The Policy Development and Approval Process

The WMA has detailed guidelines for the development and approval of policy statements (sections M and P of its Schedule of Function and Operating Policies). The guidelines contain definitions, criteria for and elements of statements, the process for consultation and approval, and the role of workgroups in this process.

Statements are normally initiated by the WMA's national medical association members. They go first to the relevant WMA standing committee; in the case of statements of an ethical nature this would be the Medical Ethics Committee. If the committee so recommends and the WMA Council concurs, the statement is sent to national medical associations, and often other interested parties, for comment. Council may appoint a workgroup to oversee the review process. The comments are collated by the WMA secretariat and a revised version is prepared that incorporates the comments. The revised version is reviewed by the committee, which can recommend its approval to Council, call for further consultation and/or revisions, or recommend that it not be approved. Once a version is approved by Council, it goes to the WMA Assembly, which alone has the authority to adopt policy statements. Those of an ethical nature require a 75% vote in favour at the Assembly.

The same process is followed for amendments to existing policy statements.

Current Policies

Since its formation in 1947, the WMA has adopted policies on a large number of ethical issues. With the exception of the International Code of Medical Ethics, the most important of these have been given the title of Declaration. Here is a list, in order of their date of first adoption (dates of amendments and notes of clarification are also included):

• Declaration of Geneva (1948, 1968, 1983, 1994, 2005, 2006)
  
• International Code of Medical Ethics (1949, 1968, 1983, 2006)
  
• Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects (1964, 1975, 1883, 1989, 1996, 2000, 2002, 2004)
  
• Declaration of Oslo on Therapeutic Abortion (1970, 1983, 2006)
  
• Declaration of Tokyo: Guidelines for Medical Doctors Concerning Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment in Relation to Detention and Imprisonment (1975, 2005, 2006)
  
• Declaration of Lisbon on the Rights of the Patient (1981, 1995, 2005)
  
• Declaration of Venice on Terminal Illness (1983, 2006)
  
• Declaration of Madrid on Professional Autonomy and Self-Regulation (1987, 2005)
  
• Declaration of Hong Kong on the Abuse of the Elderly (1989, 1990, 2005)
  
• Declaration of Hamburg Concerning Support for Medical Doctors Refusing to Participate in, or to Condone, the Use of Torture or Other Forms of Cruel, Inhuman or Degrading Treatment (1997, 2006)
  
• Declaration of Ottawa on the Right of the Child to Health Care (1998)
  
• Declaration on Ethical Considerations Regarding Health Databases (2000)
  
• Declaration of Washington on Biological Weapons (2002)

Policies under Review or Development (2007)

At its 2004 General Assembly the WMA adopted a procedure for reviewing all policy statements for which it has been 10 years or more since adoption or last amendment.

At the WMA Council meeting in May 2007, the Council reaffirmed the following policies (some with minor revisions):

• Declaration of Hamburg Concerning Support for Medical Doctors Refusing to Participate in, or to Condone, the Use of Torture or Other Forms of Cruel, Inhuman or Degrading Treatment;
• Proposal for a Rapporteur on the Independence and Integrity of Health Professionals;
• Statement on Licensing of Physicians Fleeing Prosecution for Serious Criminal Offences;
• Resolution on Economic Embargos and Health

The 2007 General Assembly adopted the following new or revised policies:

• Statement on the Ethics of Telemedicine;
• Statement on Human Tissue for Transplantation;
• Resolution on the Responsibility of Physicians in the Documentation and Denunciation of Acts of Torture or Cruel or Inhuman or Degrading Treatment;
• Statement on Noise Pollution;
• Statement on Family Planning and the Right of a Woman to Contraception;
• Statement on Health Hazards of Tobacco Products

Revised versions of the following policies are in various stages of development and will be considered by the Medical Ethics and Socio-Medical Affairs Committees at their May 2008 meetings in Divonne-les-Bains, France:

• Declaration of Helsinki;
• Statement on Freedom to Attend Medical Meetings;
• Statement on Stem Cell Research;
• Statement on Antimicrobial Drugs;
• Guidelines for Continuous Quality Improvement in Health Care;
• Resolution on the Prohibition of Access of Women to Health Care and the Prohibition of Practice by Female Doctors in Afghanistan;
• Statement on Reducing Dietary Sodium Intake;
• Statement on Reducing the Global Burden of Mercury