12/03/2026
Something to consider when offered all the screening and testing during pregnancy: Iatrogenic Harm From Medical Overuse Gains Focus
Mónica M. Bernardo
February 13, 2026. Redefining Iatrogenesis
Iatrogenesis was narrowly defined as a medical error or an unavoidable adverse effect of a properly indicated treatment. Today, the term is understood more broadly as any unintended harm caused by healthcare, even when that care conforms to accepted guidelines, protocols, or good practices.
This broader definition includes adverse drug reactions, procedural complications, excessive diagnostic and preventive interventions, cascades of unnecessary testing, and psychosocial harm arising from the labeling, uncertainty, or medicalization of everyday life.
These reframing shifts attention from individual clinician responsibility toward the systemic factors that generate harm: rigid protocols, performance-based incentives, diagnostic pressure, and a healthcare culture that tends to equate more intervention with better care. In this context, iatrogenesis ceases to be an isolated accident and becomes a structural risk to the health system.
Within this framework, QP, also termed P4, acquires its full meaning: deliberate action to protect patients from unnecessary medical interventions, particularly when the probable harm exceeds the expected benefit, even if those interventions are technically feasible or socially demanded.
Unlike traditional prevention, QP questions the indiscriminate use of screening, early diagnosis, and marginal benefit treatments. It is grounded in person-centered medicine, clinical communication, shared decision-making, and the clinician’s critical self-awareness in the face of overmedicalization. The objective is not to “do nothing.” It is important to act with greater awareness and prudence in the future.
The foundational work of Alberto Ortiz Lobo, MD, at the Centro de Salud Mental de Salamanca, Madrid, Spain, illustrates how prevention, screening, and treatment can generate harm across the entire care continuum. Although recent empirical evidence remains limited, these insights are essential for understanding the risks of intervening without a clear balance between harm and benefit, always considering alternatives, and exercising utmost caution to ensure patient safety and autonomy.
