71
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Absence of confidential contact.
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Misses in speech of the doctor, it is especial at the first occu-
rring.
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The unreasonable use of medical terminology.
Iatrogenic conditions do not necessarily result from medical errors,
such as mistakes made in surgery, or the prescription or dispensing of
the
wrong therapy, such as a drug. In fact, intrinsic and sometimes ad-
verse effects of a medical treatment are iatrogenic. For example, radia-
tion therapy and chemotherapy, due to the needed aggressiveness of the
therapeutic agents, frequently produce iatrogenic effects such as hair
loss, anemia, vomiting, nausea,
brain damage, lymphedema, infertility,
etc. The loss of functions resulting from the required removal of a disea-
sed organ also counts as iatrogenesis, thus we find (for example) iatro-
genic diabetes brought on by removal of all or part of the pancreas.
Other situations may involve actual negligence or faulty procedu-
res, such as when pharmacotherapists produce handwritten prescriptions
for drugs.
A very common iatrogenic effect is caused by drug interaction, i.e.,
when pharmacotherapists fail to check for all medications a patient is ta-
king and prescribe new ones which interact agonistically or antagonisti-
cally (potentiate or decrease the intended therapeutic effect). Such situa-
tions can cause significant morbidity and mortality. Adverse reactions,
such as allergic reactions to drugs, even when unexpected by pharmaco-
therapists, are also classified as iatrogenic.
The evolution of antibiotic resistance in
bacteria is iatrogenic as
well. Bacteria strains resistant to antibiotics have evolved in response to
the over prescription of antibiotic drugs. Certain drugs are toxic in their
own right in therapeutic doses because of their mechanism of action.
In psychology, iatrogenesis can occur due to misdiagnosis. Condi-
tions hypothesized as partially or completely iatrogenic include bipolar
disorder, dissociative identity disorder, fibromyalgia, somatoform disor-
der, chronic fatigue syndrome, posttraumatic stress disorder, substance
abuse ,etc.. The degree of association of any particular condition with ia-
trogenesis is unclear and in some cases controversial. The over-diagno-
sis of psychological conditions (with the assignment
of mental illness
terminology) may relate primarily to clinician dependence on subjective
criteria. The assignment of pathological nomenclature is rarely a benign
process and can easily rise to the level of emotional iatrogenesis, espe-