Declaration of Tokyo

Guidelines for Physicians Concerning Torture and other Cruel, Inhuman or Degrading Treatment or Punishment in Relation to Detention and Imprisonment

It is the physician’s duty to heal, alleviate suffering, provide comfort, and act in the best interests of his or her patients.  These responsibilities apply any time a physician interacts with a person by applying his or her medical knowledge.   The World Medical Association was founded in September 1947, shortly after the Nuremberg trials, where the abuses of medicine in concentration camps – including brutal acts of medical experimentation and torture - and euthanasia activities of Nazi Germany were brought to the world’s attention.   Although the scale and scope of what occurred during World War II are extreme, the abuse of medical knowledge still exists in many parts of the world.

There is a clear line between medicine for the benefit of the person and the abuse of medicine.  However, physicians may find themselves in a difficult situation in cases where the state uses or condones torture or other harmful practices and physicians are asked, or forced, to attend to the victims.  While physicians have an obligation to diagnose and treat victims of torture, they are ethically prohibited from conducting any evaluation, or providing information or treatment, that may facilitate the future or further conduct of torture.   Such actions constitute physician participation in torture, which is not only unethical, but also facilitates the acceptance of such procedures, and ultimately destroys patients’ trust in the medical profession.

The Istanbul Protocol, published by the United Nations, is a manual for physicians and other health professionals that defines their role in identifying, diagnosing, treating and rehabilitating torture victims. The WMA and several of its members co-authored the Istanbul Protocol and proactively support its distribution and use.

WMA Current Policy & Action