Law of unintended consequences

Coyne (2008) and Merton (1936) have defined “Unintended Consequence” (UC) as an outcome different from what has been intended. Merton (1936) even adds that these UC’s are either foreseen or unforeseen but are likely the results of the interventions or programs implemented. This occurs as the imperfections of the world and people leads any purposeful action to produce an unforeseen result known as the “law of unintended consequences” (Merton, 1936).

Robert Merton, having popularized this idea of John Smith, points out that the causes for UC’s are, namely: a) human ignorance where it is a fact that it is impossible to anticipate everything thereby leading to incomplete expectations of results; b) errors from incorrect analysis of problems arising from habits and traditions that worked in the past but do not in the present; c) immediate interests overriding long-term goals; d) basic values and traditions that does not permit new ideas; and, e)self-defeating prophecy where people are likely to admit failure when early trials seem difficult (Merton, 1936). Serendipity and Perversity

UC’s, as opposed to common connotation, is not all bad (Coyne, 2008). These UC’s are either positive unexpected benefits, referred to as serendipity or windfall, or negative or perverse effects, contradicting to what it was originally intended (Merton, 1936). Positive UC’s can be seen in the sunken ships of the World War as this lead to the beautiful, scientifically valuable and attractive coral reefs (Merton, 1936). Also, the butcher who sold meats for personal profits but in a way lead to the availability of meat products for consumers is another example of an intention turning to be more beneficial as targeted (Coyne, 2008).

Negative effects on the other side can be exemplified by the “Peltzman effect” (Coyne, 2008). Coyne (2008) discussed the work of Sam Peltzman who studied the mandatory seatbelt laws in the United States. As Peltzman found out, the mandatory seatbelt laws, which were intended to decrease driving-related accidents, lead to no change to that effect and even increased the driving-related accidents of pedestrian and cyclists caused by drivers who drove more recklessly as they have had the assurance of safety by the seatbelts.

Thus, this “Peltzman effect” is an UC as a result of indiciduals to respond to safety regulations by engaging in more hazardous behaviors (Coyne, 2008). Thus, UC’s can turn out to be good or bad for they are “simply surprises that can span a spectrum from lucky to unfortunate” (Campbell, et al. , 2007, p. 547) UC, Side-Effects, and Disadvantages: How Similar and Different Unintended consequences have often been substituted for side effects and disadvantages being that side effects are unintentional results of something and disadvantages as the negative outcome of an action (Merton, 1936).

Nonetheless, UC’s can be distinguished from the latter two in some ways. Disadvantage, being all negative, is different from unintended consequences since, as discussed above, UC’s occur either as positive or negative unintentional outcomes. Thus, the differentiation of the two is clear. But then, the delineation between UC’s and side-effects is blurred. MSN Encarta (2008) defines side effect as the “undesirable secondary effect produced by something” usually pertaining to drugs and other forms of medical treatment. This then puts the implication that side effects are negative outcomes.

Merton (1936), however, points out that these negative side effects can also become positive. He cited aspirin as an example saying that the blood thinning side effects of aspirin can be negative for bleeders but are good for people suffering from cases like thrombo-embolisms and risks of heart attack. With these definitions, side effect is hard to distinguish from UC’s. Nonetheless, a difference that can be pointed out is that UC’s are unexpected and unknown (Merton, 1936) while side effects are more established facts and physiologies rising from current knowledge of the action to be undertaken (Spratto & Woods, 2008).

Like in drugs, Furosemide may be intended to cause a decrease in blood pressure but as a side-effect, an increase in urination is expected as Furosemide functions as a diuretic. Another difference between UC’s and side effects is that UC’s are not used as alternatives to the intended results of the action (Merton, 1936) while side effects of interventions can be used as the main purpose of that action (Spratto & Woods, 2008).

Again, citing Furosemide as the example, its diuretic and hypotensive property can be used as the main intention of the drug with the other acting as the side effect. This study will be pertaining to the UC’s of an emerging health care technology. And though this paper would note the negative UC’s, it is with these demarcations of UC’s from disadvantages and side effects that this study hopes to point out these negative effects of a healthcare technology are neither side effects nor disadvantages but are unintended consequences.