Quaternary prevention: First, do not harm

Abstract

“First, do not harm” and “Prevention is better than cure” are two key principles of medicine. Preventive health serves for individuals and population are among the daily routine task of the family physicians. Clinical prevention are the activities taken to prevent the occurrence and development of a health problem or its complications. Preventive actions have been evaluated in three levels until today: Primary prevention, secondary prevention, tertiary prevention. Principle of “first, do not harm” requires that physicians to avoid iatrogenic harm. New information from the studies conducted in recent years indicated that the preventive actions could give harm to patients. However, health care practices which are potentially harmful to the patient are not only limited to protection interventions. Harm can be given to patients in process of investigation, diagnosis and treatment of disease. The responsibility of family physicians to prevent their patients from being harmed by medical initiatives has led to the emergence of the concept of quaternary prevention. Concept is developed by Marc Jamoulle in 1986; and has been presented in a new version of the principle of “First, do not harm”. The concept of quaternary prevention adopted during the World Organization of Family Doctors (WONCA) International Classification Committee Meeting and were published in the WONCA’s General Practice and Family Medicine Glossary. Quatenary prevention is defined as “Action taken to identify a patient or a population at risk of over-medicalisation, to protect them from invasive medical interventions and provide for them care procedures which are scientifically and medically acceptable. Consept of Quatenary prevention is also being increasingly adopted by other specialties widespread.