WMJ 05 2011 - World Medical Association

Social Disparities
NORWAY
must ensure patient safety and not compromise
the existing recognition and registration
procedures and the necessary public
safeguards.
Giving the high relevance of the Professional
Qualifications Directive, the CPME
will hold a pre-conference on the subject
in Warsaw ahead of its board meeting and
General Assembly on 26 November 2011.
The conference will take place on 25 November
and will gather the European
Medical profession, representatives from
the European Commission, the European
Parliament and the Polish EU Presidency.
More information is to be found on the
CPME web-site: www.cpme.eu ; also, please
do not hesitate to contact Birgit Beger
(birgit.beger@cpme.eu).
Dr. Konstanty Radziwill, CPME President
Birgit Beger,CPME Secretary General
Social Disparities in Health and the Physician’s Role: A Call for
Clarifying the Professional Ethical Code
Berit Bringedal Kristine Bærøe Eli Feiring
In this article, the authors address the ethics
of providing individual healthcare fairly
in populations with a social gradient in the
distribution of health. They expose a tension
within the ethical recommendations of
the World Medical Association (WMA):
The Physician’s Oath in the Declaration of
Geneva states that socioeconomic factors
should never come between the patient and
the physician, while the WMA Statement
on Inequality in Health emphasizes that
the physician should contribute to a reduction
in the unacceptable social inequality in
health – an inequality that clearly correlates
with social and economic factors. Empirical
research indicates that this tension is not of
theoretical interest only; it may have practical
implications as well, in terms of a risk
of reproducing and/or enhancing health
inequalities in clinical practice. Empirical
studies confirm that healthcare to some
extent favors the advantaged. This gives no
reason to assume the recommendation in
the Oath is violated as such. However, the
Oath’s recommendation of not taking nonmedical
factors into account can explain an
inaccurate understanding and awareness of
the fair role of social and cultural factors in
patient treatment. By clarifying the positive
role of socioeconomic and cultural factors in
healthcare and stating this explicitly in physicians’
ethical guidelines, these factors may
warrant attention both through medical education
and in clinical practice. The authors
conclude by suggesting a reformulation of
the Physician’s Oath that may guide more
effective and fair care of the disadvantaged
and help reduce health inequities produced
at the point of care.
Introduction
The World Medical Association (WMA)
International Code of Medical Ethics states
that “(A) physician shall not allow his/her
judgments to be influenced by personal
profit or unfair discrimination”. At the same
196