Rejoinder to "Perspectives on `harm' in personalized medicine – an alternative perspective"

In our original article (Sarvet Stensrud, 2024), we examine twin definitions of "harm" in personalized medicine: one based on predictions of individuals' unmeasurable response types (counterfactual harm), and another based solely on the observations of experiments (interventionist harm). In their commentary, Mueller Pearl (2024) (MP) read our review as an argument that "counterfactual logic should [...] be purged from consideration of harm and benefit" and "strongly object [...] that a rational decision maker may well apply the interventional perspective to the exclusion of counterfactual considerations." Here we show that this objection is misguided. We analyze MP's examples and derive a general result, showing that determinations of harm through interventionist and counterfactual analyses will always concur. Therefore, individuals who embrace counterfactual formulations and those who object to their use will make equivalent decisions in uncontroversial settings.