INTERNATIONAL CODE OF MEDICAL ETHICS

Adopted by the 3rd General Assembly of the World Medical Association (London, UK, October 1949), supplemented by the 22nd General Assembly of the WMA (Sydney, Australia, August 1968) and the 35th General Assembly of the WMA (Venice, Italy, October 1983).

General duties of doctors

A PHYSICIAN MUST maintain the highest professional standards at all times.

A PHYSICIAN MUST not allow considerations of self-interest to interfere with the freedom and independence of professional decision, which should be made solely in the interests of the patient.

A PHYSICIAN MUST place compassion and respect for the human dignity of the patient at the forefront and be fully responsible for all aspects of medical care, regardless of their own professional specialty.

A PHYSICIAN MUST be honest in dealing with patients and colleagues and fight those of his colleagues who show incompetence or are seen as deceitful.

The following are not compatible with the norms of medical ethics:

a) self-promotion, unless it is specifically permitted by the laws of the country and the code of ethics of the national medical association;

b) payment by a doctor of a commission for referring a patient to him, or receiving payment or other remuneration from any source for referring a patient to a certain medical institution, to a certain specialist or prescribing a certain type of treatment without sufficient medical grounds.

A PHYSICIAN MUST respect the rights of patients, colleagues, other medical professionals, and also keep medical secrecy.

The PHYSICIAN MUST only in the interests of the patient in the process of providing medical care to carry out interventions that can worsen his physical or mental condition.

A PHYSICIAN MUST be extremely careful when giving information about discoveries, new technologies and treatments through non-professional channels.

A DOCTOR SHOULD only approve what he has personally verified.

The duty of the physician to the patient

A PHYSICIAN MUST always be mindful of his duty to preserve human life.

A PHYSICIAN SHOULD turn to more competent colleagues if the examination or treatment required by the patient is beyond the level of his own professional abilities.

A PHYSICIAN MUST maintain medical secrecy even after the death of his patient.

A PHYSICIAN MUST always provide emergency care to anyone in need of it, except only in those cases when he is satisfied with the desire and ability of others to do everything necessary.

Responsibilities of physicians towards each other

A PHYSICIAN MUST behave towards his colleagues as he would like them to behave towards him.

A PHYSICIAN MUST not poach patients from his colleagues.

THE PHYSICIAN MUST abide by the principles of the “Declaration of Geneva” approved by the World Medical Association.

HELSINKI DECLARATION

Recommendations for Physicians Conducting Biomedical Research

With the participation of people

Adopted by the 18th WMA General Assembly (Helsinki, 1964)

Revised by the 29th WMA General Assembly (Tokyo, 1975)

Revised by the 35th WMA General Assembly (Venice, 1983)

Revised by the 41st WMA General Assembly (Hong Kong, 1989)

INTRODUCTION

The duty of the physician is to protect the health of the people. The knowledge and conscience of the doctor must be subordinated to this task.

The Geneva Declaration contains the words: “The health of my patients is my first concern.” The International Code of Medical Ethics states that in cases where a doctor prescribes a treatment that can weaken the physical or mental condition, he must do so solely in the interests of the patient.

The purpose of biomedical research involving people is to improve diagnostic, therapeutic and preventive methods, as well as to identify the etiology and pathogenesis of diseases.

In medicine, any diagnostic, therapeutic and preventive measures are associated with a certain risk. This is especially true for biomedical research.

The progress of medicine is impossible without scientific research, many of which are experimental and carried out with the participation of people.

A clear distinction should be made between studies with direct diagnostic or therapeutic purposes and purely scientific studies that do not solve the diagnostic and therapeutic problems of the people involved.

Particular attention should be paid to studies that pollute the environment, as well as those in which experimental animals suffer.

For the successful development of science, it is essential that the results of experimental research be applicable to man and make his life easier. As a guide for doctors of all specialties conducting biomedical research, the World Medical Association has prepared the following recommendations. It should be remembered that these instructions are very schematic and should be reviewed periodically. Physicians who follow these recommendations are not exempt from criminal, civil and ethical liability under the laws of their countries.

I. BASIC PRINCIPLES

1. Biomedical research involving people must be based on reliable experimental and laboratory data, they must comply with generally accepted scientific principles, and be carefully substantiated at the modern scientific level.

2. The general scheme and plan for conducting each stage of the study must be clearly described in the protocol, which is submitted for consideration and approval by the special commission. Panel members must be independent of those conducting the study and the sponsor of the study. The composition of the commission is formed in accordance with the legislation of the country in which the study is conducted.

3. Human studies must be performed by qualified personnel under the supervision of an experienced physician. In all cases, the doctor is responsible for the patient, but not the patient himself, despite the informed consent given by him.

4. Research can be carried out only in cases where the importance of the tasks set in it is comparable to the risk of research.

5. Each time before conducting the experimental part of the study, the expected benefits and risks to the subject should be weighed. The interests of the patient are always above the interests of science and society.

6. The patient’s right to fullness and privacy should always be respected. Every precaution should be taken to eliminate the effect of the study on the personality, physical and mental health of the subject.

7. The doctor agrees to conduct research only when he can assess the expected risk. In cases where the risk of the study outweighs the expected benefit, the physician must terminate the study.

8. When publishing research results, the doctor must be honest. The results of studies not carried out in accordance with the principles of this Declaration should not be published.

9. Each research participant must be informed in advance about its goals, objectives, methods, expected risks and benefits, as well as the inconvenience that this research may cause. The investigator must obtain from the subject a voluntarily signed informed consent to participate. Each participant must be aware that their participation in the study is voluntary and that he/she may terminate it at any time.

10. When obtaining informed consent to participate in a study, the clinician must be extremely correct in order to avoid coercion, especially if the intended participant is dependent on him. In such cases, the way out may be to obtain informed consent from another doctor who is not involved in the study and is in no way associated with either the researcher or the subject.

11. In case of officially established incapacity, as well as if the prospective participant is underage, consent to participate can be obtained by his official representative, in accordance with local law. In cases where obtaining informed consent from the subject is not possible (for example, in physically or mentally handicapped persons), close relatives may give consent for their participation, subject to the same conditions. In the case of mandatory obtaining of informed consent from a minor (minor), additional consent of his (her) official representative is required.

12. The study protocol should always contain an explanation of the ethical issues of participation in it, in accordance with the principles of this Declaration.

II. CLINICAL MEDICAL RESEARCH

1. In the process of treatment, the doctor must be free to choose methods of diagnosis and treatment if, in his opinion, this will save life, improve health or alleviate the suffering of the patient.

2. The clinician should compare the potential benefits, risks, and inconveniences of the new method with the best known and used methods.

3. In any clinical study, regardless of the presence of a control group, the patient should be given the most informative studies, he should receive the most effective treatment.

4. The patient’s refusal to participate in the study should not worsen the doctor’s attitude towards him.

5. If the doctor considers that it is not necessary to obtain the informed consent of the patient in advance, he must substantiate his opinion in writing in the protocol and submit it to the independent commission in advance, in accordance with the requirements set out in paragraph I-2 (see above) .

6. A physician may combine medical research with medical practice only in cases where this is in the interests of his patients.

III. NON-CLINICAL HEALTH BIOLOGICAL STUDIES

1. Conducting purely scientific (not practical) research on people, the doctor is responsible for their life and health.

2. Non-clinical biomedical research should involve healthy volunteers or individuals whose illnesses are not relevant to the research.

3. The investigator and his staff must terminate the study if its continuation is fraught with danger to the participants.

4. In any biomedical research, the life and health of the subjects are always above the interests of science and society.

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