Views & Reviews Personal View

Mathematics is bad for you: population risk reduction medicalises us all

BMJ 2012; 344 doi: (Published 11 April 2012) Cite this as: BMJ 2012;344:e2612
  1. James Le Fanu, general practitioner, Mawbey Brough Health Centre, London SW8 2UD
  1. james.lefanu{at}

Mathematics—“the language in which God has written the universe,” according to Galileo—can also be the enemy of reason. Twelve years ago the financial analyst David Li devised a function that allowed the risk of dodgy subprime mortgages to be repackaged as securitised collateral debt obligations. You don’t need to understand what this means because the consequences are familiar enough. The credit crunch, to which this mathematics made so substantial a contribution, would bankrupt sovereign states, require banks to be taken into public ownership, and cost the US economy, it is estimated, a cool $4.6 trillion (£2.9 trillion; €3.5 trillion).1And so too in medicine, though here the penalty for deferring uncritically to the authority of mathematics is a tidal wave of iatrogenic illness. Many letters from readers of my weekly medical column in the Daily Telegraph recount their experiences of the current enthusiasm for medicalisation. Typically, as one put it, “I visited my surgery for a flu jab in a good state of mind and ended up a worried patient,” after the practice nurse seized the opportunity …

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