WMA Statement on the Ethical Implications of Collective Action by Physicians


Adopted by the 63rd WMA General Assembly, Bangkok, Thailand, October 2012

Preamble

In recent years, in countries where physicians' satisfaction with their working conditions has decreased, collective action by physicians has become increasingly common. 

Physicians may carry out protest action and sanctions in order to improve direct and indirect working conditions that also may affect patient care.  Physicians must consider not only their duty to individual patients, but also their responsibility to improve the system such that it meets the requirements of accessibility and quality.

In addition to their professional obligations, physicians are often also employees.  There may be tension between physicians' duty not to cause harm, and their rights as employees. Therefore, physicians' strikes or other forms of collective action often give rise to public debate on ethical and moral issues. This statement attempts to address these issues.

Recommendations

The World Medical Association recommends that National Medical Associations (NMAs) adopt the following guidelines for physicians with regard to collective action:

Physicians who take part in collective action are not exempt from their ethical or professional obligations to patients.

Even when the action taken is not organized by or associated with the National Medical Association, the NMA should ensure that the individual physician is aware of and abides by his or her ethical obligations.

Whenever possible, physicians should press for reforms through non-violent public demonstrations, lobbying and publicity or informational campaigns or negotiation or mediation.

If involved in collective action, NMAs should act to minimize the harm to the public and ensure that essential and emergency health services, and the continuity of care, are provided throughout a strike.  Further, NMAs should advocate for measures to review exceptional cases.If involved in collective action, NMAs should provide continuous and up-to-date information to their patients and the general public with regard to the demands of the conflict and the actions being undertaken.  The general public must be kept informed in a timely manner about any strike actions and the restrictions they may have on health care.