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Adopted by the 39th World Medical Assembly
Madrid, Spain, October 1987
and rescinded at
the WMA General Assembly, Pilanesberg, South Africa, 2006
Confirmed cases of acquired immunodeficiency syndrome (commonly
referred to as AIDS) have been reported in more than 100 countries.
It is estimated that five to ten million people worldwide are
infected with AIDS viruses and therefore are potentially capable
of transmitting the disease. All National Medical Associations
and all physicians must share their knowledge and expertise to
develop strategies to cope with this disease until a cure can
be found.
Because AIDS is an incurable disease, and because it is a predominantly
sexually transmitted disease (STD) it presents the physician with
many complex issues in addition to the scientific and medical
issues inherent in the disease. In order to assist physicians
and National Medical Associations, the WMA adopts the guidelines
presented in this statement. The WMA is also conducting a scientific
session devoted to the subject of AIDS at this 39th World Medical
Assembly (1987). The WMA will study the advice of the experts
at this scientific session as well as the best information that
can be obtained from experts around the world, and will report
more fully on this important matter at the 40th World Medical
Assembly in 1988. Until a more complete report is available, the
WMA recommends the following:
- That National Medical Associations participate fully with
their government in developing a national policy to cope with
AIDS and AIDS related problems.
- That National Medical Associations participate fully in the
development of public awareness programs to educate the general
public as to AIDS, and the problems associated with AIDS, and
how these problems will affect society generally.
- That all physicians be trained to be effective AIDS counselors.
Physicians should counsel their patients to educate them as
to effective behaviors to avoid the risk of AIDS for themselves
and others. With reference to those patients who are found to
be seropositive, physicians must be able to effectively counsel
them regarding:
- responsible behavior to prevent the spread of the disease;
- strategies for their own health protection; and
- the necessity of alerting sexual contacts, past and present,
regarding their possible infection by the AIDS virus.
- That tests for the AIDS virus should be readily available
to all who wish to be tested. Mandarory testing for the AIDS
virus must be required of donors of blood and blood fractions,
organs and other tissues intended for transplantation, and for
donors of semen or ova collected for artificial insemination
or in vitro fertilization. In addition the national policy may
provide for mandatory testing for certain other segments of
the population, such as military personnel, inmates of penal
institutions and immigrants.
- Voluntary testing, with the patient's informed consent, should
be regularly available to the following:
- All patients seeking treatment for sexually transmitted
diseases;
- All patients seeking treatment for drug abuse;
- Pregnant women in the first trimester of pregnancy;
- Individuals who are from areas with a high incidence
of AIDS or who engage in high risk behavior seeking family
planning services; and
- Patients requiring surgical or other invasive procedures.
However, if a voluntary policy is not effective, a mandatory
requirement should be considered.
- That each confirmed case of AIDS be reported to a designated
authority anonymously or by identifier for epidemiological purposes.
Individuals who are found to be seropositive for the AIDS virus
should be reported on an anonymous basis with enough information
to be epidemiologically significant.
- That patients with AIDS and those who text positively for
the antibody to the AIDS virus must be provided with appropriate
medical care and should not be treated unfairly or suffer from
arbitrary or irrational discrimination in their daily lives.
Physicians have a long and honored tradition of tending to patients
afflicted with infectious diseases with compassion and courage.
That tradition must be continued throughout the AIDS epidemic.
Physicians and National Medical Associations must participate
actively in the development of a sound framework for carefully
balancing the right of the patient to be free from irrational
acts of prejudice and the rights of others in society to be
protected against an unreasonable risk from disease.
- That access to patient information should be limited to health
care personnel who have a ligitimate need to have access to
the information in order to assist the patient or to protect
the health of those closely associated with the patient. The
identity of AIDS patients and carriers should be protected from
disclosure except where the health of the community requires
otherwise.
- That a method be developed to warn unsuspecting sexual partners
of an infected individual, while protecting the confidentiality
of patient information to the greatest extent possible. The
method should afford adequate legal protection to physicians
who carry out their professional obligation to warn individuals
at risk.
- That reliable data be obtained through studies to determine
the prevalence and conversion rate of the virus in the population.
Such studies must be repeated at appropriate intervals to gauge
the spread of the disease.
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