WMA Statement on Armed Conflicts

Adopted by the 68th General Assembly, Chicago, United States, October 2017

PREAMBLE

1.          The duties of physicians in times of armed conflict are set out in the WMA Statement on Ethical Principles of Health Care in Times of Armed Conflict and Other Emergencies and WMA Regulations in Times of Armed Conflict and Other Situations of Violence.

2.          Physicians should encourage politicians, governments, and others in positions of power to be more aware of the consequences, including the impact on health, of their decisions on the commencement or continuation of armed conflict.

3.          Armed conflict damages the health of individuals and of populations as well as critical infrastructure including health care facilities, housing, potable-water supplies and sewerage. It also leads to environmental degradation. Such destruction of critical infrastructure may lead to adverse health consequences including malnutrition, and infectious or waterborne diseases, such as cholera and typhoid. Warfare also destroys work-related infrastructure, including factories and manufacturing centres as well as agriculture. Repair to damaged infrastructure cannot proceed until cessation of the conflict.

4.          Wars start for many different reasons.   Efforts to avoid conflicts are often insufficient and inadequate and country leaders may not seek all alternatives. Avoiding war and seeking constructive alternatives is always desirable.

5.          It is essential that those claiming that a war us a “just war” understand that this is a rare and extreme circumstance, which must not be overcited.  The concept of a “just” war must not be used to legitimize violence.

6.          Warfare and other forms of armed conflict are likely to worsen the suffering of the poorest and to contribute to the development of large numbers of Internally Displaced Persons and refugees.

7.          Physicians should seek, during conflicts, to influence parties in order to alleviate the suffering of populations.

RECOMMENDATIONS

8.          The WMA believes that armed conflict should always be a last resort.  Physicians and NMAs should alert governments and non-state actors of the human consequence of warfare.

9.          Physicians should encourage politicians, governments, and others in positions of power to be more aware of the consequence of their decisions related to armed conflict.

10.       The WMA recognizes that armed conflict always produces enormous human suffering. States and other authorities, including non-state actors, who enter into armed conflict must accept responsibility for the consequences of their actions, and be prepared to answer for their consequences including to international courts and tribunals and recommends that authorities recognize and cooperate to ensure this occurs.

11.       The WMA recognizes that the impact of armed conflict will be most significant upon women and vulnerable populations, including children, the young, the elderly and the poorest members of society. Physicians should seek to ensure that allocation of medical care resources does not have a discriminatory impact.

12.       Physicians must continually remind those in power of the need to provide essential services to those within areas damaged and disrupted by conflict.

13.       After a conflict ends, priority must be given to rebuilding the essential infrastructure necessary for a healthy life, including shelter, sewerage, fresh water supplies, and food provision, followed by the restoration of educational and occupational opportunities.

14.       The WMA demands that parties to a conflict respect relevant Humanitarian Law and do not use health facilities as military quarters, nor target health institutions, workers and vehicles, and respect established International Humanitarian Law (IHL) and do not use health facilities as military quarters, nor initiate attacks against health institutions, workers and vehicles, or restrict the access of wounded persons and patients to healthcare, as set out in the WMA Declaration on the Protection of Health Workers in Situations of Violence.

15.       Physicians should work with aid and other agencies to seek to ensure that parties protect family integrity and, wherever possible, remove people from direct and immediate danger.

16.       Physicians should be aware of the likely prevalence of Post-Traumatic Stress Disorder (PTSD) and other post-conflict psychosocial and psychosomatic problems and provide appropriate care and treatment to combatants and civilians.

17.       Physicians, including forensic medicine specialists, should help families ensure that efforts to identify the missing and the dead are not subverted by security forces.