ICMDA, which unites national associations of doctors and dentists in over 80 countries, was responding to a move by Canadian and Dutch doctors to challenge the WMA’s longstanding commitment to protecting freedom of conscience at a meeting in Iceland later this year.
The WMA was established after the second world war in the face of the atrocities carried out by Nazi doctors. It exists to ensure the independence of physicians, and to work for the highest possible standards of ethical behaviour and care by physicians, at all times.
Since 1947 the WMA has published a number of key policies, which have shaped medical ethics including the Declaration of Geneva – the successor of the Hippocratic Oath (1947) – the International Code of Medical Ethics (1949,) the Declaration of Helsinki on research involving human beings (1964), the Declaration of Tokyo commanding physicians not to participate in torture or degrading treatment (1975) and the Declaration of Malta on Hunger Strikers (1991).
But at its upcoming Medical Ethics Conference (2-4 October 2018) and General Assembly (3-6 October) in Reykjavik, it will be debating proposals that would significantly weaken its stance on the freedom of conscience rights of doctors with respect to abortion and euthanasia.
Its current position on abortion makes the freedom not to be involved in any aspect of abortion quite clear. The new proposal limits this right only to actually performing an abortion, but not to assistance, referral, oversight or more peripheral involvement.
The statement also makes it clear that doctors have an obligation to intervene when there is a threat of serious injury or damage to the woman’s health. Again, this could require doctors to perform abortions on grounds of the woman’s mental health, a caveat that could lead to doctors being pressurised to perform abortions on demand.
At the ICMDA’s General Assembly during their quadrennial World Congress in Hyderabad in August 2018, the membership unanimously supported a statement asking the WMA to reconsider these changes, and in particular to make it clear that freedom of conscience should apply to the right not to refer or advise, and that the doctor’s obligation to perform an abortion was to protect the physical health of the woman.
In addition, while the WMA has a policy of not supporting euthanasia and assisted dying, ICMDA has also asked that they make it explicit that doctors in those countries which permit euthanasia should have the right to conscientious objection to both participation and referral.
It is concerning that a body, set up to promote medical ethics and preserve freedom of conscience in the wake of the revelations at the Nuremberg trials, is under pressure to undermine freedom of conscience in this manner.
We can only hope and pray that the voices being raised to maintain such freedoms will be listened to, because to override freedom of conscience in one area for one group is threaten such freedoms for all.