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L’ASSOCIATION MEDICALE MONDIALE, INC ASOCIACION MEDICA MUNDIAL” INC
THE WORLD MEDICAL ASSOCIATION, INC.
B.P. 63 – 01212 FERNEY-VOLTAIRE Cedex, France
Centre Intemationa! de Bureaux· Immeuble A “Keynes’
13,chemindu Levant- 01210 FERNEY-VOLTAIRE,France
Telephone: (33) 4 50 40 75 75
Fax: (33) 4 50 40 59 37 .
October 1981
Revised 1987, 1993, 1999
E-mail address: infoOwrnanet
Website : www.wma.net
17.1
Original: English
WORLD MEDICAL ASSOCIATION DECLARATION
ON
PRINCIPLES OF HEALTH CARE FOR SPORTS MEDICINE
”
Adopted by the 34th
World Medical Assembly
Lisbon, Portugal, September/October 1981
and revised by the 39th
World Medical Assembly
Madrid, Spain, October 1987
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Madrid, Spain, October 1987
and the 45th
World Medical Assembly
Budapest, Hungary, October 1993
and the SIll World Medical Association General Assembly
Tel Aviv, Israel, October 1999
Considering the involvement of physicians in sports medicine, the WMA recommends the
following ethical guidelines for physicians in order to help meet the needs of athletes,
recognizing special circumstances inwhich their medical care and health guidance is given.
Consequently,
1. The physician who cares for athletes has an ethical responsibility to recognize the special
physical and mental demands placed upon them by their performance in sports activities.
2. When the sports participant is a child or an adolescent, the physician must give first
consideration to the participant’s growth and stage ofdevelopment.
2.1 The physician must ensure that the child’s state of growth and development, as
well as his or her general condition of health can absorb the rigors of the training
and competition without jeopardizing the normal physical or mental development
ofthe child or adolescent.
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2 17.1
2.2 The physician must oppose any sports or athletic activity that is not appropriate to
the child’s stage of growth and development or general condition of health. The
physician must act in .the best interest of the health of the child or adolescent,
without regard to any other interest or pressure from any other source.
3. When the sports participant is a professional athlete and derives livelihood from that
activity, the physician should pay due regard to the occupational medical aspects
involved.
4. The physician should be aware that the use of doping practices’ by a physician is a
violation of the medical oath and the basic principles of the WMA’s Declaration of
Geneva, which states: “My patient’s health will always be my first consideration.” The
WMA considers the problem ofdoping to be a threat to the health ofathletes and young
people in general, as well as being in conflict with the principles of medical ethics. The
physician must thus oppose and refuse to administer or condone any such means or e
method which is not in accordance with medical ethics, andlor which might be harmful to
the athlete using it, especially:
4.] Procedures which artificially modify blood constituents or biochemistry.
4.2 The use of drugs or other substances whatever their nature and route of
administration, including central-nervous-system stimulants . or depressants and
procedures which artificially modify reflexes.
proceoures WIDcn arnnciany monuy renexes.
4.3 Pharmacological interventions that may induce alterations ofwill or general mental
outlook.
4.4 Procedures to mask pain or other protective symptoms if used to enable the athlete
to take part in events when lesions or signs are present which make his
participation inadvisable.
4.5 Measures which artificially change features appropriate to age andsex.
4.6 Training and taking part in events when to do so would not be compatible with
preservation ofthe individual’s fitness, health or safety.
4.7 Measures aimed at an unnatural increase or maintenance of performance during
competition. Doping to improve an athlete’s performance is unethical.
5. The physician should inform the athlete, those responsible for him or her, and other
interested parties, of the consequences of the procedures the physician is opposing,
guard against their use; enlist the support of other physicians and other organizations
with the same aim, protect the athlete against any pressures which might induce him or .
her to use these methods and help With supervision against these procedures. .
6. The sports physician has the duty to give his or her objective opinion on the athlete’s
fitness or unfitness clearly and precisely, leaving no doubt as to his or her conclusions.
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7. . In competitive sports or professional sports events, it is the physician’s duty to decide
whether the athlete is medically fit to remain on the field or return to the game. ‘This
decision cannot be delegated to other professionals or to other persons. In the physician’s
absence these individuals must adhere strictly to theinstructions he or she has given
them, with priority always-being given to the best interests of the athlete’s health and
safety, and not the outcome ofthe competition.
8. In order to carry out his or her ethical obligations the sports physician must see his or her
authority fully recognized and upheld, particularly wherever it concerns the health, safety
and legitimate interests of the athlete, none of which can be prejudiced to favour the
interests of any third party whatsoever. These principles and obligations should be
supported by an agreement between the sports physician and the athletic organization
involved, recognizing that the physician is obligated to uphold the •ethical principles
determined in national and international statements to whichthe medical profession has
subscribed and by which it is bound. .
9. · The sports physician should endeavour to keep the patient’s personal physician fully
informed of facts relevant to his or her treatment. If necessarythe sports physician
should collaborate to ensure that the athlete does not exert himself or herself in ways
detrimental to his or her health and does not use potentially harmful techniques to
improve performance.
10. In sports medicine, as in all other branches of medicine,.professional confidentiality must
be observed. The right to privacy over medical attention the athlete has received must be
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be observed. The right to privacy over medical attention the athlete has received must be
protected, especially in the case ofprofessional athletes.
11. The sports doctor must not be party to any contract which obliges him or her to reserve
particular forms of therapy solely and exclusively for anyone athlete or group of
athletes.
12. It is desirable that sports physicians from foreign countries, when accompanying a team
in another country, should enjoy the right to carry out their specific functions.
13. The participation of a sports physician is desirable when sports.regulation are being
drawn up.
… ……
1 cf The Olympic Charter Against Doping in Sport and the Lausanne Declaration on Doping
in Sport adopted by the world Committee on Doping in Sport (February 1999)
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