[Quaternary prevention: An attempt to avoid the excesses of Medicine].

Seduced by technology, biometrics, practical guidelines and the use of medication, medicine has been driven away from the subject of its care. Quaternary prevention is, among other voices around the world, trying to denounce the consequent excesses of medical practice given by this situation. There are visible excesses, such as the long list of studies being performed on patients without indication, and others, much more subtle, as excessive prevention and the continuous and progressive medicalization of life itself that are rooted in our culture and demanded by a society that requests certainty at almost any cost. Quaternary prevention proposes a series of actions leaning towards avoiding and diminishing the damage produced by health care activities, in order to protect the subject of overdiagnosis and overtreatment; offering also ethical and viable alternatives in which the balance of risks and benefits (based on the best evidences) respects the autonomy of the subject by properly informing and allowing him to decide among the best options he has; altogether in a process that contemplates a rational and equitable use of resources. In order to achieve this, reliable sources of information and a medical education not dependent on industries related to technology or pharmaceuticals, are vital; in conjuction with a medicine that restablishes the subject as its main and central interest.