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An Pediatr (Barc). 2014 Dec;81(6):396.e1-8. doi: 10.1016/j.anpedi.2014.04.029. Epub 2014 Jun 5.

[Quaternary prevention: containment as an ethical necessity].

[Article in Spanish]

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Comité de Bioética de la AEP, Centro de Salud San Blas, Parla, Madrid, España. Electronic address:
Comité de Bioética de la AEP, Hospital San Agustín, Avilés, Asturias, España.
Comité de Bioética de la AEP, Centro de Salud La Victoria, Valladolid, España.
Grupo de Trabajo de Pediatría Basada en la Evidencia de la AEP, Hospital General Universitario de Alicante, Alicante, España.


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.


Atención primaria; Bioethics; Bioética; Cribado neonatal; Disease mongering; Ethics; Neonatal screening; Neonatology; Neonatología; Pediatrics; Pediatría; Prevención cuaternaria; Primary care; Quaternary prevention; Ética

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