Yeah Picard's done this like three or four times, from outright letting a civilization die to "merely" letting it go through incredibly tumultuous and dangerous times that might mark the end of it or might not, but it won't be pretty either way.

The Prime Directive is a pretty great idea and an important principle, and I do really like that Picard adheres to it so scrupulously even when I personally think it's stupid because it makes the future seem really different and weird. It's also definitely something that should have some clauses about "If an entire biosphere is about to die then the Prime Directive is void holy Kahless save those people."