World Medical Association amends its policy on doctors' duty during armed conflict
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《英国医生杂志》
The World Medical Association (WMA) announced on 9 October that it is amending its policy on physicians?behaviour in times of armed conflict to emphasise that "medical ethics in times of armed conflict are identical to medical ethics in times of peace."
The amendments were endorsed without opposition by delegates in attendance at the association抯 General Assembly in Tokyo earlier this month. Endorsers included representatives of the United States and the United Kingdom.
The amendments come on the heels of a report in the Lancet by Steven H. Miles (Lancet 2004; 364: 725-9) a physician and bioethicist, who found US medical personnel were complicit with "abuses of detainees in Iraq, Afghanistan, and Guantanamo Bay" and that a physician and psychiatrist "helped design, approve, and monitor interrogations at Abu Ghraib." Dr Miles concluded that the abuses were the result of a "military command that was inattentive to human rights."
The Department of Defense took "strong exception" to the allegations.
The WMA抯 recent action affirms its policy that it is "unethical for physicians to give advice or perform procedures that are not justifiable for the patient抯 health care or that weaken the physical or mental strength of a human being without therapeutic justification."
"As a human being it was extremely disheartening to be faced with news of the abuses and then to see that medical professionals were complicit with this," said Dr Arthur Derse, emergency physician and president-elect of the American Society for Bioethics and Humanities (ASBH). "The WMA is absolutely right, ethics don抰 change because you are in the military. Doctors don抰 get training in how to behave in a military zone. We need to teach this to our medical students."
The society sent a letter to President George W. Bush on 2 August asking for an investigation into the role of medical personnel in the reported abuses. Citing a number of international and national codes of ethics, the society charged that "if health professionals became aware that abuse of detainees was occurring, then ordering them to perform monitoring or clearance functions designed to allow this to continue would be a direct violation of卬umerous ethical standards."
Dr Derse told the BMJ that the society does not take positions on political issues but that "This goes right to the heart of what it is to be a physician."
The World Medical Association seeks to address the problem of "dual loyalty" ?in which "requests or orders by the police or military to take part in practices that violate fundamental human rights, such as torture" compete with the physician抯 primary responsibility to his or her patient. In its 2003 resolution on the responsibility of physicians in the denunciation of acts of torture or cruel or inhuman or degrading treatment of which they are aware, the WMA provided guidance for doctors on handling and reporting torture and abuse.
The WMA amendments were initiated by the BMA about 12 to 18 months ago, according to a spokesperson for the WMA who told the BMJ, "The amendments are not specifically related to Iraq but represent a more general concern in light of all the conflicts around globe."(New York Jeanne Lenzer)
The amendments were endorsed without opposition by delegates in attendance at the association抯 General Assembly in Tokyo earlier this month. Endorsers included representatives of the United States and the United Kingdom.
The amendments come on the heels of a report in the Lancet by Steven H. Miles (Lancet 2004; 364: 725-9) a physician and bioethicist, who found US medical personnel were complicit with "abuses of detainees in Iraq, Afghanistan, and Guantanamo Bay" and that a physician and psychiatrist "helped design, approve, and monitor interrogations at Abu Ghraib." Dr Miles concluded that the abuses were the result of a "military command that was inattentive to human rights."
The Department of Defense took "strong exception" to the allegations.
The WMA抯 recent action affirms its policy that it is "unethical for physicians to give advice or perform procedures that are not justifiable for the patient抯 health care or that weaken the physical or mental strength of a human being without therapeutic justification."
"As a human being it was extremely disheartening to be faced with news of the abuses and then to see that medical professionals were complicit with this," said Dr Arthur Derse, emergency physician and president-elect of the American Society for Bioethics and Humanities (ASBH). "The WMA is absolutely right, ethics don抰 change because you are in the military. Doctors don抰 get training in how to behave in a military zone. We need to teach this to our medical students."
The society sent a letter to President George W. Bush on 2 August asking for an investigation into the role of medical personnel in the reported abuses. Citing a number of international and national codes of ethics, the society charged that "if health professionals became aware that abuse of detainees was occurring, then ordering them to perform monitoring or clearance functions designed to allow this to continue would be a direct violation of卬umerous ethical standards."
Dr Derse told the BMJ that the society does not take positions on political issues but that "This goes right to the heart of what it is to be a physician."
The World Medical Association seeks to address the problem of "dual loyalty" ?in which "requests or orders by the police or military to take part in practices that violate fundamental human rights, such as torture" compete with the physician抯 primary responsibility to his or her patient. In its 2003 resolution on the responsibility of physicians in the denunciation of acts of torture or cruel or inhuman or degrading treatment of which they are aware, the WMA provided guidance for doctors on handling and reporting torture and abuse.
The WMA amendments were initiated by the BMA about 12 to 18 months ago, according to a spokesperson for the WMA who told the BMJ, "The amendments are not specifically related to Iraq but represent a more general concern in light of all the conflicts around globe."(New York Jeanne Lenzer)