Doctors' Clinical Independence Essential to High Quality Medical Care, says WMA

Unreasonable restraints on physicians’ clinical independence imposed by governments and administrators are not in the best interests of patients, according to a new Declaration from the World Medical Association. The Declaration on professional autonomy and clinical independence, approved today at the WMA’s annual General Assembly in Seoul, South Korea, says that unreasonable restraints can damage the trust which is an essential component of the patient–physician relationship.

However the Statement adds that physicians recognize they must take into account the structure of the health system and available resources.

The new Statement - adopted as the Declaration of Seoul by delegates from 42 national medical associations - declares that the central element of professional autonomy and clinical independence is the assurance that individual physicians have the freedom to exercise their professional judgment in the care and treatment of their patients without undue influence by outside parties or individuals. Patients expected their physicians to be free to make clinically appropriate recommendations.

Hospital administrators and third-party payers may consider physician professional autonomy to be incompatible with prudent management of health care costs. However, the restraints that administrators and third-party payers attempted to place on clinical independence might not be in the best interests of patients. Furthermore, restraints on the ability of physicians to refuse demands by patients or their families for inappropriate medical services are not in the best interests of either patients or society.

Dr. Edward Hill, chair of the WMA, said: ‘In this new Declaration the World Medical Association is reaffirming the importance of professional autonomy and clinical independence. We see this not only as an essential component of high quality medical care and therefore a benefit to the patient that must be preserved, but also as an essential principle of medical professionalism.’