WMA Statement on the Ethical Implications of Collective Action by Physicians

Adopted by the 63^rd WMA General Assembly, Bangkok, Thailand, October 2012
and reaffirmed with minor revisions by the 221^st WMA Council Session, Berlin, Germany, October 2022

Preamble

In recent years, in countries where physicians’ satisfaction with their working conditions has decreased, collective action by physicians to advocate for better conditions has become increasingly common.

Physicians may carry out protests and sanctions, including collective resignations, in order to improve direct and indirect working conditions and to ensure safe and resilient health care systems. Physicians must consider not only their duty to individual patients, but also their responsibility to improve the system, such that it meets the requirements of accessibility and quality.

In addition to their professional obligations, physicians are often also employees. There may be tension between physicians’ duty not to cause harm, and their rights as employees. Therefore, physicians’ strikes or other forms of collective action often give rise to public debate on ethical and moral issues. This statement attempts to address these issues.

RECOMMENDATIONS

The World Medical Association recommends that Constituent Members adopt the following guidelines for physicians with regard to collective action:

1. Physicians who take part in collective action are not exempt from their ethical or professional obligations to patients.
2. Even when the action taken is not organized by or associated with the Constituent Member, the Constituent Member should ensure that the individual physician is aware of and abides by their ethical obligations.
3. Whenever possible, physicians should press for reforms through non-violent public demonstrations, lobbying and publicity or informational campaigns, and/or through negotiation or mediation.
4. If involved in collective action, Constituent Members should act to minimize the harm to the public and ensure that essential and emergency health services, and the continuity of care, are provided throughout a strike. Further, Constituents Members should advocate for measures to review exceptional cases. If involved in collective action, Constituent Members should provide continuous and up-to-date information to their patients and the general public with regard to the demands of the conflict and the actions being undertaken. The general public must be kept informed in a timely manner about any strike actions and the restrictions they may have on health care.