S-1993-03-1993_OVE

L’ASSOCIATION MEDICALE MONDIALE. INC ASOCIACION MEDICA MUNDIAL, INC
Telephone : 5040 75 75
Fax: 50 40 59 37
October 1993
THE WORLD MEDICAL ASSOCIATION. INC.
B.P. 63 • 01212 FERNEY·VOLTAIRE Cedex, France
28. avenue des Alpes· 01210 FERNEY·VOLTAIRE, France
Cable Address:
WOMEDAS. Ferney·Voltaire
17.00
Original: English
WORLD MEDICAL ASSOCIATION STATEMENT
ON
PATIENT ADVOCACY AND CONFIDENTIALITY
Adopted by the 45th Wond Medical Assembly
Budapest, Hungary, October 1993
Medical practitioners have an ethical duty and a professionat responsibility to act in
the best interests of their patients at all times.
the best interests of their pauents at an times.
Should medical practitioners perceive circumstances which might adversely affect
patient’s health, it is their duty to inform responsible authorities so that remedial
action may be taken.
Should responsible authorities decline to take remedial action, reasons for the
decision should be made known to the medical practitioners who reported the
circumstances. Should such notification not be provided or should the rationale for
the decision prove unconvincing, the medical practitioners concerned have a duty to
take further action.
Such further action might conflict with confidentiality provisions in the rnedlcai
practitioners’ contracts of employment, thereby creating sociat, occupational and
ethicaJ dilemmas for the medical practitioners.
Whenever health care finances are limited, bUdgetary constraint measures provide
the potential for conflict between medical practitioners and authorities which employ
them over appropriate and necessary health care services.
Health service administrators are responsible for implementation of governments’
policies and may be required to make choices with which employed medical
practitioners may disagree. Opponents of governments’ health care policies and their
implementation by administrators should direct criticisms to the sources.ot the policy
decisions or implementation measures considered to be unsatisfactory.
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Mutually accepted and acceptable mechanisms by which medical practitioners may
express concerns either for individual patients or for public health, without breaching
terms of employment contracts, should be established.
Such mechanisms should be embodied in medical practitioners’employment
contracts. These employment contracts should acknowledge that medical
practitioners’ ethical obligations override purely contractual obligations related to
employment.
Particular difficulties may arise where medical practitioners suspect that
administrative decisions are made for spurious reasons such as religious, racial or
sexual prejudice, or for purposes of financial gain, or that clinical research is being
conducted without appropriate ethical consideration and supervision.
Where such considerations arise, adverse comments by medical practitioners might
appear libellous or defamatory in some jurisdictions and may be so in fact. Specific
concerns on such matters should be referred by medical practitioners to an
appropriate professional forum such as the registration or licensure authority for their
jurisdiction.
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