WMA Declaration of Madrid on Professionally-led Regulation


Adopted by the 60th WMA General Assembly, New Delhi, India, October 2009

The collective action by the medical profession seeking for the benefit of patients, in assuming responsibility for implementing a system of professionally-led regulation will enhance and assure the individual physician's right to treat patients without interference, based on his or her best clinical judgment. Therefore, the WMA urges the national medical associations and all physicians to take the following actions.

  1. Physicians have been granted by society a high degree of professional autonomy and clinical independence, whereby they are able to make recommendations based on the best interests of their patients without undue outside influence.
  2. As a corollary to the right of professional autonomy and clinical independence, the medical profession has a continuing responsibility to be self-regulating. Ultimate control and decision-making authority must rest with physicians, based on their specific medical training, knowledge, experience and expertise
  3. Physicians in each country are urged to establish, maintain and actively participate in a legitimate system of professionally-led regulation. This dedication is to ultimately assure full clinical independence in patient care decisions.
  4. To avoid being influenced by the inherent potential conflicts of interest that will arise from assuming both representational and regulatory duties, National Medical Associations must do their utmost to promote and support the concept of professionally-led regulation amongst their membership and the public.
  5. Any system of professionally-led regulation must ensure
    a) the quality of the care provided to patients,
    b) the competence of the physician providing that care and
    c) the professional conduct of physician.
    To ensure the patient quality continuing care, physicians must participate actively in the process of Continuing Professional Development in order to update and maintain their clinical knowledge, skills and competence.
  6. The professional conduct of physicians must always be within the bounds of the Code of Ethics governing physicians in each country. National Medical Associations must promote professional and ethical conduct among physicians for the benefit of their patients. Ethical violations must be promptly recognized and reported. The physicians who have erred must be appropriately disciplined and where possible be rehabilitated.
  7. National Medical Associations are urged to assist each other in coping with new and developing problems, including potential inappropriate threats to professionally-led regulation. The ongoing exchange of information and experiences between National Medical Associations is essential for the benefit of patients.
  8. An effective and responsible system of professionally-led regulation by the medical profession in each country must not be self serving or internally protective of the profession, and the process must be fair, reasonable and sufficiently transparent to ensure this.  National Medical Associations should assist their members in understanding that self-regulation cannot only be perceived as being protective of physicians, but must maintain the safety, support and confidence of the general public as well as the honour of the profession itself.