An updated version of the International Code of Medical Ethics has been agreed and published by the World Medical Association.
The revised Code, regarded as the foundation of ethical principles for physicians worldwide, defines the professional duties of physicians towards their patients, other physicians and health professionals, themselves, and society as a whole. It was adopted today in a unanimous vote at the WMA’s annual General Assembly in Berlin by physician leaders from almost 60 national medical associations.
The Code was first adopted in 1949 and last revised in 2006, and the new version includes for the first time sections on patient autonomy, physician well-being, remote treatment and environmental sustainability.
The revision process has taken the WMA three years and involved several expert regional conferences and public consultation.
During the debates, the most contentious proposal concerned mandatory referral, obliging doctors who object to controversial procedures such as physician assisted suicide or abortion to refer to a willing doctor. After considerable debate, a compromise agreement was reached that does not require doctors to refer in case of a conscientious objection. Rather, the compromise says ‘Physician conscientious objection to provision of any lawful medical interventions may only be exercised if the individual patient is not harmed or discriminated against and if the patient’s health is not endangered.
‘The physician must immediately and respectfully inform the patient of this objection and of the patient’s right to consult another qualified physician and provide sufficient information to enable the patient to initiate such a consultation in a timely manner’.
The Code says that physicians must respect not only the dignity and the rights of patients, but also explicitly mentions their autonomy. For the first time the Code refers to environmental health, saying ‘The physician should strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.’
Remote treatment is included for the first time. The Code says: ‘When providing medical care remotely, the physician must ensure that this form of communication is medically justifiable and that the necessary medical care is provided. The physician must also inform the patient about the benefits and limitations of receiving medical care remotely, obtain the patient’s consent, and ensure that patient confidentiality is upheld. Wherever medically appropriate, the physician must aim to provide care to the patient through direct, personal contact.’
And finally, the Code declares that physicians must attend to their own health, well-being, and abilities, and seek appropriate care to ensure that they are able to practise safely.