Recommendations, and autoplaying videos in particular based on them, clearly drive growth and profits. But they are clearly the crux of the problem.
Sure, defining harm is not straightforward. But it's possible, and frankly as a private platform, it is their choice.
One could, for example, take a broader definition of harm, and use that to limit recommendations, but still host the video and allow it to return in search results. Is this the right answer? I don't know. But it's silly to just throw up your hands and somehow take recommendations as some sacrosanct part of the system, when it was clearly a choice to have them to begin with.