Quaternary Prevention (P4) is an action taken to identify patients at risk of overmedicalisation, to protect them from new medical invasions, and to suggest interventions ethically acceptable. Recently, three European articles have proposed a new definition: “to protect individuals from more harmful than beneficial interventions”. The objective is to discuss this proposal critically. We have identified and analysed seven criticisms to P4 original definition. Five are unfounded: (1) Ethically vague; (2) Restricted scope; (3) Creation of an unnecessary step; (4) Focus on medicalisation; (5) Demedicalisation non-scientific based. The remaining two do not justify a new definition: (6) Changing visual representation; (7) Centeredness on Evidence-Based Medicine (EBM). The new proposal reduces the scope of P4 and the professional role. The original definition is robust and incorporates the challenge of social/cultural iatrogeny resulting from overmedicalisation, partially unattainable via EBM.
Keywords
Quaternary prevention; Family practice; Medicalisation; Evidence-based medicine; Primary health care
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P1= primary prevention; P2= secondary prevention; P3= tertiary prevention; P4= quaternary prevention. Source: elaborated by the authors, based on Jamoulle
P1= primary prevention; P2= secondary prevention; P3= tertiary prevention; P4= quaternary prevention Source: elaborated by the authors, based on Brodersen et al.