Declaration of Tokyo

Guidelines for Medical Doctors concerning Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment in relation to Detention and Imprisonment

A problem of increasing occurrence - and repugnance - had been the methods of interrogation and torture perpetrated upon prisoners and detained persons. Some governments had attempted to enlist the assistance of physicians to monitor these activities. The WMA attempted to deal with such incidents as they arose. But as reports of such incidents began to multiply, it became evident that a professional guideline for physicians was needed.

Early in 1974, the British Medical Association (BMA) notified the WMA about medical aspects of torture with special reference to happenings in Northern Ireland. A document prepared by the BMA's Central Ethical Committee stated that so far as the United Kingdom, the territories under its control, and BMA members were concerned. The Committee held the view that in such circumstances as those occurring in Northern Ireland, a doctor's duty, as always, lied in the prevention and treatment of illness, and in the care of the wounded. No doctors should take part, directly or indirectly in interrogation procedures.

The BMA documents concluded with the suggestion that the wider issues of the matter should be discussed by the WMA. It noted that some of form of International Medical Commission should try to see that mental damage did not occur under intensive interrogation, to subjects who in many cases had not been tried in a normal Court of Law. The BMA foresaw grave ethical difficulties where local doctors were drawn into such situations.

The same year, the WMA Council took particular note of the medical ethics involved in this problem. It was not confined only to the situation in North Ireland. Doctors in the U.K. armed forces were crying out for advice as to what policy they should adopt. During discussion at the Assembly in Stockholm, in 1974, the British Medical Association offered to assist in the study of the issue, and so did the Irish Medical Association which was interested also on account of the cases of torture existing in Ireland. The French Medical Federation provided also some documents related to the subject.

One of the most difficult and important task facing the WMA Council and its Committee on Medical Ethics was the preparation of a guideline for medical doctors relative to torture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment. With the tremendous amount of work done by the three associations named above, it had been possible to prepare a draft statement which was sent to the Tokyo Assembly where it was unanimously adopted.

It is worthwhile to mention that the WHO had requested WMA's cooperation in the development of a statement on this topic which would be forwarded to the Fifth U.N. Congress on Crime and treatment of Offenders. The UN Congress used the WMA Declaration as a background paper.

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