WMA rethinks patients' rights

BMJ 1995; 311 doi: (Published 16 September 1995) Cite this as: BMJ 1995;311:709

The World Medical Association(WMA) has issued a new declaration on the rights of the patient. Although it was largely welcomed by the BMA, the British delegation took issue with the requirement that doctors should always attempt to resuscitate people who had attempted to commit suicide and with the provisions regarding treatment against the patient's will.

The new guidelines, proposed by the Finnish Medical Association at the WMA's meeting lat week in Bali, replace the 1991 Declaration of Lisbon. They take into account such issues as consent from patients who are unconscious or legally incompetent and the recent acceptance of advance directives of living wills as binding.

The most contentious points are set out in sections four, five, and six of the document. Section four on the unconscious patient says that if no valid representative can be found to make a decision on urgently needed treatment, “consent may be presumed, unless it is obvious and beyond any doubt on the basis of the patient's previous firm expression or conviction that he/she would refuse consent in that situation. However, physicians …

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