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What is the WMA for? The Secretary General Replies

 

Articles - The Lancet

Health and Human Rights     World Medical Association: response to Derek Summerfield

Delon Humana    Secretary General, World Medical Association, PO Box 63, Ferney-Voltaire 01210, France

Available online 30 January 2003.

The WMA, the independent global representative body for physicians, was founded in 1947, just after World War II. A driving force behind its establishment was the fact that physicians could no longer stand to see how systematic torture and brutal killing, especially during wars and often sanctioned by governments, were destroying patients, societies, and indeed, humanity.

It is against this background that we seriously take issue with even the inference in Derek Summerfield's article1 that the WMA is condoning the involvement of physicians in torture. The Declaration of Tokyo2 clearly states the view of the WMA (panel). It is evident that any physician, from any country, being involved in torture in any way, even condoning it in private or public, would be totally unacceptable for the WMA and its members.

WMA   Declaration of Tokyo

It is the privilege of the medical doctor to practise medicine in the service of humanity, to preserve and restore bodily and mental health without distinction as to persons, to comfort and to ease the suffering of his or her patients. The utmost respect for human life is to be maintained even under threat, and no use made of any medical knowledge contrary to the laws of humanity.

For the purpose of this Declaration, torture is defined as the deliberate, systematic, or wanton infliction of physical or mental suffering by one or more persons acting alone or on the orders of any authority, to force another person to yield information, to make a confession, or for any other reason.

• The doctor shall not countenance, condone, or participate in the practice of torture or other forms of cruel, inhuman, or degrading procedures, whatever the offence of which the victim of such procedures is suspected, accused, or guilty, and whatever the victim's beliefs or motives, and in all situations, including armed conflict and civil strife.
• The doctor shall not provide any premises, instruments, substances, or knowledge to facilitate the practice of torture or other forms of cruel, inhuman, or degrading treatment or to diminish the ability of the victim to resist such treatment.
• The doctor shall not be present during any procedure during which torture or other forms of cruel, inhuman, or degrading treatment is used or threatened.
• A doctor must have complete clinical independence in deciding upon the care of a person for whom he or she is medically responsible. The doctor's fundamental role is to alleviate the distress of his or her fellow men, and no motive whether personal, collective, or political shall prevail against this higher purpose.
• Where a prisoner refuses nourishment and is considered by the doctor as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially. The decision as to the capacity of the prisoner to form such a judgment should be confirmed by at least one other independent doctor. The consequences of the refusal of nourishment shall be explained by the doctor to the prisoner.
• The WMA will support, and should encourage the international community, the national medical associations, and fellow doctors to support the doctor and his or her family in the face of threats or reprisals resulting from a refusal to condone the use of torture or other forms of cruel, inhuman, or degrading treatment.

What Summerfield rightly refers to is the difficulty of effectively combating torture. Any experienced human rights worker will know how much input and work is necessary before advances are made to improve government and non-governmental organisation policies and action against torture. The WMA has worked tirelessly behind the scenes and in the public domain to help combat torture globally but especially in Turkey, Zimbabwe, Nigeria, Peru, and China. Through public appeals, press statements, on-site visits, and collaborative action with our members and other humanitarian and human rights groups, we have done our best to be more effective in bringing acts of torture to the fore and stopping them. Additionally, during the past 4 years, we have planned and implemented several projects to strengthen our capacity to act against torture.

•We successfully lobbied for the appointment of a Special Rapporteur to the UN Commission on Human Rights for the protection of human rights workers, especially those involved in providing health care.
•We established a partnership with The International Rehabilitation Council for Torture Victims (IRCT), an organisation that has done groundbreaking work for torture victims worldwide. Together, we plan to develop training manuals for physicians on the detection and treatment of torture victims (based on the Istanbul Protocol, of which the WMA was a co-developer).
•We established a human rights unit to help systematically follow up and act on cases of torture and human rights violations against physicians and their patients. There has been a worrying increase of torture and abuse of health-care professionals who treat patients who happen to vote or work for the opposition in certain countries. We have attended court cases to help defend colleagues who have found themselves in this position and who have been victimised, tortured, and even murdered for doing their ethical duty.

Last, let us consider the references to the IMA. The IMA is a cosignatory of the Declaration of Tokyo and has declared its willingness to root out any form of torture condoned, countenanced, or practised by physicians in that country. IMA members come from both sides of the political divide and treat patients from both sides of the current conflict. Rather than condemn, let us help them uncover and act against cases of torture in which physicians or other health-care professionals are directly or indirectly involved.
Furthermore, as I explained to Summerfield by telephone, we are in the process of trying to build a so-called medical peace bridge between physicians of Israel and of the Palestinian areas. If we, as physicians and to a certain extent social leaders, can agree on how to combat torture and human rights violations, we can perhaps forge links that are impossible for politicians to attain. The IMA is willing to enter into talks with any recognised medical leader from the Palestinian areas, with the WMA as mediator. A neutral country for such meetings has already been identified.

This is an incredibly important opportunity, which I urge your readers to help us with. If you have contacts with Palestinian medical leaders, please contact the WMA with details. Likewise, although I realise that Summerfield is not a member of the BMA or the WMA (when last we spoke), we urge him to put his good intentions to constructive use by helping us find these leaders and to continue his struggle against torture.

References
1 D Summerfield, What is the WMA for? The case of the Israel Medical Association, Lancet 361 (2003), p. 424. Article |  PDF (44 K) | View Record in Scopus | Cited By in Scopus (4)
2 World Medical Association, Declaration of Tokyo on guidelines for medical doctors concerning torture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment, 29th World Medical Assembly, Tokyo (1975) (http://www.wma.net/e/policy/17-f_e.html) (accessed Jan 16, 2003).


Volume 361, Issue 9355, 1 February 2003, Pages 425-426