Inaugural speech – Dr Xavier Deau, WMA President 2014-2015

WMA General Assembly, Durban 2014 at Durban ICC, South Africa

It is a great honour and pleasure for me to be here in Durban to take on the Presidency of the World Medical Association in front of all of you and to represent the 106 Medical Associations of our Association. I’m sure you will understand that it is with some emotion that I address you today.

Allow me first to pay tribute to our Past President, Dr Margaret Mungherera, whose great amount of work over the past year has contributed to promoting the ethical standards of our Association at the highest level, particularly on the African continent through the African Forum project.

-Let me introduce myself:

I am a medical specialist in general medicine, and since 1976 I have been working in Epinal (in the Eastern part of France) in a multi-professional medical practice located in a socially disadvantaged area (which includes a re-housing center, a children’s home and social housing…). I founded this multi-professional and multidisciplinary medical practice in order to optimize the quality of healthcare and answer the specific needs of a precarious population in a coordinated manner.

Having lived in Lorraine, 20 meters from the German border, for the first 25 years of my life, I have always been sensitive to multiculturalism, to the importance of respecting difference, and to the construction of a Europe in the spirit of peace and understanding so dear to Robert Schuman, the founder of the European Union who was born in the same region. Therefore, I have always held within me great faith in a world of peace, fraternity and joy.

This spirit of peace, respect and understanding has led me to take on professional responsibilities within the French Medical Council as an Elected Representative, first at Departmental level, then at National level as Vice-President, then as President of the European and International Relations Delegation, and lastly as Secretary General of the European Council of Medical Orders and of the Francophone Conference of Medical Orders gathering of 22 countries, including 15  from the African continent. I would like to express my gratitude to the French Medical Council for making all these commitments possible.

During my studies, I was fortunate enough to get to know Doctor Bernard Kouchner and Doctor Xavier Emmanuelli, founders of Doctors without Borders and of the SAMU Social International, who have been outstanding examples of the universality of medical ethics for me.

Lastly, I could never forget my daily source of energy: the affection of my wife who is here with us today, as well as my 5 children and 12 grandchildren, who are not physically present, but who are in my heart and soul.

Therefore, you will understand that, as is true for each of us, my path has been marked by my own family and my own cultural determinants. I would like to thank all of those who have helped me to be here with you today.

All your actions within the World Medical Association have allowed me to continue along this path.

The question I am now asking myself is probably the same one that you have in mind:

Why did I accept the role of the Presidency of the WMA?

I would first like to call to mind one of the fathers of the WMA, the French doctor Eugène Marquis, who, following the atrocities of the last World War, showed along with many of his colleagues a very strong willingness to work for peace by raising the ethical standards of medical practice to the highest level through the foundation of the WMA.

Since its creation in 1947, the WMA has been constantly affirming loud and clear through its declarations and statements the universality of essential ethical values for practicing our profession.

I want to maintain continuity with my predecessors; it is with humility that I will head our Association.

Therefore, throughout the coming year I will endeavour to enhance our ethical values even further because, beyond the deontology proper to the legislation in each of our countries, these ethical values should sway the mind of each and every doctor, regardless of his or her culture, religion or skin colour.

Along with you, I will seek to protect and further develop:

  1. The INDEPENDENCE of the medical profession, which should be duly respected by political, administrative, military as well as religious authorities. The independence of doctors’ decision-making forms the basis of the TRUST indispensable to the doctor–patient relationship.
  2. PROFESSIONAL SECRECY: in all circumstances, including during armed conflicts, professional secrecy must be respected along with all INFORMATION on patients and their CONSENT to the health care proposed to them.
  3. A high-level, good quality EDUCATION is the cornerstone of the competence of doctors, and it is essential that the WMA be one of the effective players in this field, especially through the development of the worldwide Junior Doctors Network. The JDN has demonstrated its role within the WMA. The WMA should remain at the service of the education of the doctors of tomorrow.
  4. Let us not forget the PROTECTION of our patients’ PERSONAL DATA at this time of new technologies, e-health and m-health. The protection of these sensitive data should be enhanced as rigorously as possible without jeopardizing the evolution of our medical science.
  5. At the same time, in a world where everything tends to have a monetary value, we should remain very watchful of all potential CONFLICTS of INTEREST. Human values must always prevail over financial considerations, bearing in mind that the well-being of humans cannot be dissociated from financial contingencies. The WMA has to participate in finding a balance between the “primacy of the individual” and “societal primacy”.

All of these ethical values have been underlined in the latest version of the Declaration of Helsinki, which is a shining example of the universality of medical ethics. Even if its drafting seemed laborious at times, our Declaration of Helsinki has the merit of compiling the cultures of 106 medical associations, and thus is an authentic factor in promoting PEACE and the UNION between medical professions around the world in full respect for patients and their care.

Nonetheless, these ethical values cannot exist without a structured and organized society, taking into account the SOCIAL DETERMINANTS of health in order to optimize health EQUITY.

This coordination should include all the different players around patients, both in care and prevention, as well as in health education, in one single, all-encompassing and dynamic vision within a given territory.

The WMA should contribute to a genuine revolution in primary care by promoting holistic and personalized medicine, coordinated between the different health professions.

In this respect, I would particularly like to praise the work of Sir Michael Marmot for his contribution towards this goal, both in his own country and worldwide.

Taking account of our cultural differences necessarily raises the level of care requirements, particularly at a time when viruses like Ebola have no more borders and require a maximum level of coordination from all health care professionals and politicians. In this regard, the role of the WMA becomes indispensable. We must all mobilize ourselves.

Working through their constant perspective of multiculturalism, I would like to pay tribute to the efforts of our WMA leaders: our Chairman of the Board, Mukesh Haikerwal, our Secretary General, Otmar Kloiber, as well as the rigorous and careful vigilance of our Treasurer, Frank Ulrich Montgomery, not forgetting our legal advisor, Annabel Seebohm and ethical advisor Jeff Blackmer. I would also like to thank all the members of the WMA’s Executive Committee, not forgetting the efficiency of the entire Secretariat and those who support their work (Sunny, Clarisse, Anne-Marie, Roderic, Rosie, Julia and Lamine, and of course…Nigel, always looking out for the latest news).

I am French and my country, France, is not only a country with a strong human rights record, but also a republic which has been based on the triptych: LIBERTY, EQUALITY, FRATERNITY since 1789 (and the French Revolution).

I will therefore strive during this mandate to promote healthcare EQUITY for every human being regardless of his or her language, culture or religion…

To conclude, I have one final wish: our world is currently going through a dramatic increase in armed conflicts, which are seeing the values of our Association permanently violated. IMPARTIALITY remains an inescapable ethical value, as much in our schools as in our administrations and our hospitals. This impartiality guarantees a deep respect for all cultural differences and the rejection of all forms of fundamentalism.

That is why I am asking everyone to act as peacemakers by strictly observing these values within your Associations, towards your governments and also with respect to each of your patients.

Today marks the 12th World Day Against the Death Penalty, and I would like to stress the importance of this issue for the WMA. This gives me an opportunity to pay tribute to the work of our association in this field through its policies aimed at supporting doctors working in prisons to promote human rights and ethics. I refer in this regard to the Declaration of Tokyo, which provides Guidelines for Physicians Concerning Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment in Relation to Detention and Imprisonment, the Declaration of Malta on Hunger Strikers and the Declaration of Edinburgh on Prison Conditions and the Spread of Tuberculosis and Other Communicable Diseases.

On this special day of my election, I would also like to underline the crucial action of two South African Nobel Peace Prize Laureates, Nelson Mandela and Archbishop Desmond Tutu. These two men have managed to be drivers for peace and impartiality beyond the borders of South Africa.

Let us be the actors and also the builders of a healthier, fairer and more equitable society, in which human rights, but also liberty, equality and fraternity, as well as high quality health care, enable each person to grow and live in peace.

Let us be doctors acting towards peace in the name of the universality of the ethics of our Medical Association…!

Seamos médicos actores de paz en nombre de la universalidad de la ética de nuestra asociación… !

I thank you all,

Dr Xavier Deau

Xavier Deau