DoM-Oct2009

Handbook of WMA Policies
World Medical Association ½ D-2009-02-2009

WMA DECLARATION OF MADRID
ON
PROFESSIONALLY-LED REGULATION
Adopted by the 60th
WMA General Assembly, New Delhi, India, October 2009
The collective action by the medical profession seeking for the benefit of patients, in
assuming responsibility for implementing a system of professionally-led regulation will
enhance and assure the individual physician’s right to treat patients without interference,
based on his or her best clinical judgment. Therefore, the WMA urges the national medical
associations and all physicians to take the following actions.
1. Physicians have been granted by society a high degree of professional autonomy and
clinical independence, whereby they are able to make recommendations based on the
best interests of their patients without undue outside influence.
2. As a corollary to the right of professional autonomy and clinical independence, the
medical profession has a continuing responsibility to be self-regulating. Ultimate con-
trol and decision-making authority must rest with physicians, based on their specific
medical training, knowledge, experience and expertise.
3. Physicians in each country are urged to establish, maintain and actively participate in
a legitimate system of professionally-led regulation. This dedication is to ultimately
assure full clinical independence in patient care decisions.
4. To avoid being influenced by the inherent potential conflicts of interest that will arise
from assuming both representational and regulatory duties, National Medical Associa-
tions must do their utmost to promote and support the concept of professionally-led
regulation amongst their membership and the public.
5. Any system of professionally-led regulation must ensure
a) the quality of the care provided to patients,
b) the competence of the physician providing that care and
c) the professional conduct of physician.
To ensure the patient quality continuing care, physicians must participate actively in
the process of Continuing Professional Development in order to update and maintain
their clinical knowledge, skills and competence.
6. The professional conduct of physicians must always be within the bounds of the Code
of Ethics governing physicians in each country. National Medical Associations must
promote professional and ethical conduct among physicians for the benefit of their
patients. Ethical violations must be promptly recognized and reported. The physicians
who have erred must be appropriately disciplined and where possible be rehabilitated.
D-2009-02-2009½ New Delhi
Medical Education

7. National Medical Associations are urged to assist each other in coping with new and
developing problems, including potential inappropriate threats to professionally-led
regulation. The ongoing exchange of information and experiences between National
Medical Associations is essential for the benefit of patients.
8. An effective and responsible system of professionally-led regulation by the medical
profession in each country must not be self serving or internally protective of the pro-
fession, and the process must be fair, reasonable and sufficiently transparent to ensure
this. National Medical Associations should assist their members in understanding that
self-regulation cannot only be perceived as being protective of physicians, but must
maintain the safety, support and confidence of the general public as well as the ho-
nour of the profession itself.