-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><a rel="nofollow" class="external text" href="https://www.encyclopedia.com/social-sciences/dictionaries-thesauruses-pictures-and-press-releases/iatrogenesis">"iatrogenesis"</a>, <i>A Dictionary of Sociology</i>, <a href="/wiki/Encyclopedia.com" title="Encyclopedia.com">Encyclopedia.com</a>. updated 31 May 2020.</span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text">David Kuhl, <i>What Dying People Want: Practical Wisdom for the End of Life</i> (New York: <a href="/wiki/PublicAffairs" title="PublicAffairs">PublicAffairs</a>, 2002), <a rel="nofollow" class="external text" href="https://books.google.com/books?id=QfiLuC7a47sC&pg=PA55">p 55</a>.</span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text">Paul F. Lazarsfeld, "Working with Merton", in Lewis A. Cosar, ed., <i>The Idea of Social Structure: Papers in Honor of <a href="/wiki/Robert_K._Merton" title="Robert K. Merton">Robert K. 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Infection+Control+and+Hospital+Epidemiology&rft.atitle=Ignaz+Philipp+Semmelweis%2C+the+prophet+of+bacteriology&rft.volume=4&rft.issue=5&rft.pages=367-370&rft.date=1983&rft_id=info%3Apmid%2F6354955&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A25830725%23id-name%3DS2CID&rft_id=https%3A%2F%2Fwww.jstor.org%2Fstable%2F30142576%23id-name%3DJSTOR&rft_id=info%3Adoi%2F10.1017%2FS0195941700059762&rft.aulast=Hanninen&rft.aufirst=O&rft.au=Farago%2C+M.&rft.au=Monos%2C+E.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIatrogenesis" class="Z3988"></span></span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Iatrogenesis&action=edit&section=14" title="Edit section: External links"><span>edit</span></a><span 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.navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}</style></div><div role="navigation" class="navbox" aria-labelledby="Medical_harm" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="text-align:center;"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Medical_harm" title="Template:Medical harm"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Medical_harm" title="Template talk:Medical harm"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Medical_harm" title="Special:EditPage/Template:Medical harm"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Medical_harm" style="font-size:114%;margin:0 4em">Medical harm</div></th></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Concepts</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Iatrogenesis</a></li> <li><a href="/wiki/Medical_malpractice" title="Medical malpractice">Medical malpractice</a></li> <li><a href="/wiki/Medical_error" title="Medical error">Medical error</a></li> <li><a href="/wiki/Patient_safety" title="Patient safety">Patient safety</a></li> <li><a href="/wiki/Unnecessary_health_care" title="Unnecessary health care">Unnecessary health care</a></li> <li><a href="/wiki/Adverse_effect" title="Adverse effect">Adverse effect</a></li> <li><a href="/wiki/Patient_abuse" title="Patient abuse">Patient abuse</a></li> <li><a href="/wiki/Never_event" title="Never event">Never event</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Economic and financial concerns</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Medical_debt" title="Medical debt">Medical debt</a></li> <li><a href="/wiki/Balance_billing" title="Balance billing">Balance billing</a></li> <li><a href="/wiki/Financial_toxicity" title="Financial toxicity">Financial toxicity</a></li> <li><a href="/wiki/Prescription_drug_prices_in_the_United_States" title="Prescription drug prices in the United States">Prescription drug prices in the United States</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Political abuse</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drapetomania" title="Drapetomania">Drapetomania</a></li> <li><a href="/wiki/Sluggish_schizophrenia" title="Sluggish schizophrenia">Sluggish schizophrenia</a></li> <li><a href="/wiki/Compulsory_sterilization" title="Compulsory sterilization">Compulsory sterilization</a></li> <li><a href="/wiki/Physician_gag_law" title="Physician gag law">Physician gag law</a></li> <li><i><a href="/wiki/The_Protest_Psychosis" title="The Protest Psychosis">The Protest Psychosis</a></i></li> <li><a href="/wiki/Political_abuse_of_psychiatry" title="Political abuse of psychiatry">Political abuse of psychiatry</a></li> <li><a href="/wiki/Political_abuse_of_psychiatry_in_the_United_States" class="mw-redirect" title="Political abuse of psychiatry in the United States">Political abuse of psychiatry in the United States</a></li> <li><a href="/wiki/Political_abuse_of_psychiatry_in_Russia" title="Political abuse of psychiatry in Russia">Political abuse of psychiatry in Russia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Related concerns</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">Adverse drug reaction</a></li> <li><a href="/wiki/Hospital-acquired_pneumonia" title="Hospital-acquired pneumonia">Hospital-acquired pneumonia</a></li> <li><a href="/wiki/Hospital-acquired_infection" title="Hospital-acquired infection">Hospital-acquired infection</a></li> <li><a href="/wiki/Iatrogenic_anemia" title="Iatrogenic anemia">Iatrogenic anemia</a></li> <li><a href="/wiki/Hand_washing" title="Hand washing">Hand washing</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Records and histories</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drug_pollution" title="Drug pollution">Drug pollution</a> (<a href="/wiki/List_of_medicine_contamination_incidents" title="List of medicine contamination incidents">List</a>)</li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q284220#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q284220#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q284220#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">International</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="http://id.worldcat.org/fast/966438/">FAST</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4026422-1">Germany</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85063896">United States</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://catalogue.bnf.fr/ark:/12148/cb11946828q">France</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://data.bnf.fr/ark:/12148/cb11946828q">BnF data</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/00563912">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="iatrogenie"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph184791&CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://kopkatalogs.lv/F?func=direct&local_base=lnc10&doc_number=000343912&P_CON_LNG=ENG">Latvia</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="http://olduli.nli.org.il/F/?func=find-b&local_base=NLX10&find_code=UID&request=987007536290505171">Israel</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Maladies iatrogéniques"><a rel="nofollow" class="external text" href="https://www.idref.fr/027423670">IdRef</a></span></span><ul><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" 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