Martínez González C, Riaño Galán I, Sánchez Jacob M, González de Dios J
Comité de Bioética de la AEP, Centro de Salud San Blas, Parla, Madrid, España.
Comité de Bioética de la AEP, Hospital San Agustín, Avilés, Asturias, España.
An Pediatr (Barc). 2014 Dec;81(6):396.e1-8. doi: 10.1016/j.anpedi.2014.04.029. Epub 2014 Jun 5.
The growing capacity of medicine to generate more iatrogenic events than ever, and the risk of unsustainability of health systems have led to new prevention concept: quaternary prevention aimed at restraining medicalization. Quaternary prevention is essential in the phenomenon called disease mongering, which could be translated as commercialization of disease. Encouraging this sort of prevention and halting the consequences of disease mongering requires the development of all the institutional potential for prevention, as well as all the personal willingness for restraint; it involves separating us from the unnecessary auspices of industry, being critical of our work, not being maleficent, respecting the principle of justice as managers of the limited public resources and making ourselves feel responsible for the social cost resulting from medical decisions. From this point of view, this work analyses neonatal screening, developments in the area of neonatology and primary health care.
医学引发比以往更多医源性事件的能力不断增强，以及卫生系统不可持续的风险，催生了新的预防理念：旨在抑制医疗化的四级预防。四级预防在所谓的疾病商品化现象中至关重要，疾病商品化可理解为疾病的商业化。鼓励这种预防并遏制疾病商品化的后果，需要挖掘所有的机构预防潜力以及所有人的自我约束意愿；这涉及摆脱行业不必要的庇护，审视我们的工作，不做有害之事，作为有限公共资源的管理者尊重公正原则，并为医疗决策产生的社会成本承担责任。从这一角度出发，本文分析了新生儿筛查、新生儿学领域的发展以及初级卫生保健。
