Philosophical roots of Quaternary Prevention

Daniel Widmer

doi:10.5712/rbmfc10(35)1128

Autores/as

Daniel Widmer Institut Universitaire de Médecine Générale, Lausanne, Switzerland.

DOI:

https://doi.org/10.5712/rbmfc10(35)1128

Palabras clave:

Prevención Cuaternaria, Filosofía, Ética, Medicina Basada en Evidencia, Epistemología

Resumen

Este artículo explora dos dimensiones filosóficas de la prevención cuaternaria, ya que esta representa la respuesta de los médicos de familia a la sobremedicalización. La primera dimensión se refiere a la teoría del conocimiento y la segunda a la teoría de la acción. A pesar de sus interconexiones, ellas serán discutidas en separado. En primer lugar, con respecto a las teorías del conocimiento (Epistemología) argumentase que el positivismo de la Medicina Basada en la Evidencia (MBE), tan útil para seleccionar las buenas prácticas, debería ser equilibrada con una visión crítica del uso de la
MBE, junto con una visión constructivista por medio de la medicina basada en la narrativa. En segundo lugar, con respecto a la teoría de la acción (Ética) argumentase que el principio de no maleficencia (primum non nocere) debe ser equilibrado por el principio de beneficencia. Este último es la obligación médica primaria y los médicos deberían cultivar esta sabiduría en la práctica. Finalmente, se discuten algunos aspectos de los retos futuros de la P4, como las desigualdades en salud, la colaboración interprofesional, la responsabilidad, el gerencialismo, y la medicina integral, donde sus posiciones filosóficas deberían ser consideradas.

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Biografía del autor/a

Daniel Widmer, Institut Universitaire de Médecine Générale, Lausanne, Switzerland.

MD, general practitioner, chargé de cours.

Citas

Widmer D, Herzig L, Jamoulle M. [Quaternary prevention: is acting always justified in family medicine?]. Rev Med Suisse. 2014 May 14;10(430):1052–6.

Dewey J. The quest for certainty. A study of the relation of knowledge and action. New York: Minton, Balch & Co; 1929.

Gartoulla RP. Textbook of medical sociology and medical anthropology. Kathmandu: Research Centre fir Integrated Development - Nepal; 2008. 654 p.

Sackett DL, Richardson WS, Rosenberg W, Haynes RB. Evidence-based Medicine. New York: Churchikk Livingstone; 1997.

Steel N. Thresholds for taking antihypertensive drugs in different professional and lay groups: questionnaire survey. BMJ. 2000 May 27;320(7247):1446–7. DOI: https://doi.org/10.1136/bmj.320.7247.1446

Schön DA. The reflective practitioner: how professionals think in action. New York: Basic Books; 1983. 374 p.

Thomas P. General medical practitioners need to be aware of the theories on which our work depend. Ann Fam Med. 2006 Oct;4(5):450–4. DOI: https://doi.org/10.1370/afm.581

Sturmberg JP, Martin CM, editors. Handbook of Systems and Complexity in Health [Internet]. New York, NY: Springer New York; 2013 [cited 2014 Aug 23]. Available from: http://link.springer.com/10.1007/978-1-4614-4998-0

Sturmberg JP, Martin CM, Katerndahl DA. Systems and Complexity Thinking in the General Practice Literature: An Integrative, Historical Narrative Review. The Annals of Family Medicine. 2014 Jan 1;12(1):66–74. DOI: https://doi.org/10.1370/afm.1593

Kuper A, Reeves S, Levinson W. An introduction to reading and appraising qualitative research. BMJ. 2008 Aug 7;337(aug07 3):a288–a288. DOI: https://doi.org/10.1136/bmj.a288

Launer J. Narrative-based primary care: a practical guide. Abingdon, Oxon, U.K.: Radcliffe Medical Press; 2002.

Balint M. The doctor, his patient and the illness. Edinburgh: Churchill Livingstone; 2000.

Harris MF, Dennis S, Pillay M. Multimorbidity: negotiating priorities and making progress. Aust Fam Physician. 2013 Dec;42(12):850–4.

Hippocrates, Jones WHS, Withington ET. [Medical works]. Vol 1 ; Ancient medicine.Vol 4 ; Heracleitus on the Universe. Harvard University Press; 1923. DOI: https://doi.org/10.4159/DLCL.hippocrates_cos-ancient_medicine.1923

Pilet F. [Medicine based on proof (evidence based medicine)...or the Ouin-Ouin syndrome]. Rev Med Suisse Romande. 2001 Apr;121(4):329–30.

Raynaud M. An Address on Scepticism in Medicine. Br Med J. 1881 Aug 13;2(1076):268–73. DOI: https://doi.org/10.1136/bmj.2.1076.268

Sanchez F. Il n’est science de rien. Paris: Klincksieck; 1984. 178 p. Original text on : http://gallica.bnf.fr/ark:/12148/bpt6k49823t

Sextus, Bury RG. Sextus Empiricus. Cambridge, Mass.: Harvard University Press; 1933.

Johnston WM. Vienna, Vienna: the golden age, 1815-1914. New York: C.N. Potter : Distributed by Crown Publishers; 1981. 332 p.

Gillon R. Philosophical medical ethics. Chichester ; New York: Wiley; 1986. 189 p.

Gadamer H-G. The enigma of health: the art of healing in a scientific age. Stanford: Stanford University Press; 1996. 180 p.

Pellegrino ED. The virtues in medical practice. New York: Oxford University Press; 1993. 205 p.

Benaroyo L. Éthique et responsabilité en médecine. Genève: Éditions Médecine & hygiène; 2006.

Chatelard S, Vaucher P, Wolff H, Bischoff T, Herzig L, Panese F, et al. [General practitioners facing social inequalities in health: which power to act?]. Rev Med Suisse. 2012 May 16;8(341):1061–2, 1064–6.

Chatelard S, Bodenmann P, Vaucher P, Herzig L, Bischoff T, Burnand B. General Practitioners Can Evaluate the Material, Social and Health Dimensions of Patient Social Status. Ribera JM, editor. PLoS ONE. 2014 Jan 15;9(1):e84828. DOI: https://doi.org/10.1371/journal.pone.0084828

Fraser N. Redistribution or recognition?: a political-philosophical exchange. London ; New York: Verso; 2003. 276 p.

Samuelson M, Herzig L, Widmer D. [Future of interprofessional primary care in time of crisis]. Rev Med Suisse. 2012 Nov 28;8(364):2254, 2256–9.

May C, Montori VM, Mair FS. We need minimally disruptive medicine. BMJ. 2009 Aug 11;339(aug11 2):b2803–b2803. DOI: https://doi.org/10.1136/bmj.b2803

Rodondi P-Y, Maillefer J, Suardi F, Rodondi N, Cornuz J, Vannotti M. Physician Response to “By-the-Way” Syndrome in Primary Care. Journal of General Internal Medicine. 2009 Jun;24(6):739–41. DOI: https://doi.org/10.1007/s11606-009-0980-2

Kernberg O. Borderline Personality Organization. Journal of the American Psychoanalytic Association. 1967 Jul 1;15(3):641–85. DOI: https://doi.org/10.1177/000306516701500309

Stigler M, Quinche P, Bonsack C. [Following “low threshold”: the “optimal minimum” in the therapeutic approach to the difficult patient]. Rev Med Suisse Romande. 1999 May;119(5):429–35.

Dowrick C, Frith L, editors. General practice and ethics: uncertainty and responsibility. London ; New York: Routledge; 1999. 196 p.

Arendt H, Kohn J. Responsibility and judgment. New York: Schocken Books; 2003.

Grant S, Huby G, Watkins F, Checkland K, McDonald R, Davies H, et al. The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study. Sociology of Health & Illness. 2009 Mar;31(2):229–45. DOI: https://doi.org/10.1111/j.1467-9566.2008.01129.x

Checkland K, Harrison S, McDonald R, Grant S, Campbell S, Guthrie B. Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract. Sociology of Health & Illness. 2008 Jul;30(5):788–803. DOI: https://doi.org/10.1111/j.1467-9566.2008.01081.x

Harrison MJ, Dusheiko M, Sutton M, Gravelle H, Doran T, Roland M. Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study. BMJ. 2014 Nov 11;349(nov11 1):g6423–g6423. DOI: https://doi.org/10.1136/bmj.g6423

Rakel D, editor. Integrative medicine. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012. 1039 p.

Kuehlein T, Sghedoni D, Visentin G, Gervas J, Jamoulle M. Quaternary prevention: a task of the general practitioner [Internet]. PrimaryCare; 2010. Available from: http://www.primary-care.ch/docs/primarycare/archiv/de/2010/2010-18/2010-18-368_ELPS_engl.pdf