Submission to the World Medical Association

Public Consultation on a draft devised version of the International Code of Medical Ethics

The Anscombe Bioethics Centre

The Anscombe Bioethics Centre

The Anscombe Bioethics Centre is the oldest national bioethics centre in the United Kingdom, established in 1977 by the Roman Catholic Archbishops of England and Wales. It was originally known as The Linacre Centre for Healthcare Ethics and was situated in London before moving to Oxford. The Centre engages with the moral questions arising in clinical practice and biomedical research. It brings to bear on those questions principles of natural law, virtue ethics, and the teaching of the Catholic Church, and seeks to develop the implications of that teaching for emerging fields of practice. The Centre engages in scholarly dialogue with academics and practitioners of other traditions. It contributes to public policy debates as well as to debates and consultations within the Church.

A key issue: conscientious objection

For the first time this draft Code introduces the idea of “conscientious objection”:

Paragraph 27 reads:

Physicians have an ethical obligation to minimise disruption to patient care. Conscientious objection must only be considered if the individual patient is not discriminated against or disadvantaged, the patient’s health is not endangered, and undelayed continuity of care is ensured through effective and timely referral to another qualified physician.*

* This paragraph will be debated in greater detail at the WMA’s dedicated conference on the subject of conscientious objection in 2021 or 2022. However, comments on this paragraph are also welcome at this time.

Unfortunately, this is deeply problematic as a statement of the rights of conscience in medicine. In the first place it utterly fails to establish the duty of doctors to object to practices and procedures that are unconscionable because harmful, discriminatory, unjust or unethical. The right to conscientious objection is based on the duty to be conscientious which is fundamental to medical ethics. . . continue reading

Comment on the draft International Code of Medical Ethics of the World Medical Association

European Institute of Bioethics

In the context of the International Code of Medical Ethics’ revision, the European Institute of Bioethics (EIB) would like to share some comments with the World Medical Association (WMA) Assembly on paragraph 27 of the draft.

Since 2001, the European Institute of Bioethics has developed an expertise in healthcare ethics, with a special focus on the right of healthcare practitioners to freedom of conscience in their practice.

We acknowledge that the International Code of Medical Ethics (hereafter: the Code) is not a binding instrument for the WMA member states. However, one cannot deny the considerable influence the Code may have on national codes of deontology and even on national laws. Moreover, physicians and healthcare organizations expect from the WMA to promote the highest quality of healthcare relationship between physicians and patients.

Paragraph 27 of the Code is drafted as follows:

Physicians have an ethical obligation to minimise disruption to patient care. Conscientious objection must only be considered if the individual patient is not discriminated against or disadvantaged, the patient’s health is not endangered, and undelayed continuity of care is ensured through effective and timely referral to another qualified physician.

In the following note, we discuss one by one the different parts of this paragraph which we consider, written as such, highly problematic for the physicians’ rights and the patients’ care. . . continue reading

World Medical Association Reaffirms Opposition to Euthanasia and Physician-Assisted Suicide

News Release

World Medical Association

The World Medical Association has reaffirmed its long-standing policy of opposition to euthanasia and physician-assisted suicide.

After an intensive process of consultation with physicians and non physicians around the world, the WMA at its annual Assembly in Tbilisi, Georgia, adopted a revised Declaration on Euthanasia and Physician-Assisted Suicide.

This states: ‘The WMA reiterates its strong commitment to the principles of medical ethics and that utmost respect has to be maintained for human life. Therefore, the WMA is firmly opposed to euthanasia and physician-assisted suicide.’

It adds: ‘No physician should be forced to participate in euthanasia or assisted suicide, nor should any physician be obliged to make referral decisions to this end.’

The Declaration says: ‘Separately, the physician who respects the basic right of the patient to decline medical treatment does not act unethically in forgoing or withholding unwanted care, even if respecting such a wish results in the death of the patient.’

The revised Declaration defines euthanasia as ‘a physician deliberately administering a lethal substance or carrying out an intervention to cause the death of a patient with decision-making capacity at the patient’s own voluntary request.’

It says that physician-assisted suicide ‘refers to cases in which, at the voluntary request of a patient with decision-making capacity, a physician deliberately enables a patient to end his or her own life by prescribing or providing medical substances with the intent to bring about death.’

WMA Chair Dr. Frank Ulrich Montgomery said: ‘Having held consultative conferences involving every continent in the world, we believe that this revised wording is in accord with the views of most physicians worldwide.’

American Medical Association: Call It ‘Physician-Assisted Suicide,’ Not ‘Aid-in-Dying’

CNS News

Patrick  Goodenough

CNSNews.com) – Advocates of assisted suicide are dismayed that the largest association of physicians in the U.S. has decided to continue using the term “physician-assisted suicide” rather than euphemisms such as “medical aid-in-dying.”

Meeting in Chicago on Monday, the American Medical Association, by a vote of 360-190, adopted a report by its Council on Ethical and Judicial Affairs (CEJA) recommending that the term “physician-assisted suicide” continue to be used.

Significantly, the AMA also voted to reaffirm its Code of Medical Ethics’ current policy on assisted suicide – the view that allowing doctors to help patients to die “is fundamentally incompatible with the physician’s role as healer.” That vote was 392-162. . . [Full text]

AMA Reaffirms Stance Against Physician-Aided Death

Medscape

Marcia Frellick

CHICAGO — Delegates voted overwhelmingly to affirm the current policy opposing physician-assisted dying here at the American Medical Association (AMA) 2019 Annual Meeting.

After impassioned testimony from both sides at last year’s meeting, the Council on Ethical and Judicial Affairs was asked to further examine the issue.

“The AMA House of Delegates concluded that established guidance in the Code of Medical Ethics supports shared decisions that respect the deeply held beliefs of physicians and their patients with respect to assisted suicide,” said AMA President Barbara McAneny, MD. . . [Full text]

American Academy of Family Physicians, American Academy of Hospice and Palliative Medicine, American Academy of Neurology