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Social egg freezing (oocyte banking for anticipated gamete exhaustion). Ethical, practical and social problems

18 Sep

This text has two objectives: 1/to draw attention to an important issue in women’s health; and 2/to help train health professionals by providing evidence-based information about and criteria for what is called “social egg freezing.” Why don’t we extract eggs or ovarian tissue from women who are still young and then freeze and store them [...]

“Dr Cholesterol” against the “British Medical Journal”. Do not measure your cholesterol, be happy

26 May

The British Medical Journal has had problems with two papers about primary prevention of coronary artery disease (heart disease). Both papers have data that demonstrate statins have no use in primary prevention for most patients. The British Medical Journal problems relate to power, money and censorship. In this text a teacher explain the situation to [...]

Health and politics: a not so innocent relationship

15 Oct

Democracy is associated with a better level of health, but not all democratic policies bring about the same health results, or the same alternatives as regards the organisation of services. In Spain there in an association between right-wing governments and less interest in primary health care. Health and politics: a not so innocent relationship. Gérvas [...]

Primary health care oriented systems, for whom, why and how

4 Jun

Health systems are social products, and as such they cannot being invented. They are expression of the final election between “freedom” and “equity”. Freedom means that each person may select and pay for the needed health services. Equity means solidarity, to help those in need even at the cost that are fit. Only the USA [...]

Quaternary prevention: a summary

4 Jun

Quaternary prevention is the prevention of harms by medical interventions and as such a foundation block of medicine (primum non nocere). All services have adverse effects, all services might produce damage to health. A few services produce more benefits than harms in specific situations. Unnecessary and inappropriate services mainly produce harms, and few benefits if [...]

Clinical care and health disparities

10 Apr

In this review, we consider empirical studies from the United States and elsewhere, and we focus on how one aspect of health systems, clinical care, contributes to maintaining systematic differences in health across population groups characterized by social disadvantage. We consider inequities in clinical care and the policies that influence them. We develop a framework [...]

Quaternary prevention: theory and practice

13 Oct

All health services have adverse effects, all health services might produce damage to health. A few services produce more benefits than harms in specific situations. Unnecessary and inappropriate services mainly produce harms, and few benefits if any. Quaternary prevention is the prevention of unnecessary and/or inappropriate services and the prevention of over-medicalisation. Quaternary prevention refers mainly to personal services, [...]