Policy Tag: Medical Neutrality

Adopted by the 226th WMA Council session, Seoul, Korea, April 2024
and adopted by the 75th WMA General Assembly, Helsinki, Finland, October 2024

 

PREAMBLE

In response to the ongoing conflict in Israel and Gaza, the WMA is gravely concerned by the deepening healthcare and humanitarian crisis in Gaza, the growing starvation and the lack of medical care and deeply concerned about the continued imprisonment and abuse of hostages.

 

RECOMMENDATIONS

The WMA Council and its constituent members call for:

  1. A bilateral, negotiated and sustainable ceasefire in order to protect all civilian life, secure the release and safe passage of all hostages and to allow the transfer of humanitarian aid for all those in need.
  2. The immediate and safe release of all hostages.
  3. Pending their release, humanitarian aid and healthcare attention to be provided to the hostages.
  4. All parties to abide by international humanitarian law and the principle of medical neutrality to safeguard the rights and protection of healthcare facilities, healthcare personnel and patients from further threat, interference and attack.
  5. Unimpeded and accelerated humanitarian access throughout all of Gaza, including the entry of humanitarian aid and safe passage of medical personnel. This also includes the evacuation of urgent medical cases to reduce secondary morbidity and mortality, public health risks, and alleviate pressure on hospitals inside Gaza.
  6. The re-establishment of access to healthcare and the creation of a safe working environment for healthcare personnel to work in through the restoration of medical capacity and essential services.
  7. Verified investigations into alleged gross violations and abuses of human rights and international humanitarian law including attacks on healthcare staff and facilities and the misuse of those facilities for military purposes.
  8. The upholding by physicians of the principles in the WMA Declaration of Geneva and other documents that serve as guidance for medical personnel during times of conflict.

 

 

Adopted by the 223rd WMA Council, Nairobi, Kenya, April 2023
Revised and adopted by the 74th WMA General Assembly, Kigali, Rwanda, October 2023

 

PREAMBLE

Violent fighting has broken out since April 2023 in Khartoum and in several cities of Sudan between the Sudan Armed Forces (SAF) and Rapid Support Forces (RSF), an independent paramilitary force.

Amnesty International reports extensive war crimes with mass civilian victims in both deliberate and indiscriminate attacks by the conflicting parties as well as sexual violence against women and girls. Rampant looting has affected hospitals, medical facilities, and humanitarian warehouses across various regions. This widespread looting has exacerbated an already dire situation by depriving communities of essential medical and humanitarian resources. Even if supplies manage to enter Sudan, the challenge lies in safely delivering them to conflict-affected regions, where they are critically required [1].

The WMA and its constituent members join the United Nations Security Council in condemning in the strongest terms all attacks on the civilian population, United Nations and associated personnel and humanitarian actors, as well as civilian objects, medical personnel and facilities, and the looting of humanitarian supplies [2].

 

RECOMMENDATIONS

  1. The WMA supports the call by the UN Security Council to conflicting parties to immediately cease hostilities, facilitate humanitarian access and establish a permanent ceasefire arrangement and to resume the process towards reaching a lasting, inclusive and democratic political settlement in Sudan.
  2. The WMA calls upon all parties in conflicts to:
    • Respect the ethical principles of health care, including medical neutrality, to guarantee the safety of patients and health personnel, and take immediate steps to ensure that they are not targeted or affected by the fighting, including the provision of safe passage of health care personnel and patients where evacuation is required;
    • Ensure that hospitals and healthcare facilities have adequate supplies and staffing to provide care to those in need and facilitate humanitarian aid;
    • End immediately gender-based violence, including sexual violence as a tactic of war to terrorize people.
  1. The WMA urges the Sudanese authorities to ensure impartial and independent investigations into all alleged gross violations and abuses of human rights and serious violations of international humanitarian law; and for perpetrators to be held accountable.

[1] Sudan: “Death came to our home”: War crimes and civilian suffering in Sudan – Amnesty International

[2] Security Council Press Statement on Sudan | UN Press, 02.06.2023

Adopted as Council Resolution by the 220th WMA Council Session, Paris (hybrid), France, April 2022
and as Resolution by the 73rd WMA General Assembly, Berlin, Germany, October 2022 

 

PREAMBLE

Reminding that the World Medical Association was founded on the backdrop of the atrocities of war and how the medical profession was abused for violation of human rights and dignity;

Reaffirming the WMA Declaration of Geneva as a beacon of fundamental principles to which the world’s physicians are committed;

Deeply shocked by the Russian army’s bombing of Ukrainian civilians and hospitals, including maternity wards, thus infringing on medical neutrality in conflict zones. The WMA and its members express their solidarity with the Ukrainian people and provide their support for Ukrainian and international healthcare workers mobilized under extremely difficult conditions;

Recalling the WMA’s Statements on the Cooperation of National Medical Associations during or in the Aftermath of Conflicts, on Armed Conflicts, the Regulations in Times of Armed Conflict and Other Situations of Violence, the Statement on the Protection and Integrity of Medical Personnel in Armed Conflicts and Other Situations of Violence, the Declaration on the protection of healthcare workers in emergency situations and the Statement on Medical Care for Migrants;

Emphasizing the need to respect the Geneva Conventions and their protocols as the core of international humanitarian law, as well as the United Nations Security Council Resolution 2286;

Considering the suffering and human tragedy caused by the Russian invasion of Ukraine, including a refugee crisis on a massive scale;

 

RECOMMENDATIONS

  1. The Constituent Members of the WMA stand in solidarity with the Ukrainian Medical Association and all healthcare professionals.
  2. The WMA condemns Russia’s invasion of Ukraine and calls for an end to hostilities.
  3. The WMA considers that Russia’s political leadership and armed forces bear responsibility for the human suffering caused by the conflict.
  4. The WMA calls on Russian and Ukrainian doctors to hold high the principles in the WMA Declaration of Geneva and other documents that serve as guidance for medical personnel during times of conflict.
  5. The WMA demands that the parties to the conflict respect relevant Humanitarian Law and do not use health facilities as military quarters, nor target health institutions, workers and vehicles, or restrict the access of wounded persons and patients to healthcare, as set out in the WMA Declaration on the Protection of Health Workers in Situations of Violence.
  6. The WMA stresses that the parties to the conflict must strive to protect the most vulnerable populations.
  7. The WMA underlines that it is essential that access to medical care be guaranteed to all victims, civil or military, of this conflict, without distinction.
  8. Physicians and all other medical personnel, both Ukrainian and international, involved in NGOs, must not under any circumstances be hindered in the exercise of their unwavering duty, in accordance with the international recommendations provided in the WMA declaration on the protection of healthcare workers in emergency situations, the WMA’s position on the protection and integrity of medical personnel in armed conflicts and other violent situations and in the declaration of the United Nations General Assembly on the rights and responsibility of individuals, groups and organs of society to promote and protect human rights and universally recognized fundamental freedoms.
  9. The WMA calls on the parties to ensure that essential services are provided to those within areas damaged and disrupted by conflict.
  10. The WMA calls on the international community and governments to come to the aid of all persons displaced by this conflict who may choose their country as a destination following their departure from Ukraine.
  11. The WMA urges all nations receiving persons fleeing the conflict to ensure access to safe and adequate living conditions and essential services to all migrants, including appropriate medical care, as needed.
  12. The WMA calls on the parties to the conflict as well as the international community to ensure that when the conflict ends, priority must be given to rebuilding the essential infrastructure necessary for a healthy life, including shelter, sewerage, fresh water supplies, and food provision, followed by the restoration of educational and occupational opportunities.

Adopted by the 65th WMA General Assembly, Durban, South Africa, October 2014
and rescinded and archived by the 73rd WMA General Assembly, Berlin, Germany, October 2022

Preamble

The right to health is a fundamental element of human rights which does not change in situations of conflict and violence. Access to medical assistance for the sick and wounded, whether they have been engaged in active combat or not, is guaranteed through various international agreements, including the Geneva Convention and the Basic Principles on the Use of Force and Firearms by Law Enforcement Officials of the United Nations.

The primary obligation of physicians is always to their patients, and physicians have the same ethical responsibilities to preserve health and save life in situations of violence or armed conflicts as in peacetime. These are as set out in the WMA Regulations in Times of Armed Conflict and Other Situations of Violence.

It is essential to ensure the safety and personal security of healthcare workers in order to enable the provision of the highest standard of care to patients. If healthcare workers are not safe, they might not be able to provide care, and patients will suffer.

In situations of violence, the delivery of healthcare is frequently obstructed and the sick and wounded deprived of essential treatment through:

1. Medical workers being prevented from attending to the injured;

2. Interference by the state or others in positions of power through intimidation, detention or other legal measures;

3. Patients being denied access to medical facilities;

4. Targeted attacks upon medical facilities and medical transport;

5. Targeted attacks upon medical personnel, including kidnapping;

6. Non-targeted violent acts which result in the damage to or destruction of facilities or vehicles, or cause injury or death to medical personnel.

Such actions have serious humanitarian implications and violate international standards of medical neutrality as set out in the provisions of international human rights and humanitarian law and codes of medical ethics.

Attacks on the fundamental ethical principles of the medical profession, such as attempts to coerce medical professionals into providing details regarding those under their care, can undermine the confidence of patients and discourage injured people from seeking necessary treatment.

RECOMMENDATIONS

The WMA calls upon governments and all parties involved in situations of violence to:

1. Ensure the safety, independence and personal security of healthcare personnel at all times, including during armed conflicts and other situations of violence, in accordance with the Geneva Conventions and their additional protocols;

2. Enable healthcare personnel to attend to injured and sick patients, regardless of their role in a conflict, and to carry out their medical duties freely, independently and in accordance with the principles of their profession without fear of punishment or intimidation;

3. Safe access to adequate medical facilities for the injured and others in need of medical aid should not be unduly impeded;

4. Protect medical facilities, medical transport and the people being treated in them and provide the safest possible working environment for healthcare workers and protect them from interference and attack;

5. Respect and promote the principles of international humanitarian and human rights law which safeguard medical neutrality in situations of conflict;

6. Establish reporting mechanisms to document violence against medical personnel and facilities as set out in the WMA Statement on the Protection and Integrity of Medical Personnel in Armed Conflicts and Other Situations of Violence.

7. Raise awareness of international norms on the protection of healthcare workers and cooperate with different actors to identify strategies to tackle threats to healthcare. The collaboration between the WMA and the International Committee of the Red Cross on the Health Care in Danger project provides one example of this.

Adopted by the 64th General Assembly, Fortaleza, Brazil, October 2013
And reaffirmed with minor revisions by the 215th Council session (online), Cordoba, Spain, October 2020

PREAMBLE

During wars and armed conflicts, hospitals and other medical facilities have often been attacked and misused and patients and medical personnel have been killed or wounded. Such attacks are a violation of the Geneva Conventions (1949), Additional Protocols to the Geneva Conventions (1977) and WMA policies, in particular, the WMA Statement on the Protection and Integrity of Medical Personnel in Armed Conflicts and Other Situations of Violence (Montevideo 2011) as well as WMA Regulations in Times of Armed Conflicts and Other Situations of Violence (Bangkok 2012).

The World Medical Association (WMA) has been active in condemning documented attacks on medical personnel and facilities in armed conflicts, including civil wars. The Geneva Conventions and their Additional Protocols are designed to protect medical personnel, medical facilities and their patients in international and non-international armed conflicts. The parties on both sides of the conflict have legal and moral duties not to interfere with medical care for wounded or sick combatants and civilians, and to not attack, threaten or impede medical functions. Physicians and other health care personnel must act as and be considered neutral and must not be prevented from fulfilling their duties.

RECOMMENDATIONS

  1. The WMA recalls the United Nations Security Council Resolution 2286 adopted in 2016 condemning attacks and threats against medical personnel and facilities in conflict situations and demanding an end to impunity for those responsible.
  2. The WMA calls upon all parties in the Syrian conflict to ensure the safety of healthcare personnel and their patients, as well as medical facilities and medical transport, and to respect the ethical obligation of health personnel to treat all patients, irrespective of who they are in line with the Ethical Principles of Health Care in Times of Armed Conflict and other Emergencies endorsed by civilian and military health-care organizations in 2015.
  3. The WMA calls upon its members to approach local governments in order to facilitate international cooperation in the United Nations, the European Union or other international body with the aim of ensuring the safe provision of health care to the Syrian people.

 

Adopted by the 182nd WMA Council Session, Tel Aviv, Israel, May 2009

WHEREAS:

Recent international conflicts, including the Israeli-Palestinian conflict in Gaza, the conflict in Sri Lanka, the conflict in Darfur, and the conflict in the Democratic Republic of Congo, have led to loss of life and the impairment of living conditions; and International standards of medical neutrality must be upheld throughout such conflicts;

THEREFORE, the WMA

  1. Reaffirms its policy, “Regulations in Time of Armed Conflict” and the obligations of physicians stated in this document. The WMA calls on its members to act in accordance with all internationally accepted principles of healthcare delivery in times of conflict.
  2. Reiterates its commitment to the universal right to health, and access to the highest attainable standard of health care. This universal right is not conditional on peaceful existence, although a peaceful existence accommodates greater ability to provide health to all.
  3. Reaffirms the obligation incumbent on all parties involved in conflict situations to abide by the rules of international medical ethics, a swell as the provisions of international humanitarian law, as expressed in the Geneva Conventions, particularly their common article 3, and, specifically, to assure the provision of medical care and/or evacuation of the trapped and wounded and to refrain from targeting medical personnel and medical facilities.