AMA fully supports Physician’s Pledge update
BY DR CHRIS MOY, CHAIR, AMA ETHICS AND MEDICO LEGAL COMMITTEE
As a member of the World Medical Association (WMA), the AMA takes great pride in highlighting the achievements of the WMA as a world leader in the development and promotion of global ethical standards for the medical profession.
While the WMA adopts a wide range of global policy statements on ethical issues related to medical professionalism, human rights, patient care, medical research and public health, it also actively counteracts violations of its ethical standards.
As examples, the WMA consistently condemns governments and others who threaten to compromise professional autonomy and clinical independence, as well as those who undermine the role of medical neutrality and fail to protect healthcare workers in areas of armed conflict.
One of the oldest, and most defining, of the WMA’s ethical statements is the Declaration of Geneva, often considered a modern version of the Hippocratic Oath. Established in 1947, the WMA (of which the Federal Council of the British Medical Association in Australia was a founding member) was particularly concerned with the global state of medical ethics and decided to take on the responsibility of developing ethical guidelines for the world’s doctors.
The WMA believed that developing an international oath, or pledge, to be recited upon graduating medical school, would impress upon newly qualified doctors the fundamental ethics of medicine and raise the standard of professional conduct.
Attempting to seek international consensus on a pledge that was relevant to, and representative of, doctors from a wide range of cultural, religious, racial, political and linguistically diverse backgrounds, was challenging, but in 1948 the 2nd WMA General Assembly officially adopted the Declaration of Geneva to serve that role.
Over the years, the Declaration has undergone only minor amendments, the exception being its most recent iteration. In October 2017, the 68th WMA General Assembly in Chicago adopted the 7th revision of the Declaration, a culmination of a two-year consultation with more than 100 member National Medical Associations, as well as the public.
According to the Chair of the WMA Declaration of Geneva Workgroup, Dr Ramin Walter Parsa-Parsi of the German Medical Association, when reviewing the document, the workgroup considered modern developments in medicine and medical ethics, as well as contemporary WMA policies and international literature.
The Declaration has changed in subtle, but significant, ways. It is now more patient-centred. For the first time, it refers to patient autonomy and dignity and recognises the importance of ‘well-being’ to patient care. Further, the whole document has been reformatted to emphasise obligations to patients first followed by obligations to colleagues and society.
The updated Declaration better reflects the modern notion of collegiality, while doctors should respect their teachers, it now recognises they should respect their colleagues and students as well. Particularly relevant to the Australian context, the Declaration acknowledges the essential role that physician ‘well-being’ (and not just health) has on a doctor’s ability to provide a high standard of patient care.
In addition, it now refers to sharing medical knowledge for the benefit of the individual patient and wider health care, recognising the duty not just to the individual but the broader health system and society.
The WMA advocates that the Declaration of Geneva, now formally referred to as the Physician’s Pledge, be taken up on a global scale. The AMA has formally adopted the updated Declaration of Geneva. It is our hope as well that the Declaration will unite doctors throughout the world by affirming the highest standards of ethical conduct in the profession’s service to humanity.
The WMA Declaration of Geneva can be accessed at https://www.wma.net/policies-post/wma-declaration-of-geneva/.