Quaternary Prevention: Medical Ethics, Evaluation and Efficiency in the Health Systems
DOI:
https://doi.org/10.5712/rbmfc11(0)1388Keywords:
Quaternary Prevention . Physician-Patient Relations . Bioethics . Medicalization . OverdiagnosisAbstract
Quaternary Prevention as main focus and practice, promotes changes in developing health care and practicing medicine, prioritizing the person centred care.Their conceptual framework is sustained on ethical and philosophical aspects essential to medicine practice, in epistemological aspects of social and others related to political nature. Its objective is to protect fundamentally the patients, but also the members of the health group from excessive medicalization and unnecessary and hurtful practices. The present article is the result of the synthesis of the work documents, discussion and proposals carried forward by a large group of committed professionals from CIMF, with particular interest in Quaternary Prevention. The materials were produced in collaboration through a complex long distance work process, done during preparatory forums of the VI Ibero-American Summit of Family And Community Medicine. The work documents made during the same summit in San Joséof Costa Rica, in April 2016 were added to this material. The purpose of this document is to spread the state of development and current commitment to this approach and the outstanding initiative that it has had in Ibero America in the last five years. Due to its relevance, the intention is to stimulate greater dissemination of the concept; the implementation of content related to at in the training and academic levels. At a political level, to promote its consideration on decision making and public health issues so as to broadcast to demographic levels and promote the making of quality content. Finally to offer reflection clues to consider and concrete application tools.
Downloads
Metrics
References
SUMEFAC/Grupo de Trabajo en Prevención Cuaternaria de CIMF. Acta de creación del grupo de trabajo. Sugerencias de la
Primera reunión presencial del Grupo de Trabajo de CIMF a sociedades miembro [base de datos en Internet]*. Uruguay:
SUMEFAC - Pizzanelli M.; 14 julio 2016, [actualizada julio 2016; acceso 14 de julio de 2016]. Disponible en: https://drive.
google.com/file/d/0B2tjwHv1enqDZThrN2FDYzZpM3c/view?usp=sharing
Bentzen N, editor. Wonca International Dictionary of General/Family Practice: Wonca International Classification Committee; 1999.
Jamoulle M. A propos d’un dessin. Ethica Clinica [Internet]. 2013; 70:28-31. Disponible en: http://www.ph3c.org/PH3C/
docs/27/000281/0000416.pdf.
Leavell H, Clark E. Preventive Medicine for the Doctor in His Community an Epidemiologic Approach. McGraw-Hill, 1958. DOI: https://doi.org/10.2105/AJPH.48.7.947-a
Hart JT. The inverse care law. Lancet. 1971;1:405-412. DOI: https://doi.org/10.1016/S0140-6736(71)92410-X
Illich I. Némesis Médica. Editorial Joaquín Mortiz, S.A. México D.F. La expropiación de la salud, 1978.
Nye RA. The evolution of the concept of medicalization in the late twentieth century. J Hist Behav Sci. 2003;39(2):115-129. DOI: https://doi.org/10.1002/jhbs.10108
Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag. 2015;4(2):61-64.
Cardoso RV. Medicalização e o cuidado em saúde na estratégia de saúde da família [thesis online]. Campinas: Universidade
Estadual de Campinas; 2014. 268 p. Disponible en: http://www.ph3c.org/PH3C/docs/27/000281/0000605.pdf.
Jamoulle M, Bernstein J, Pizzanelli M, Silva AD, Wagner H. Quaternary prevention: a concept based on the time and the
relationship. Second part. The surprising international dissemination of the concept. Médecine [Internet]. 2014 Feb 1 [cited 2015
Jul 19];10(2):75-7. Available from: http://www.jle.com/en/revues/med/e-docs/prevention_quaternaire_un_concept_fonde_sur_
le_temps_et_la_relation._deuxieme_partie._l_etonnante_diffusion_internationale_du_concept_299639/article.phtml?tab=texte
Socarrás Suárez MM, Bolet Astoviza M, Lara Rodríguez RF. Vínculo universidad-sociedad a través de la percepción de médicos y
pacientes diabéticos sobre su enfermedad. Educ Med Super [Internet]. 2010 Sep [citado 2016 Jul 23];24(3):290-299. Disponible
en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21412010000300002&lng=es.
López ML. Extensión universitaria y salud pública en Argentina como caso testigo en la región. Revista de Investigación
Educativa, 34(1), 119-132. DOI: http://dx.doi.org/10.6018/rie.34.1.215411 DOI: https://doi.org/10.6018/rie.34.1.215411
Abreu Suárez G, González Valdés JA, Muñoz Peña R. La preparación del estudiante de Medicina para la eliminación de la
tuberculosis. Educ Med Super [Internet]. 2013 Mar [citado 2016 Jul 23];27(1):38-45. Disponible en: http://scielo.sld.cu/scielo.
php?script=sci_arttext&pid=S0864-21412013000100006&lng=es.
Vicente Sánchez B, Vicente Peña E, Altuna Delgado A, Identificación de individuos con riesgo de desarrollar diabetes tipo 2:
una explicación necesaria. Rev. Finlay [Internet]. 2015 Sep [citado 2016 Jul 23];5(3):148-160. Disponible en: http://scielo.sld.
cu/scielo.php?script=sci_arttext&pid=S2221-24342015000300002&lng=es.
Manterola Carlos, Otzen Tamara. Análisis Crítico de la Literatura Biomédica. Int. J. Morphol. [Internet]. 2014 Jun [citado 2016 Jul DOI: https://doi.org/10.4067/S0717-95022014000200037
;32(2):599-607. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022014000200037&lng=es.
Brodersen J, Schwartz LM, Woloshin S. Overdiagnosis: how cancer screening can turn indolent pathology into illness. APMIS.
Aug;122(8):683-9
Sackett DL. The arrogance of preventive medicine. CMAJ [Internet]. 2002 8-20 [cited 2015 Sep 23];167(4):363-4. Available
from:http://www.cmaj.ca/content/167/4/363
Welch HG. Should I be tested for cancer? University of California Press, 2004
United Nations, Sustainable Development Goals [sede Web]. New York: Division for Sustainable Development. Department of
Economic and Social Affairs; julio 2016. [acceso 12 de julio de 2006]. Disponible en: https://sustainabledevelopment.un.org/
La Valle R. Prevención cuaternaria o la Medicina sin corbata. Archivos de Medicina Familiar y General 2015; 12(2): 5-6
Biodiversidadla.org. Carta de Brasilia: La salud es un derecho [sede Web]. Organización y movimientos de América; 3
de diciembre de 2015. [acceso 20 de julio de 2006]. Disponible en: http://www.biodiversidadla.org/Portada_Principal/
Documentos/Carta_de_Brasilia_La_salud_es_un_derecho
Menéndez, E. El Modelo Médico y la Salud de los Trabajadores. Salud Colectiva, La Plata, 2005.1 (1) 9-32. DOI: https://doi.org/10.18294/sc.2005.1
World Health Organization [sede Web]*. WHO; octubre 2006 [acceso 20 de julio de 2006]. Constitución de la Organización
Mundial de la Salud [1-20]. http://www.who.int/governance/eb/who_constitution_sp.pdf.
Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag. 2015;4(2):61-64 DOI: https://doi.org/10.15171/ijhpm.2015.24
Published
How to Cite
Issue
Section
License
By submitting a manuscript to the RBMFC, authors retain ownership of the copyright in the article, and authorize RBMFC to publish that manuscript under the Creative Commons Attribution 4.0 license and identify itself as the vehicle of its original publication.
