The WMA's annual General Assembly ended in Washington, USA, at the weekend. A summary of the decisions follows.

Elections

Dr Kati Myllymaki, a female general practitioner from Finland, was elected President of the WMA for 2002-3.
Dr James Appleyard, a children's physician from Britain, was elected as President for the year 2003-4.

Growing Threat Of Bioterrorism

Following a scientific session on the growing threat of terrorism and biological weapons, the WMA repeated its plea to all physicians who participate in biomedical research to consider the implications and possible applications of their work and to weigh carefully in the balance the pursuit of scientific knowledge with their ethical responsibilities to society.

The meeting approved a new Washington Declaration on Biological Weapons that urges national medical associations worldwide to promote an international ethos condemning the development, production, or use of toxins and biological agents that have no justification for peaceful purposes. The WMA called for an international consortium of medical and public health leaders to monitor the threat of biological weapons, to identify actions likely to prevent bioweapons proliferation, and to develop a coordinated plan for monitoring the worldwide emergence of infectious diseases.

Dr Randolph D. Smoak Jr, chairman of the WMA, said: 'It is time for physicians worldwide to take a more aggressive stance in tackling the threats from bioterrorism. These issues are no longer distant threats.
They're here and they're real and the medical community has a central role to play to do all it can to protect citizens around the world'.

Health Databases

New guidelines were approved on the creation of central health databases to protect the interests of patients. They lay down policy on confidentiality against which the creation of national health databases should be judged, by setting out controls over the use and disclosure of personal information. The guidelines declare that consent from patients is needed if the inclusion of their health information on a database involves disclosure to a third party. Patients should be allowed to withdraw their health information from a database.

The guidelines follow the dispute three years ago when the Icelandic Medical Association strongly opposed legislation setting up a healthcare database in Iceland. At the time, the WMA supported the Icelandic doctors, pointing to the need to protect the integrity of patient data while continuing to have open access to all scientific data.

Abuse Of Psychiatry

The detention of political dissidents and social activists in psychiatric institutions for unnecessary psychiatric treatment as punishment was condemned as abusive and unacceptable. The WMA called on physicians to resist involvement in these practices and it urged national medical associations to support their members who resisted such involvement.

Euthanasia

The Assembly adopted a resolution reaffirming the WMA's opposition to euthanasia. All national medical associations and physicians were strongly encouraged to refrain from participating in euthanasia, even if national law allows it or decriminalises it in certain conditions. The motion reaffirmed the WMA's view that euthanasia is in conflict with basic ethical principles of medical practice.

Health Care Services In Afghanistan

The Assembly called on national governments and international agencies to commit funding to rebuilding the education and training system for health care workers in Afghanistan so that Afghani doctors, nurses and others can return to providing health care to the Afghani population. The meeting approved a resolution urging governments to help Afghani health care workers who left Afghanistan under previous regimes to return home, at least for short periods of time, and if their safety could be guaranteed.

Safe Injections

Measures to help combat unsafe injections were agreed at the meeting. A new Statement was approved which urged physicians worldwide to prescribe non-injectable medication rather than injectable medication whenever possible and to promote the use of non-injectable medication. The Statement declared that of the 12 billion injections administered worldwide each year, many millions were unsafe, leading to 8-16 million new hepatitis B infections each year, 2.3-4.7 million new hepatitis C virus infections and 80,000 to 160,000 new HIV infections. Unsafe injections resulted from the overuse of injections and unsafe injection practices, including the use of unsterilized needles, the re-use of syringes and the inappropriate and unsafe disposal of syringes and needles

Patient Safety

In a new Declaration, the WMA says that national medical associations should encourage physicians, other health care professionals and patients to establish systems that secure patient safety.

Female Foeticide

A resolution was approved denouncing female foeticide as a totally unacceptable example of gender discrimination.

Prevention Of Mother-To-Child Hiv Infection

A resolution on women's rights to health care declared that in many parts of the world women were predominantly at risk from the HIV pandemic. It urged governments to provide prophylactic treatment to women who had been raped and also to women who were about to give birth and were HIV positive.

Declaration Of Helsinki

Further debate took place about the revised Declaration on medical research on humans and it was agreed that work should continue on clarifying concerns on the benefits to populations from the results of research.

New Members

Five new associations were admitted to membership of the WMA ? the Russian Medical Society and the medical associations of Kuwait, Nepal, Azerbaijan and Georgia.

Other issues discussed included:

• Self medication
  
• Sustainability of national health systems
  
• Physician workforce, recruitment and migration
  
• Forensic investigations