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.

翻译：[译摘要] 在我们的原始文章（Sarvet & Stensrud, 2024）中，我们探讨了个性化医学中“伤害”的两种定义：一种基于对个体不可测量反应类型的预测（反事实伤害），另一种仅基于实验观察（干涉主义伤害）。Mueller & Pearl（2024）（简称MP）在评论中将我们的综述解读为一种主张，即“反事实逻辑应该……被排除在伤害和获益的考量之外”，并“强烈反对……理性决策者可能完全采用干涉主义视角而排除反事实考量”。在此，我们证明这一反对意见是错误的。我们分析了MP的示例并推导出一个一般性结论，表明通过干涉主义分析和反事实分析确定的伤害始终是一致的。因此，接受反事实表述的人与反对使用反事实表述的人在无争议情境下将做出等效决策。