1) surgery is dangerous. Even innocuous surgeries can have complications such as infection that can kill. There’s also complications that aren’t factored into the obvious math, for example ever since I got 2 of my wisdom teeth out, my jaw regularly tightens up and cracks if I open my mouth wide, something that never happened beforehand. I wasn’t warned about this and didn’t consider it when I was deciding to get the surgery.
2) If it’s something dangerous, you’re very likely to find out anyway before it becomes serious. eg, if it’s a tumor, it’s going to keep growing and you can come back a month later and get it out then with little problem.
3) even if it’s not nothing, it might be something else that’s unlikely to kill you. Thus the 5/1000 chance of death you’re imagining is actually a 5/1000 chance of being not nothing.
Are you just making these points as things to keep in mind, or are you making a stronger point? If the latter, can you elaborate? Are you particularly knowledgeable?
The point is your consideration of “if surgery, definitely fine” vs “if no surgery, 5/1000 chance of death” are ignoring a lot of information. You’re acting like your doctor is being unreasonable when in fact they’re probably correct.
Stronger point: since we are at Less Wrong, think Bayes Theorem. In this case, a “true positive” would be cancer leading to death, and a “false positive” would be death from a medical mishap trying to remove a benign cyst (or even check it further). Death is very bad in either case, and very unlikely in either case.
P (death | cancer, untreated) - this is your explicit worry
P (death | cancer, surgery)
P (death | benign cyst, untreated)
P (death | benign cyst, surgery) - this is what drethelin is encouraging you to note
P (benign cyst)
P (cancer)
My prior for medical mishaps is higher than 0.5% of the time, but not for fatal ones while checking/removing a cyst near the surface of the skin. As drethelin’s #2 notes, this is not binary. If it is not a benign cyst, you will probably have indicators before it becomes something serious. Similarly, you have non-surgical options such as a cream or testing. Testing probably has a lower risk rate than surgery, although if it is a very minor surgery, perhaps not that much lower.
If the cyst worries you, having it checked/removed is probably low risk and may be good for your mental health. But now we might have worried you about the risks of doing that (sorry) when we meant to reduce your worries about leaving the cyst untreated.
In general if you list everything you can think of and give it probability scores, you ignore unknown unknowns.
For medical interventions like surgery unknown unknowns are more likely to be bad than to be good.
As a result it’s useful to have a prior against doing a medical intervention if there no strong evidence that the intervention is beneficial.
Maybe we need to visualize surgery different. I used to think about it like replacing a part in a car. Why not just do it if the part is not working too well.
Maybe we should see it as damage. It’s like someone attacking you with a knife. Except that the intention is completely different, they know what they are doing, their implements are far more precise and so on, so the parallel is not very good either, I am just saying that “recovering from an appendicitis” could be at least visualized as something closer to “recovering after a nasty knife fight” than to “just had the clutch in my car replaced”.
1) surgery is dangerous. Even innocuous surgeries can have complications such as infection that can kill. There’s also complications that aren’t factored into the obvious math, for example ever since I got 2 of my wisdom teeth out, my jaw regularly tightens up and cracks if I open my mouth wide, something that never happened beforehand. I wasn’t warned about this and didn’t consider it when I was deciding to get the surgery.
2) If it’s something dangerous, you’re very likely to find out anyway before it becomes serious. eg, if it’s a tumor, it’s going to keep growing and you can come back a month later and get it out then with little problem.
3) even if it’s not nothing, it might be something else that’s unlikely to kill you. Thus the 5/1000 chance of death you’re imagining is actually a 5/1000 chance of being not nothing.
Are you just making these points as things to keep in mind, or are you making a stronger point? If the latter, can you elaborate? Are you particularly knowledgeable?
The point is your consideration of “if surgery, definitely fine” vs “if no surgery, 5/1000 chance of death” are ignoring a lot of information. You’re acting like your doctor is being unreasonable when in fact they’re probably correct.
Stronger point: since we are at Less Wrong, think Bayes Theorem. In this case, a “true positive” would be cancer leading to death, and a “false positive” would be death from a medical mishap trying to remove a benign cyst (or even check it further). Death is very bad in either case, and very unlikely in either case.
P (death | cancer, untreated) - this is your explicit worry P (death | cancer, surgery) P (death | benign cyst, untreated) P (death | benign cyst, surgery) - this is what drethelin is encouraging you to note P (benign cyst) P (cancer)
My prior for medical mishaps is higher than 0.5% of the time, but not for fatal ones while checking/removing a cyst near the surface of the skin. As drethelin’s #2 notes, this is not binary. If it is not a benign cyst, you will probably have indicators before it becomes something serious. Similarly, you have non-surgical options such as a cream or testing. Testing probably has a lower risk rate than surgery, although if it is a very minor surgery, perhaps not that much lower.
If the cyst worries you, having it checked/removed is probably low risk and may be good for your mental health. But now we might have worried you about the risks of doing that (sorry) when we meant to reduce your worries about leaving the cyst untreated.
In general if you list everything you can think of and give it probability scores, you ignore unknown unknowns. For medical interventions like surgery unknown unknowns are more likely to be bad than to be good.
As a result it’s useful to have a prior against doing a medical intervention if there no strong evidence that the intervention is beneficial.
Maybe we need to visualize surgery different. I used to think about it like replacing a part in a car. Why not just do it if the part is not working too well.
Maybe we should see it as damage. It’s like someone attacking you with a knife. Except that the intention is completely different, they know what they are doing, their implements are far more precise and so on, so the parallel is not very good either, I am just saying that “recovering from an appendicitis” could be at least visualized as something closer to “recovering after a nasty knife fight” than to “just had the clutch in my car replaced”.
What do you think?
Why do you think we need to do so?
agreed; if you are getting it done; and prefer the higher chance of life; get it done without being fully anaesthetized.
Possibly by a plastic surgeon; they seem to have profits to burn on quality equipment from people doing unnecessary (debatable) cosmetic procedures.