WMA Council Meeting

At its Council meeting in Bali, Indonesia (April 4-6), attended by delegates from 35 national medical associations, the World Medical Association discussed a number of issues, including the following:

Declaration of Helsinki

The Council agreed that revisions to the Declaration of Helsinki involving medical research on subjects be made available for public consultation, including input from national medical associations. A separate press release was issued on this.

Criminalisation of medical practice

Attempts by governments to control physicians’ practice of medicine, including criminalizing medical decision making, were condemned by the Council. Delegates protested that physicians had seen attempts by governments to prevent medically indicated procedures, to mandate medical procedures that were not indicated and to mandate certain drug prescribing practices. In addition, criminal penalties had been imposed on physicians for various aspects of medical practice, including medical errors, despite the availability of adequate non-criminal redress.

Physician leaders at the meeting made it clear that doctors who commit criminal acts which are not part of patient care must remain as liable to sanctions as all other members of society and that serious abuses of medical practice must be subject to sanctions, usually through professional regulatory processes. But they declared that criminalizing medical decision making was a disservice to patients.

They said that in times of war and civil strife, there had also been attempts to criminalize compassionate medical care to those injured as a result of these conflicts, with reports of more than 400 physicians under arrest in Syria.

The meeting passed an urgent resolution recommending national medical associations to oppose government intrusions into the practice of medicine and in healthcare decision making, including the government’s ability to define appropriate medical practice through imposition of criminal penalties. It opposed criminalizing medical judgment and healthcare decisions, including physician variance from guidelines and standards, and opposed criminalizing medical care provided to patients injured in civil conflicts.

Standardisation in Medical Practice

The meeting expressed concerns about the trend, particularly in the European Union, for non-medical standardisation bodies to introduce standards in clinical and medical care. The Council passed a resolution declaring that such bodies had neither the necessary professional ethical and technical competencies nor a public mandate to do this and that such trends were likely to reduce the quality of care offered.

Dr. Cecil Wilson, President of the WMA, commented: ‘Ensuring patient safety and quality of care is at the core of medical practice. For patients, a high level of performance can be a matter of life or death. So guidance and standardisation in healthcare must be based on solid medical evidence and has to take ethical considerations into account. We call on governments and other institutions not to leave standardisation of medical care up to non-medical self- selected bodies’.

Separate press releases were issued on advice to physicians about working in the United Arab Emirates, following the case of Professor Karabus, and the criminalisation of medical practice.

Other issues discussed included:

The death penalty
Person centred medicine
Euthanasia

Elections

Dr. Mukesh Haikerwal (Australian Medical Association) was re-elected Chair of Council
Dr. Masami Ishii (Japan Medical Association) was re-elected Vice-Chair
Dr. Frank Montgomery (German Medical Association) was re-elected Treasurer
Sir Michael Marmot (British Medical Association) was re-elected Chair of the Socio-Medical Affairs Committee
Dr. Heikki Pälve (Finnish Medical Association) was elected Chair of the Medical Ethics Committee
Dr. Leonid Eidelman (Israel Medical Association) was re-elected Chair of the Finance and Planning Committee