Council Guide-April2017

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WMA Council Orientation Guide page 1
This booklet was developed to assist new Council members of the World Medical
Association to understand the processes of WMA and to guide their participation as leaders
within the organization.
Council Members
WMA Council is a unique international body that includes physicians from every
region of the world, representing a variety of languages, cultures, and health systems.
Serving on WMA Council provides the opportunity to share ideas and experiences,
learn about the challenges facing your colleagues in other countries, form lasting
friendships and, most importantly, assume a leadership role in the work of the WMA.
Members of the Council are individuals chosen by the National Medical Association
(NMA) elected to occupy a particular seat. The NMA may choose to change or
substitute its individual representative at its own discretion, informing the Secretary
General as soon as it wishes to make a change. It is generally expected that the
Council member will represent the views of his or her NMA or the region they have
been elected from rather than his or her personal views, however this is a matter to be
decided between the NMA and its chosen representative.
Role of the Council
WMA Council is the governing body of the association, responsible for developing
policy proposals for General Assembly consideration, setting organizational priorities
and goals, and overseeing financial and administrative functions. For a full
description of specific responsibilities of the Council, please see Chapter 3 of the
Procedures and Operating Policies of the WMA.
Reporting Relationships
➢➢ WMA Council reports to WMA General Assembly, which meets annually. The
General Assembly consists of all WMA constituent members. All major policy
and financial decisions, as well as changes to the WMA Articles and Bylaws,
must be approved by the General Assembly.
➢➢ The Standing Committees of the Council report to the Council as a whole.
➢➢ The Secretary General reports to the Council.
WMA Council Orientation Guide page 2
Only Council members are eligible to stand for election to the following positions:
● Chair
● Vice-Chair
● Treasurer
● Finance and Planning Committee Chair
● Medical Ethics Committee Chair
● Socio-Medical Affairs Committee Chair
Elections to these positions are held at the first meeting of each two-year Council
term. The Chair, Vice Chair, and Treasurer are elected as soon as the Council
convenes. Until the Chair of Council is elected, the Secretary General presides
over the meeting. Committee Chairs are elected as soon as each Committee
convenes. For all officer positions, nominations are made on the floor of the
meeting and a vote is taken. Officers are elected by a simple majority.
● The Chair and Vice-Chair have full voting rights in the Council. They are also
ex-officio members of all three Standing Committees with full voting rights.
During their tenure the Chair and Vice-Chair are not eligible to be elected as
Chair of any Committee.
● Committee Chairs serve on two of the three Committees, like all other Council
members. They have no special privileges on any Committee besides the one
for which they serve as Chair.
● The President, President-Elect and Immediate Past President are ex-officio
members of the Council (and its Committees) with full right of discussion but
without the right to vote. The WMA President is elected annually by the
General Assembly and serves one year as President-Elect, one year as
President and one year as Immediate Past President.
Standing Committees
Proposed policies and actions are considered first by the Standing Committees. The
Committees then make recommendations to the Council.
The Council has three Standing Committees:
● Finance and Planning
● Medical Ethics
● Socio-Medical Affairs
WMA Council Orientation Guide page 3
The Procedures and Operating Policies of the WMA require that all Council members
serve on at least one but no more than two Standing Committees. In practice, it is
extremely rare for a Council member to serve on only one Committee. Before the
beginning of the Council term, the Secretary General will request Council members to
indicate the Committees on which they would like to serve.
Council members may attend the meetings of a Committee even if they are not
members of that Committee. The Chair will normally allow non-members to speak, if
requested. However, Council members are encouraged to reserve their active
participation for Committees on which they are members.
Official Advisors (non Council-members) to the Standing Committees are appointed
by the Council for a two-year term. New advisors can be appointed at any meeting of
the Council. In most cases, nominations are made by the candidate’s NMA, although
the Committee or Council (or their members) may nominate individuals as well.
Serving as a WMA Council member entails certain important responsibilities. The Council is
elected by the WMA membership to lead the organization and serve as the voice of the
world’s physicians when the General Assembly is not in session. Council members not only
represent their respective NMAs on the Council, but also represent WMA and its constituents
to the public and the media. Although attending meetings and voting on WMA matters is a
key responsibility, Council members should remain engaged in the work of WMA between
meetings as well.
Promoting the WMA
Council members should take advantage of opportunities to promote the work of
WMA within their own organizations and beyond. The WMA does not have a large
public relations budget or staff and depends heavily on its members – and especially
its leaders – to raise the public profile of the association.
Currently, despite 70 years of work, the WMA is sometimes overlooked by the
mainstream international health community and is often confused with the World
Health Organization – even among physicians. Nonetheless, the WMA represents the
global medical profession and the potential power of the unified voice of millions of
physicians should not be underestimated. Serving as an ambassador for WMA and
working to amplify WMA’s voice globally should be among the top priorities for
WMA Council members. To that end, Council members can:
WMA Council Orientation Guide page 4
● Actively support and distribute WMA positions and policies within their
● Increase the visibility of WMA through:
– finding opportunities to discuss the work and role of the WMA when
speaking publicly, especially to the media
– writing articles for medical journals
– encouraging colleagues to view WMA as a resource;
● Bring to WMA’s attention relevant national or international issues or events so
that WMA can respond either by publicizing its existing positions or
developing a new policy.
Financial and Administrative Issues
The Secretariat and the financial officers work hard throughout the year to manage
most administrative and fiscal matters. The main responsibility for Council and
Finance and Planning Committee members is to review and approve proposals and
reports prepared by the Secretariat and the financial officers. Members should arrive
at meetings familiar with the documents and prepared to comment, make
recommendations, vote, etc., however most of the difficult background work in these
areas is done between meetings by the Secretariat, Treasurer and Finance and
Planning Committee Chair.
Medical Ethics and Socio-Medical Affairs Policy Process
The responsibility for development of WMA policy falls largely to the Council and its
Committees. By the time a proposed policy is presented to the General Assembly for
adoption, it will have been circulated to NMAs for input (sometimes several times),
undergone multiple reviews and revisions by the relevant Committee, and received
the approval of the Council.
The workflow for a policy document normally entails the following steps:
1. A document is submitted to the Secretariat by a constituent member in one of the
three official languages of WMA (French, Spanish or English).
2. The Secretariat:
a) evaluates the document to ensure that it does not repeat or contradict existing
b) edits the document to ensure proper format, style and readability;
c) translates the document into the other two official languages; and
d) assigns the document to the proper Committee.
WMA Council Orientation Guide page 5
If a proposal clearly reiterates an existing position or policy, without adding new
content, the Secretariat will consult with the Council Chair and/or Committee
Chair, and, with their approval, request that the author withdraw the document.
If a proposal contradicts or expands upon an existing WMA policy, the Secretariat
will explain this to the author and offer suggestions regarding how the proposal
might be reorganized as a proposal to amend the existing policy.
3. The document receives initial consideration by the appropriate Committee. In
most cases, the Committee will recommend that the document be circulated to
NMAs for comments. Council members should encourage their NMA to submit
written comments to the Committee, rather than providing verbal input during
Committee meetings. Meeting time generally should be reserved for discussing
and debating the comments properly submitted by NMAs.
4. The comments are reviewed and compiled by the Secretariat and a revised
document is prepared, either by the Secretariat or an appointed rapporteur or work
group. Council members receive the original document, the proposed revision and
the compilation of comments to review before the forthcoming meeting.
5. The Committee considers the revised proposal. At this point, the Committee has
several options:
a) If the document is acceptable to the Committee as written, the Committee can
approve the document.
b) If it is determined that the document requires some additional work, and the
Committee believes that this work could be accomplished in a short amount of
time, the Committee can use Committee time to further amend the document
(which is not encouraged) or, preferably, assign the document to a small
working group or a rapporteur to revise. In this situation, the objective is for
the working group or rapporteur to begin work immediately and submit an
amended document back to the Committee or directly to the Council during
that session.
c) If the Committee agrees that substantial revisions are still needed, which
cannot be accomplished within the time period of the Council session, the
Committee may assign a working group or rapporteur to review the comments
and revise the document for consideration at its next meeting.
d) If it is decided that special expertise is required to ensure the best possible
policy, the Committee can request the assistance of a particular NMA or
WMA advisor. Outside experts can also be consulted.
e) If it is clear that consensus will not be reached, or the Committee decides that
the topic is not appropriate for a WMA policy, the Committee can recommend
to the Council that the document be rejected and the subject be dropped. The
Council can either accept this recommendation or instruct the Committee to
continue working on the subject.
WMA Council Orientation Guide page 6
6. Once the Committee agrees that the document is ready, it will submit the proposed
policy to the Council with the recommendation that it be approved and forwarded
to the General Assembly for adoption. Often, some or all of steps 3-5 outlined
above are repeated several times before the Committee is satisfied that the
document is ready for consideration by the Council.
7. The Council considers the recommendation of the Committee to approve the
document. The Council may:
● amend the document
● send the document back to the Committee for additional work
● approve the document and forward it to the General Assembly with the
recommendation that it be adopted.
The above description of the WMA policy process is not exhaustive. Most policy
proposals are handled in this way, but sometimes the Committee or the Council will
decide to take a different approach.
Consent Calendar
WMA Standing Committees use a “consent calendar” for their reports to the Council.
A consent calendar is a mechanism designed to eliminate time-consuming procedural
steps for approving recommendations on items in the report. Instead of addressing
these items one by one – which requires introducing the item, stating the
recommendation, inviting discussion and taking a vote – the Chair asks the committee
members if they disagree with, or would like to discuss for any reason, any
recommendation(s) listed in the report. Items identified for discussion or
disagreement are “extracted” from the report. All requests for extractions will be
honoured. Such requests do not require a vote. Items do not need to be identified in
any order.
The Chair then asks for approval of all of the remaining recommendations in the
report (the ones that have not been extracted.) The committee votes once to approve
all of these items, without discussion.
The Chair then addresses the items that have been extracted. These subjects are dealt
with individually, in the traditional manner.
The following illustrates the operation of a consent calendar:
A report lists 10 items with recommendations. One committee member asks that
items numbered 3 and 7 be extracted. Another committee member asks that items
numbered 2 and 9 be extracted. Following these extractions, the committee votes on
accepting the remaining recommendations (on items 1, 4,5,6,8 and 10) as a whole.
WMA Council Orientation Guide page 7
Following that vote, the Chair then allows discussion and vote on item 2, then item 3,
then item 7 and then item 9.
Due to the limited number of hours that Council members sit together to work on policy
development, it is important for members to be familiar with both the content and history of
the documents on their agenda. Perhaps the most important attribute of a good Council
member is that he or she comes to the meeting prepared. The Secretariat works hard to
ensure documents are processed and translated as quickly as possible so that they can be
circulated to Council members several weeks before a Council session. Please do not leave
your preparation to be done on the airplane or at breakfast on the day of the meeting!
To ensure that discussions run smoothly, and to help the Chair expedite the work of the
group, Council members should:
Be diplomatic but also precise. In sensitive (especially political) discussions, speakers
sometimes try to use images or metaphors to convey messages, expecting other to read
understand their subtle meaning. In an international meeting, this hardly ever works.
Your message will often be lost or distorted through the simultaneous interpretation
process or through the cultural perceptions of your colleagues from other countries. Of
course it is important to be thoughtful and avoid making harsh statements. However, if
you want your intervention or motion to be understood, you must be very explicit about
what you mean.
Make concrete suggestions and amendments. When proposing a wording change to a
document, express exactly how you want the new text to read. The Secretariat will
project your amendment in English on a large screen visible to all participants. If
possible, please give your proposal to a WMA staff member before the meeting. This is
especially important when you are proposing a large text change. In some cases, the
Secretariat will even give the new text to the interpreters beforehand. This helps ensure
that all languages have the advantage of a precise interpretation.
Speak clearly and slowly. Remember that to understand you, participants who speak a
language other than your own must depend either on simultaneous interpretation or on
their own ability to translate what you are saying. The WMA employs the best
interpreters available, however no interpreter can perform well if the speaker speaks too
quickly or does not enunciate. If you read from a text, provide this text to the interpreters
before the session or read extra slowly. Otherwise, what you say may not be translated
WMA Council Orientation Guide page 8
Avoid idioms, jokes and abbreviations. Idioms are difficult, sometimes impossible, to
translate. The same is true with jokes. There is always a risk that you may not be
understood or, even worse, that the jokes you offer with good intentions may actually be
misunderstood in a way that offends or embarrasses somebody. It is also uncomfortable
when some people are able to enjoy a joke while others are left in the dark. Nobody
wants WMA meetings to be gloomy or without any humour, we just want to make sure
everyone can understand and enjoy the discussions. Another problem is caused by
abbreviations and acronyms. We all use them constantly within our own healthcare
systems and organizations, but in an international meeting they are nearly always cryptic
and meaningless codes – even to colleagues that share the same language with you.
Some of them are very familiar (WMA, UN, WHO, etc.) but most of them should be
Be sensitive to cultural and linguistic differences. For many Council members, WMA is
the only forum in which they have the opportunity to interact with colleagues from so
many other places. Remember that in a multi-cultural and multi-lingual meeting, things
tend to take a little longer than in your own system. People have different styles of
communicating their views and there is always a delay in discussion due to the use of
In addition, some participants tend to be less formal and rule-oriented, while others are
accustomed to following a very specific process during group discussions. This is also
true of the Chairs. Therefore it is important to be patient and to enjoy the opportunity to
experience the styles and approaches of your international colleagues. As mentioned
above, the best way to ensure that your views are heard is to come prepared and provide
very specific comments and suggestions.
Proposing and Voting
The WMA uses a fairly universal system of parliamentary procedure. Any Council
member can make a motion. That motion must be seconded by another member. Once
a motion has been seconded, the Chair will invite discussion. After the discussion is
finished, or if there is no discussion, the Chair will ask for members to vote by raising the
cards provided by the Secretariat. The Chair will begin by asking for a count of those
“For” the motion, then those “Against” the motion and then those who “Abstain” from
voting. The votes will be counted and the Chair will announce whether the motion is
passed or defeated.
For detailed information on the parliamentary procedures of the WMA, please see the
Rules of Procedure for all Deliberative Bodies of the World Medical Association, which
can be obtained from the Secretariat.
WMA Council Orientation Guide page 9
The WMA has several policy products:
Declarations and Statements
A Declaration or Statement is a document that “reflects WMA policy on an issue
considered to be of significance, to be universally applicable and embodying principles
that endure over time.” Declarations are broader in scope than Statements, which address
more specific or specialized topics.
Examples of WMA Declarations include:
● Declaration of Lisbon on the Rights of the Patient
● Declaration of Helsinki – Ethical Principles for Medical Research involving Human
● Declaration of Seoul on Professional Autonomy and Clinical Independence
● Declaration on Euthanasia
Examples of WMA Statements include:
● Statement on Ethical Issues Concerning Patients with Mental Illness
● Statement on Health Emergencies Communication and Coordination
● Statement on Resistance to Antimicrobial Drugs
● Statement on Body Searches of Prisoners
Specific criteria distinguishing a Declaration from a Statement was not developed until the
late 1990s. Therefore, over the years, some documents were designated as Declarations
even though they should be classified as Statements. A comprehensive review of the
entire body of WMA policy is currently underway and some reclassification is expected
during the updating of certain documents.
Resolutions express WMA reaction to a specific, usually urgent, situation. Resolutions
are subject to the same basic policy process as Declarations and Statements, however, due
to the urgent nature of the topic, the process is usually accelerated and often does not
include circulation to all NMAs for comments. If NMAs have concerns or suggestions
about a Resolution that has not been circulated, they have ample opportunity to comment
when the document is presented for adoption to the General Assembly.
WMA Council Orientation Guide page 10
Council Resolutions
The Council may adopt a “Council Resolution” on a matter of substantial importance that
requires immediate action which cannot be taken by the General Assembly within the
appropriate time. Council Resolutions may not articulate entirely new policy positions.
They may only:
● Reaffirm a previous Declaration/Statement/Resolution
● Express a position based on the intent of an existing related policy or WMA action
Council Resolutions are not included in the main body of WMA policy (compiled in the
Handbook of WMA Policy), however they may be widely distributed publicly. If
appropriate, the Council may ultimately refer the document to the General Assembly for
adoption as a “WMA Resolution”.
Background Papers
Background papers are occasionally developed to explore new topics or to examine in
detail conflicting views on an important topic. The purpose of these papers is to analyse
issues and provide information to guide WMA in addressing particular subjects.
Serving on the WMA Council should be an enjoyable and productive experience. The
Secretary General and WMA staff are available to provide you with information and will do
their best to assist you with any concerns or questions you might have regarding your
responsibilities as a Council member.
Telephone: +33 4 50 40 75 75
Fax: +33 4 50 40 59 37
Additional information on topics related to the work of the Council can be found in the
Procedures and Operating Policies of the World Medical Association, which is available in
the members’ area of the WMA website.
April 2017