In medicine, more is not always better.: The case of prevention (and prediabetes)

Abstract

Health is a social construct, and maintaining or improving it requires an intersectoral approach -what is often referred to as “Health in All Policies.” Medical interventions are frequently overvalued, perhaps due to their dramatic nature and effectiveness, which can sometimes appear almost miraculous -such as the appropriate use of medication to ease pain during the dying process. However, overall health depends more on social conditions than on medical care, and it is essential to understand that more medicine does not necessarily mean better health. In fact, physicians should be kept at a distance, especially in the realm of prevention. Driven by a preventive zeal, healthcare professionals may unintentionally cause harm by promoting a form of “health tyranny” -interventions lacking both scientific evidence and ethical grounding. One example is the proliferation of “predisease” categories such as preosteoporosis, prediabetes, or preobesity, which pathologize healthy individuals under the illusion of avoiding future illness. Prevention is not always better than cure, and above all, we must recognize that preventive interventions can also produce adverse effects.