The World Federation of Catholic Medical Associations (FIAMC) welcomes several new policies published by the World Medical Association (WMA) following the General Assembly in Berlin, October 2022. They include new Declarations on Racism and Discrimination Against Elderly Individuals in Healthcare Settings as well as the updated International Code on Medical Ethics (ICME).
FIAMC has more than 80 National Associations from all continents, reflected by the wide ethnic and geographic diversity at the 2022 FIAMC meeting in Rome. Naturally we concur with the WMAs Declaration on Racism and their 12 recommendations.
The Declaration regarding Discrimination against the Elderly has 15 recommendations addressing different groups within healthcare. The first to “Governments, Medical Associations and Physicians” advocates “priority actions, to defend the human rights and health of all individuals, including the elderly, as well as to ensure that their dignity is respected”.The last to “Physicians”, is “to report any discrimination against the elderly that is observed in healthcare”.
FIAMC acknowledges the work involved in updating the 2006 ICME and that “the revision process has taken the WMA three years and involved several expert regional conferences and public consultation”.
We also appreciate the WMA candor that, “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 recognition by the WMA, that in exercising Conscientious Objection, a Physician is not required to make a referral to a colleague without such an objection, is wholly endorsed by FIAMC. Both the American and British Medical Associations have similar policy as does the General Medical Council in the UK. Surprisingly, divergence from the ICME statement on Conscientious Objection appears most prevalent in more prosperous and developed nations. In a number of jurisdictions, there is concern that Conscientious Objection has led to adverse consequences for and discrimination against Physicians and Healthcare Providers. The ICME guidance applies not only to Physicians and Medical Associations but also to Government, Organizations and Regulators. Such action in contravention of the International Code of Medical Practice weakens the code and most crucially it’s impact to improve equitable healthcare across the globe plus counter torture or degrading treatment by repressive/authoritarian regimes.
FIAMC urges Physicians, Organizations, Regulators and Government to adhere to the text and spirit of the revised 2022 ICME Guidance, especially in respect to Conscientious Objection.