World Medical Association General Assembly

The General Assembly of the World Medical Association was held in Helsinki from 10-13 September. The meeting was attended by 250 physicians from 42 countries and among the decisions taken were:

Ethical Recruitment of Doctors: A Statement was issued suggesting that every country should do its utmost to educate an adequate number of physicians and should not rely on immigration from other countries to meet its need for physicians. Countries that wished to recruit physicians from another country should only do so in accordance with the provisions of a new Memorandum of Understanding entered into between the countries. A working group under the Canadian Medical Association will now draw up a draft Memorandum for consideration at the next meeting of the WMA.

Non-Commercialisation of Human Reproductive Material: A Resolution was approved, calling on national medical associations to urge their governments to enact legislation prohibiting commercial transactions in human ova, sperm and embryos and urging physicians involved in the procurement and use of these materials to ascertain that they have not been purchased from the source individuals. In this way, the Resolution said, physicians could contribute, in a practical way, to the upholding of the ethical principle of non-commercialization of human reproductive tissue.

Living Wills: A new Statement was issued to guide doctors on the use of living wills or advanced directives, particularly where there is concern over their legal validity. The Statement declared that a patient’s duly executed advance directive should be honoured unless there were reasonable grounds to suppose that was not valid because it no longer represented the wishes of the patient or that the patient’s understanding was incomplete at the time the directive was prepared. If the advance directive was contrary to the physician’s convictions, provisions should be made to transfer the care of the patient to another consenting physician. The Statement noted that the majority of people who drew up such directives were particularly concerned about excessive, ineffective or prolonged therapeutic interventions in the terminal phases of life, in situations where there was clear and irreversible physical or mental degeneration.

Forensic Investigations of the Missing: A new Statement was adopted calling on all national medical associations to ensure that when their members took part in any forensic investigations of the missing, such as when mass graves are discovered, they saw that these were established with a clear mandate according to the highest possible ethical, scientific and legal standards. The Statement said that information gained from an investigation should be shared with the families of the missing as well as the relevant tribunals and that physicians should refuse to take part in those investigations that were ethically or otherwise unacceptable.

Violence and Health: A Statement was approved encouraging national medical associations to contribute to more systematic approaches to dealing with violence, including data collection, medical training, prevention, research and the co-ordination of victim assistance.
Full texts of these statements will be available shortly on the WMA’s website.

Elections: Dr James Appleyard, a paediatrician from the United Kingdom, was installed as President of the WMA for 2003-4.
Dr Yank D. Coble, immediate past president of the American Medical Association, was elected unopposed as President-elect. Dr Coble, who is a practising endocrinologist from Jacksonville, Florida, will take up office in October 2004.

New Members: The medical associations of Armenia, the Bahamas, Bangladesh and Kazakstan were all admitted as members of the WMA.

Separate Statements have been issued on:

• The Declaration of Helsinki
• The denunciation of torture
• Sars
• Medical Education