Implicações éticas, pedagógicas, sócio-políticas e antropológicas da prevenção quaternária

Autores

  • Marc Jamoulle MD, PhD. Family Physician, researcher, University of Liège (ULg), Belgium; University Isalud, Buenos Aires, Argentina.
  • Michel Roland MD, PhD. Family Physician. Emeritus professor of family medicine, Free university of Brussels (ULB). President of Médecins du Monde, Belgium
  • Jong-Myon Bae MD, PhD. Professor of preventive medicine, Jeju National University, South-Korea
  • Bruno Heleno MD, PhD. Family doctor, Lumiar Health Center. Assistant Professor, New University of Lisbon, Portugal
  • Giorgio Visentin MD. Family Physician, Specialist in emergency medicine. Centro Studi e Ricerche in Medicina Generale. Milan, Italy
  • Gustavo Diniz Ferreira Gusso Universidade de São Paulo (USP). São Paulo, SP
  • Maciek Godycki-Ćwirko MD, PhD. General Practitioner, Professor, Centre for Family & Community Medicine, Division of Public Health, Faculty of Medical Sciences, Medical University of Lodz, Poland
  • Miguel Pizzanell MD, MSc. Family Physician, Assistant professor of Family and Community Medicine, University of the Republic (UDELAR), Florida, Uruguay. President of the Special Interest Group of WONCA on Quaternary prevention and overmedicalization
  • Patrick Ouvrard MD. Family Physician, Director of research of the French society for teaching in Medicine (SFTG). Paris, France. Vice-president of European Union of General Practitioners (UEMO)
  • Ricardo La Valle MD, PhD. Family physician. Department of Family Medicine. University of Buenos Aires. National University of Hurlingham. Argentina
  • Luis Filipe Gomes MD, PhD. Family Physician. Emeritus professor of Family Medicine, Faro University. Portugal
  • Daniel Widmer MD. Family Physician. Lecturer in Family Medicine, University of Lausanne. Switzerland. Vice-president of European Union of General Practitioners (UEMO)
  • Jorge Bernstein MD. Psychiatrist, president of the Quaternary Prevention Commission of the Argentine Federation of General and Family Medicine (FAMFyG), President of the Chapter of Quaternary Prevention of the Association of Psychiatrists of Argentina. Buenos Aires.Argentina
  • Mariana Mariño MD.MSc. Sociedad Argentina de Medicina Internal General (SAMIG). Ciudad de Buenos Aires, Argentina
  • Hamilton Lima Wagner MD. Masters in Surgery. Family and Community Medicine, Preceptor of the residency program in Family and Community Medicine at Health Secretariat of Curitiba, Brazil
  • Ilario Rossi MA. PhD. Anthropologist, Professor, THEMA - Institute of Social Sciences, Faculty of Social and Political Sciences, University of Lausanne (UNIL), Switzerland

DOI:

https://doi.org/10.5712/rbmfc13(40)1860

Palavras-chave:

Prevenção Quaternária, Ética Profissional, Medicina Baseada em Evidências, Medicina Geral

Resumo

O conceito de prevenção quaternária, resultante de uma reflexão sobre a relação médico-paciente, é apresentado como uma renovação da antiga exigência ética: primeiro, o médico não deve causar nenhum dano; segundo, o médico deve se controlar. A origem do conceito, o seu endosso pela Organização Mundial de Médicos de Família (WONCA) e a União Europeia de Médicos de Clínica Geral (UEMO), a sua divulgação e os debates a que deu origem, são apresentados por um painel de autores de 10 países. Este artigo baseia-se na bioética da prevenção, na importância do ensino da prevenção quaternária e na medicina factual, nas implicações sociais e políticas do conceito de prevenção quaternária e nas suas dimensões antropológicas.

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Biografia do Autor

Gustavo Diniz Ferreira Gusso, Universidade de São Paulo (USP). São Paulo, SP

Doutor em Ciências Médicas

Professor da Disciplina de Clinica Geral e Propedêutica da Universidade de São Paulo

Referências

Lévy E. Ilya Prigogine «L’incertitude, c’est la vie»: lepoint.fr; 2002/01/18 [Available from: http://www.lepoint.fr/actualites-chroniques/2007-01-20/ilya-prigogine-l-incertitude-c-est-la-vie/989/0/60025.

Bloy G. L’incertitude en médecine générale: sources, formes et accommodements possibles. Sciences sociales et santé. 2008;26(1):67-91.

Davidoff F, Haynes B, Sackett D, Smith R. Evidence based medicine. BMJ. 1995. DOI: https://doi.org/10.1136/bmj.310.6987.1085

Greenhalgh T, Howick J, Maskrey N. Evidence based medicine: a movement in crisis? Bmj. 2014;348:g3725. DOI: https://doi.org/10.1136/bmj.g3725

Clark EG. Natural history of syphilis and levels of prevention. British Journal of Venereal Diseases. 1954;30(4):191. DOI: https://doi.org/10.1136/sti.30.4.191

Bury J. Éducation pour la santé: concepts enjeux planifications. 1988.

Gofrit ON, Shemer J, Leibovici D, Modan B, Shapira SC. Quarternary prevention: a new look at an old challenge. Isr Med Assoc J. 2000;2:498-500.

Bentzen N. WONCA Dictionary of General/Family Practice. Copenhagen: Maanedsskr; 2003.

Jamoulle M. Information et informatisation en médecine générale [Computer and computerisation in general practice]. Namur, Belgium: Presses Universitaires de Namur; 1986.

Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag. 2015;4(2):61-4. DOI: https://doi.org/10.15171/ijhpm.2015.24

Hellstrom OW. Health promotion in general practice. Eur J Public Health. 1994;4:119-24. DOI: https://doi.org/10.1093/eurpub/4.2.119

Sadegh-Zadeh K. Anamnesis and diagnosis. In: Sadegh-Zadeh K, editor. Handbook of Analytic Philosophy of Medicine. Dordrecht: Springer; 2015. p. 363. DOI: https://doi.org/10.1007/978-94-017-9579-1

Carpentier J. Medical Flipper. Cahiers libres, 402. 1989:154.

UEMO. UEMO position on Disease Mongering/Quaternary Prevention 2008 [Available from: http://www.uemo.eu/2011/02/08/uemo-position-on-disease-mongering-quaternary-prevention/

Jamoulle M, Tsoi G, Heath I, Mangin D, Pezeshki M, Pizzanelli Báez M, editors. Quaternary prevention, addressing the limits of medical practice. WONCA World; 2013 2013; Prague.

Foucault M. La crisis de la medicina o la crisis de la antimedicina. 1974. Revista Cubana de Salud Pública. 2018;44:172-83.

Brownlee S. Overtreated: Why too much medicine is making us sicker and poorer: Bloomsbury New York; 2007.

Martins C, Godycki-Cwirko M, Heleno B, Brodersen J. Quaternary prevention: reviewing the concept: Quaternary prevention aims to protect patients from medical harm. European Journal of General Practice. 2018;24(1):106-11. DOI: https://doi.org/10.1080/13814788.2017.1422177

Sagan A, Panteli D, Borkowski W, Dmowski M, Domanski F, Czyzewski M, et al. Poland health system review. Health Systems in Transition. 2011;13(8):1-193.

Godycki-Ćwirko M, Krawczyk J, Tomiak E, Osiecka R, Mazurek L, Ludwikow G, et al. Czasochłonność profilaktyki w podstawowej opiece zdrowotnej [Time requirements for prevention in primary health care]. Probl Med Rodz. 2009;1(26):23-7.

Wonca Special Interest Group on Quaternary Prevention and Overmedicalisation. Manifeste; La Prévention quaternaire, présent et futur Proclamation de Rio de Janeiro. Décembre 2016 [Available from: http://www.ph3c.org/PH3C/docs/27/000449/0000842.pdf.

WONCA Special Interest Group: Quaternary Prevention & Overmedicalization 2017 [Available from: http://www.globalfamilydoctor.com/groups/SpecialInterestGroups/QuaternaryPrevention.aspx.

Gomes LF, Gusso G, Jamoulle M. Teaching and learning quaternary prevention. Revista Brasileira de Medicina de Família e Comunidade. 2015;10(35):1-14. DOI: https://doi.org/10.5712/rbmfc10(35)1050

Alber K, Kuehlein T, Schedlbauer A, Schaffer S. Medical overuse and quaternary prevention in primary care–A qualitative study with general practitioners. BMC family practice. 2017;18(1):99. DOI: https://doi.org/10.1186/s12875-017-0667-4

Franken G. Prävention und Demenz Eine Begriffsklärung Literaturstudie. Witten: Universität Witten/ Herdecke (Arbeitspapier des DZD, 12). Dialog- und Transferzentrum Demenz (DZD); 2016.

La Valle RA. Prevención Cuaternaria o la Medicina sin corbata. Archivos de Medicina Familiar y General. 2015;12:5-6.

Brodersen J, Schwartz LM, Woloshin S. Overdiagnosis: how cancer screening can turn indolent pathology into illness. Apmis. 2014;122(8):683-9. DOI: https://doi.org/10.1111/apm.12278

Martínez CG, Riaño IG, Sánchez MJ, de Dios González J, editors. Quaternary prevention: Containment as an ethical necessity. Anales de pediatria (Barcelona, Spain: 2003); 2014.

Tesser CD. Why is quaternary prevention important in prevention? Revista de saude publica. 2017;51:116. DOI: https://doi.org/10.11606/S1518-8787.2017051000041

Department of Health E. The Belmont Report. Ethical principles and guidelines for the protection of human subjects of research. The Journal of the American College of Dentists. 2014;81(3):4.

Gillon R. Medical ethics: four principles plus attention to scope. BMJ: British Medical Journal. 1994;309(6948):184. DOI: https://doi.org/10.1136/bmj.309.6948.184

Bae J-M. Shared decision making: relevant concepts and facilitating strategies. Epidemiology and health. 2017;39. DOI: https://doi.org/10.4178/epih.e2017048

Smith CM. Origin and uses of primum non nocere—above all, do no harm! The Journal of Clinical Pharmacology. 2005;45(4):371-7. DOI: https://doi.org/10.1177/0091270004273680

Visentin G. The difficult choice of” not doing”: comment on” Quaternary prevention, an answer of family doctors to overmedicalization”. International journal of health policy and management. 2015;4(8):559. DOI: https://doi.org/10.15171/ijhpm.2015.108

Bae J-M, Jamoulle M. Primary care physicians’ action plans for responding to results of screening tests based on the concept of quaternary prevention. Journal of Preventive Medicine and Public Health. 2016;49(6):343. DOI: https://doi.org/10.3961/jpmph.16.059

Gérvas J, Starfield B, Heath I. Is clinical prevention better than cure? The Lancet. 2008;372(9654):1997-9. DOI: https://doi.org/10.1016/S0140-6736(08)61843-7

Deyo RA. Cascade effects of medical technology. Annual review of public health. 2002;23(1):23-44. DOI: https://doi.org/10.1146/annurev.publhealth.23.092101.134534

Medicine AFABoI. ACP-ASIM Foundation. American College of Physicians-American Society of Internal Medicine; European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136(3):243-6. DOI: https://doi.org/10.7326/0003-4819-136-3-200202050-00012

Bae J-M. Suggestions for the promotion of evidence-based public health in South Korea. Epidemiology and health. 2017;39. DOI: https://doi.org/10.4178/epih.e2017030

Sackett DL. Evidence-based Medicine How to practice and teach EBM: WB Saunders Company; 1997.

Bae J-M. Value-based medicine: concepts and application. Epidemiology and health. 2015;37. DOI: https://doi.org/10.4178/epih/e2015014

Brown GC, Brown MM, Sharma S. Health care economic analyses. Retina. 2004;24(1):139-46. DOI: https://doi.org/10.1097/00006982-200402000-00019

Jamoulle M. A Comment on “Quaternary Prevention in Public Health” by Dr. Jong-Myon Bae. J Prev Med Public Health. 2016;49(2):139-40. DOI: https://doi.org/10.3961/jpmph.16.031

Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean?(or it takes at least two to tango). Social science & medicine. 1997;44(5):681-92. DOI: https://doi.org/10.1016/S0277-9536(96)00221-3

Widmer D. Care and do not harm: Possible misunderstandings with quaternary prevention (P4): comment on “Quaternary prevention, an answer of family doctors to over medicalization”. International journal of health policy and management. 2015;4(8):561. DOI: https://doi.org/10.15171/ijhpm.2015.99

Premji K, Upshur R, Légaré F, Pottie K. Future of family medicine: Role of patient-centred care and evidence-based medicine. Canadian Family Physician. 2014;60(5):409-12.

Malin JL. Wrestling with the high price of cancer care: should we control costs by individuals’ ability to pay or society’s willingness to pay?: American Society of Clinical Oncology; 2010. DOI: https://doi.org/10.1200/JCO.2010.28.9967

Swanson JW, Van McCrary S. Medical futility decisions and physicians’ legal defensiveness: the impact of anticipated conflict on thresholds for end-of-life treatment. Social Science & Medicine. 1996;42(1):125-32. DOI: https://doi.org/10.1016/0277-9536(95)00082-8

Bae J-M. Development and application of patient decision aids. Epidemiology and health. 2015;37. DOI: https://doi.org/10.4178/epih/e2015018

Bae J-M. Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea. Journal of Preventive Medicine and Public Health. 2017;50(4):217. DOI: https://doi.org/10.3961/jpmph.17.069

Starfield B, Hyde J, Gérvas J, Heath I. The concept of prevention: a good idea gone astray? Journal of Epidemiology & Community Health. 2008;62(7):580-3. DOI: https://doi.org/10.1136/jech.2007.071027

Kalra S, Baruah MP, Sahay R. Quaternary prevention in thyroidology. Thyroid Research and Practice. 2014;11(2):43. DOI: https://doi.org/10.4103/0973-0354.129561

Godycki-Ćwirko M, Tomiak E, Wrzeciono B, Lukas W. Zakres profilaktyki w podstawowej opiece zdrowotnej [Scope of prevention in primary care]. Problemy Medycyny Rodzinnej. 2009;11(1):15-22.

Bentaberry M, Bernstein J, Jamoulle M, La Valle R, Mariño MA, Piñero A, et al. Curso Introductorio a la Práctica de la Prevención Cuaternaria (P4) SUMEFAC & FAMFyG 2017 [Available from: http://www.famg.org.ar/archivos/Version-Imprimible-Curso-Introduccion-a-la-Practica-de-la%20-Prevencion-Cuaternaria%20(P4).pdf.

Tran THV, Vo TL. Impact of quaternary prevention as a brief intervention in medical students’ clinical decisions: experience from Vietnam Impacto da prevenção quaternária como intervenção breve nas decisões clínicas de estudantes de medicina : In the last decades medica. Revista Brasileira de Medicina de Família e Comunidade. 2015;10:1-8. DOI: https://doi.org/10.5712/rbmfc10(35)1119

Hirsch CD, Barlem ELD, Barlem JGT, Dalmolin GdL, Pereira LA, Ferreira AG. Cross-cultural adaptation and validation of the Nursing Student Satisfaction Scale for use with Brazilian nursing students. Revista latino-americana de enfermagem. 2016;24. DOI: https://doi.org/10.1590/1518-8345.1053.2776

Balint M. The doctor, his patient, and the illness. The Lancet. 1955;265(6866):683-8. DOI: https://doi.org/10.1016/S0140-6736(55)91061-8

Illich I. Medical nemesis: The expropriation of health. New York: Pantheon Books; 1976. DOI: https://doi.org/10.1097/00004010-197700000-00017

Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129-36. DOI: https://doi.org/10.1126/science.847460

Commission E. Proposal for a regulation of the European Parliament and of the Councilon health technology assessment and amending Directive 2011/24/EUBrussels: European commission; 31.1.2018.

Sackett DL, Rosenberg WM, Gray JM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. British Medical Journal Publishing Group; 1996. DOI: https://doi.org/10.1136/bmj.312.7023.71

Stange KC, Ferrer RL. The paradox of primary care. Annals of Family Medicine. 2009;7(4):293-9. DOI: https://doi.org/10.1370/afm.1023

Pluye P, Hong QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Annual review of public health. 2014;35. DOI: https://doi.org/10.1146/annurev-publhealth-032013-182440

Olivier de Sardan J-P. La rigueur du qualitatif. Les contraintes empiriques de l’interprétation socio-anthropologique. Lectures, Publications reçues. 2008.

Rossi I. La clínica como espacio social ¿Época de cambios o cambio de época? In: Sutton LHM, Torres A, Hernández I, editors. La comunicación dialógica como competencia médica esencial. Mexico: Editorial El Manual Moderno; 2017. p. 38-57.

Toon P. Books: Mapping Uncertainty in Medicine: What to Do When You Don’t Know What to Do: Mapping the Terrain. British Journal of General Practice; 2016 DOI: https://doi.org/10.3399/bjgp16X687829

Kumar NS. Health situation of scheduled castes in Bolpur-Sriniketan. Anthropological Survey of India. Kolkata: Ministry of Culture; 2011.

Chaudhuri B. Health for All: Looking for an Alternative Approach. Dr Ambedkar Chair in Anthropology. Department of Anthropology, Calcutta University; 2008.

Farmer P, Kim JY, Kleinman A, Basilico M. Reimagining global health: an introduction: Univ of California Press; 2013. DOI: https://doi.org/10.1525/9780520954632

Menendez EL. El modelo médico y la salud de los trabajadores. Salud colectiva. 2005;1:9-32. DOI: https://doi.org/10.18294/sc.2005.1

Publicado

2018-10-10

Como Citar

1.
Jamoulle M, Roland M, Bae J-M, Heleno B, Visentin G, Gusso GDF, Godycki-Ćwirko M, Pizzanell M, Ouvrard P, La Valle R, Gomes LF, Widmer D, Bernstein J, Mariño M, Wagner HL, Rossi I. Implicações éticas, pedagógicas, sócio-políticas e antropológicas da prevenção quaternária. Rev Bras Med Fam Comunidade [Internet]. 10º de outubro de 2018 [citado 28º de março de 2024];13(40):1-14. Disponível em: https://rbmfc.org.br/rbmfc/article/view/1860

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