In medicine, more is not always better

The ancient principle of "primum non nocere," meaning "first, do no harm," remains a cornerstone of bioethics and medical practice. Originating in ancient Greece and articulated by figures like Hippocrates, this principle, alongside beneficence, autonomy, and justice, guides ethical healthcare delivery. Experts like Beauchamp and Childress, and locally Ignacio Maglio, have emphasized its importance.

Globally, the "Choosing Wisely" campaign, launched in the United States by the American Board of Internal Medicine (ABIM) in 2012, actively works to raise awareness about making medical decisions based on the best available scientific evidence. Its goal is to combat the harm caused by inappropriate or unnecessary medical treatments and to foster better patient dialogue and information sharing. The campaign involves interdisciplinary collaboration to create consensus-based recommendations within various medical specialties.

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the importance of making medical decisions based on the best evidence available to avoid the harm generated by inappropriate or unnecessary healthcare services

Central to this discussion are the concepts of quaternary prevention, value-based healthcare, and inverse care laws, all underscoring that "more is not always better" in medicine. Quaternary prevention, defined by Marc Jamoulle in 1995 and later expanded by the World Organization of Family Doctors, focuses on activities to prevent or reduce harm associated with healthcare itself. This includes protecting patients from over-medicalization and unnecessary interventions, a growing concern amplified by the "medicalization of life" and evolving diagnostic thresholds that can label healthy individuals as "sick healthy."

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the set of activities aimed at avoiding or reducing the harms associated with healthcare