one thing i really never liked about Picard (especially early Picard) is he would rather have millions of people die from a preventive disaster then violate the sacred prime directive and people have to twist his arm to do anything sometimes
Getting away with Prime Directive violations was a lot easier in the 23rd century than it is in the 24th I'd imagine... and the P.D. was maybe a bit less defined in terms of WHEN AND HOW can you interfere.
I would imagine that Starfleet tightened up regulations in that regard by the 24th century.