Intended for healthcare professionals

Rapid response to:


Doctors in Syria are being forced to treat patients in secret, charity says

BMJ 2012; 344 doi: (Published 09 February 2012) Cite this as: BMJ 2012;344:e1000

Rapid Response:

Re: Doctors in Syria are being forced to treat patients in secret, charity says

The medical professionalism is grossly undermined in the current situation in Syria.Cruess et al. described medical professionalism as an idea to be sustained (1) and this cannot be achieved unless there are structural supports available and functional. Creating long list of attributes on medical education and professionalism alone (2) would not do any better in real health work environment or in extra-ordinary situations. Syria is not the first state violating the code of ethics in the medical field and may not be the last. Almost a year ago the World Medical Association (WMA) issued a resolution on Bahrain (3), demanding that all states understand and respect the concept of medical neutrality.

Medical professionalism has survived through its continuous engagement with society. Nevertheless, such societal contract is only meaningful when a mutual understanding exists between the government which defines and renders the licensing of the profession and the professionals in an organised society (4). The issue of dual loyalty is more magnified in situations of armed conflict, where medical personnel are threatened to abandon their professionalism.

Whilst there are numerous international Conventions and Declarations aimed at upholding medical ethics, they lack affirmative action for effectual and timely intervention. United Nations and the North Atlantic Treaty Organization could be more involved in taking a more proactive approach to intervene to ensure medical professionalism is upheld under any circumstances.

1.Cruess RL, Cruess SR, Johnston SE. Professionalism: an ideal to be sustained. The Lancet. 2000 Jul;356:156–9.

2.The Lancet. Medical education and professionalism. The Lancet. 2009 Mar;373(9668):980.

3.WMA Resolution on Bahrain [Internet]. [cited 2012 Feb 21]. Available from:

4.Richmond B J, Eisenberg L. Medical Professionalism in Society. The New England Journal of Medicine. 2000;342(17):1288–90.

Competing interests: No competing interests

20 March 2012
Keivan Ahmadi
PhD candidate, Clinical pharmacist
Chee Ho CHEAH, Ireneous N. SOYIRI
Monash University Sunway Campus
Jalan Lagoon Selatan,46150 Bandar Sunway, Selangor Darul Ehsan, Malaysia