DoS-Oct2008
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Handbook of WMA Policies
World Medical Association ½ D-2008-01-2008
WMA DECLARATION OF SEOUL
ON
PROFESSIONAL AUTONOMY AND CLINICAL INDEPENDENCE
Adopted by the 59th
WMA General Assembly, Seoul, Korea, October 2008
The World Medical Association, having explored the importance of professional auto-
nomy and physician clinical independence, hereby adopts the following principles:
1. The central element of professional autonomy and clinical independence is the assur-
ance that individual physicians have the freedom to exercise their professional judg-
ment in the care and treatment of their patients without undue influence by outside
parties or individuals.
2. Medicine is a highly complex art and science. Through lengthy training and experi-
ence, physicians become medical experts and healers. Whereas patients have the right
to decide to a large extent which medical interventions they will undergo, they expect
their physicians to be free to make clinically appropriate recommendations.
3. Although physicians recognize that they must take into account the structure of the
health system and available resources, unreasonable restraints on clinical indepen-
dence imposed by governments and administrators are not in the best interests of pa-
tients, not least because they can damage the trust which is an essential component of
the patient-physician relationship.
4. Hospital administrators and third-party payers may consider physician professional
autonomy to be incompatible with prudent management of health care costs. How-
ever, the restraints that administrators and third-party payers attempt to place on cli-
nical independence may not be in the best interests of patients. Furthermore, restraints
on the ability of physicians to refuse demands by patients or their families for inap-
propriate medical services are not in the best interests of either patients or society.
5. The World Medical Association reaffirms the importance of professional autonomy
and clinical independence not only as an essential component of high quality medical
care and therefore a benefit to the patient that must be preserved, but also as an essen-
tial principle of medical professionalism. The World Medical Association therefore
rededicates itself to maintaining and assuring the continuation of professional auto-
nomy and clinical independence in the care of patients.