WMA Statement on Bullying and Harassment within the Profession
Adopted by the 68th General Assembly, Chicago, October 2017
1. Workplace bullying has been recognised as a major occupational stressor since the early 1980s.
2. Workplace bullying is unreasonable and inappropriate behaviour directed towards a worker or a group of workers that creates a risk to health and safety. By definition, bullying is behaviour that is repeated over time or occurs as part of a pattern of behaviour, rather than a single episode. Unreasonable behaviour is what a reasonable person in the same circumstances would see as unreasonable. It includes behaviour that intimidates, offends, victimises, threatens, degrades, insults or humiliates. Bullying can take psychological, social and physical forms. It is not the perpetrator’s intention, but the victim’s perception, that is key to determining whether bullying has occurred.
3. Harassment is unwanted, unwelcome or uninvited behaviour that makes a person feel humiliated, intimidated or offended. Harassment can be related to a person’s ethnicity, gender, sexual orientation, disability or other factors such as whether a person has made a complaint.
4. Employers generally have a legal duty to ensure the health, safety and welfare of their employees. This includes identifying bullying and harassment and taking steps to eliminate and prevent it. Employees are generally required to take reasonable care for their own health and safety as well as for the health and safety of others who may be affected by their acts in the workplace.
5. In recent years, bullying and harassment have become more recognised in the medical profession; there is good evidence that disruptive behaviour, inappropriate behaviour and harassment occurs in the medical workplace. International research has shown that bullying in the healthcare profession is not associated with specialty or sex. It appears that bullying is widespread and occurs across all specialties and at all levels of seniority, although it is fair to say that where bullying occurs it is more common to be inflicted by a more senior employee upon a more junior one. The hierarchical nature of medicine and the inherent power imbalance associated with this can however create a culture of bullying and harassment which, in some cases, becomes pervasive and institutionalized.
6. Workplace bullying can have detrimental effects such as decreased job satisfaction, depression, anxiety, and absenteeism, all of which impact adversely on staff retention and quality of patient care.
7. The WMA condemns bullying or harassment under any circumstances. It further believes that raising awareness of inappropriate behaviour, disruptive behaviour and harassment in the medical profession is an important step in the process of eliminating the problem. The WMA is of the view that this is an issue of professionalism and it encourages National Medical Associations (NMAs), medical schools, employers, and medical colleges to establish and implement anti-bullying and harassment policies.
8. The WMA recommends that NMAs recognise and, where possible, actively address the following:
8.1 Bullying in the health workplace is an entirely unprofessional and destructive behaviour and should not be tolerated.
8.2 Steps should be taken to prevent, confront, report and eliminate bullying at any level.
8.3 Bystanders also have a responsibility to take action.
8.4 There can be significant barriers for junior doctors to speak out about bullying by senior colleagues, for example fear of career retribution.
8.5 Professionalism is not just how we treat our patients, but how we treat each other as professional colleagues. Acting professionally means also being vigilant and stepping in to intervene, for the good of all.
8.6 Bullying is unprofessional, contradicts the fundamentals of the profession and raises fitness to medical practise concerns.
8.7 Healthcare needs good teams. Eliminating bullying ensures a safer team environment and a safer healthcare environment for patients.
8.8 It is the responsibility of the management to maintain a good working environment and address all signs of harassment and bullying. There should be zero tolerance of bullying and harassment