153rd WMA Council Session: Santiago, Chile

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The following subjects are likely to be debated during next week's meeting of the World Medical Association, although some of this might change after the debates.

Doping In Sport

A statement on this is likely to be issued on Thursday, calling on the medical profession to rally to oppose doping and censure any doctors who involve themselves in doping. Doping is unethical and sometimes criminal. The argument that if doctors did not involve themselves, the athletes' health would be placed in even greater danger is spurious and unacceptable. The statement will say that there is a need for legislative measures. Access to some substances must be limited, particularly where they are easily available, even over the counter in pharmacies. Therefore the WMA calls for international action to introduce restrictions.

Human Organ And Tissue Transplantation

A proposed Statement will be debated declaring that consent must always be obtained for transplantation. It says that the organs and tissues of executed prisoners should not be used for transplantation because of the difficulty, if not impossibility, of obtaining the prospective donor's free and informed consent. Physicians should refuse to participate in transplantation procedures involving executed prisoners.

Accountability, Responsibilities And Ethical Guidelines In The Practice Of Telemedicine

A working group under the Australians (French, Americans, Finns, Germans) has been working on new ethical guidelines for doctors on the use of telemedicine. These may recommend that National Medical Associations promote training for telemedicine techniques, develop practice guidelines and standard protocols and estsablish guidelines prohibiting the commercialisation or mass exploitation of tele-consultations.

Medical Patents

The American Medical Association is revising a proposed Statement on the issue of patenting of medical procedures, which may declare that such patents pose serious risks to the effective practice of medicine by potentially limiting the availability of new procedures to patients. There will be a debate on whether the WMA considers that the patenting of medical procedures is unethical and contrary to the values of professionalism that should guide physicians' service to their patients and relations with their colleagues.

Icelandic Bill

There will be a debate about a Bill that has passed through the Icelandic Parliament allowing the establishment of a central health database for the entire population of Iceland. The database would be financed by a private licensee who, in exchange for financing and running the database, would be given a monopoly on the data for research purposes. The coalition of Nordic National Medical Associations is concerned about the alarming ethical implications of registering all health data for an entire population, the monopolistic control of such data, which would allow a licensee to deny access to data for other researchers whose work might impinge on the business interests of the licensee, the possibility that there could be a complete DNA registration of the entire population and the risk of identifying people, this stigmatising families and isolated population groups.

Declaration Of Helsinki

A working group has been considering revisions to the Declaration, to make it clear that there is an important distinction between clinical and non clinical research. The Declaration of Helsinki is one of the WMA's key documents, setting out guidance worldwide for doctors and other investigators in biomedical research involving human subjects. It was adopted in 1964 following evidence from the Nuremberg trials of widespread Nazi experiments on people without their consent. Since then the Helsinki Declaration has been a shield protecting the vulnerable, children, the senile and the mentally handicapped in the area of research, and it forms the basis for most of the world's ethical guidelines in research.

The Public Promotion And Marketing Of Pharmaceutical Preparations

A joint statement with the International Pharmaceutical Federation and the World Self Medication Industry will be debated, opposing the aggressive marketing of over-the-counter drugs which might encourage people to self medicate inappropriately. Medicines should not be promoted in a way designed to stimulate an impulse purchase.