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ASOCIACION MEDICA MUNDIAL


Documento:

MEC 201/Curriculum of Medical Schools COM REV/Oct2015/Rev


Original:

Inglés


Título:

proyecto de declaracion sobre la etica medica y los derechos humanos en el curriculo de las escuelas de medicina del mundo




Destinación:

Comité de Etica Médica

201ª Sesión del Consejo

Asamblea General de la AMM 2015

World Trade Center Moscow

Moscú, Rusia

14-17 octubre 2015



Medidas necesarias:

Para consideración

Nota:

Como parte del proceso de revisión de las políticas de 10 años, la Asociación Médica Británica se ofreció para revisar este documento. El 200º Consejo en Oslo decidió enviarlo para comentarios.




Abbreviations Key:

AMC

Austria Medical Chamber




AMV

Associazione Medica del Vaticano




AuMA

Autralian Medical Association




BMA

British Medical Association




CGCM

Consejo General de Colegios Médicos de España (Spain)




ChMA

Chinese Medical Association




CMA

Canadian Medical Association




DMA

Danish Medical Association




FMA

Finnish Medical Association




JMA

Japan Medical Association




NMA

Norwegian Medical Association




NzMA

New Zealand Medical Association




RMS

Russian Medical Society




SAMA

SwMA

South African Medical Association

Swedish medical Association






TuMA

Turish Medical Association


GENERAL COMMENTS


AMC

Provided that the statement is restricted to the aspect of medical ethics and human rights only, we are satisfied with the current version.

However, if it should provide a guideline for medical curricula in general, we would like to point out that education in psychosocial, psychosomatic and psychotherapeutic medicine must be included.



AMV

The Vatican Medical Association supports the new version of this important document, and thanks BMA for the work they have done.

We would propose, as a friendly amendment to the text, delete the name of Mengele in order to avoid the mention of only one single person from only one country.



AuMA

The AMA supports the general principle behind this document - namely, that medical schools worldwide should include a strong focus on ethics, highlighting how a sound knowledge of ethical theory and practice benefits the (future) doctor, patients, colleagues, the community and the wider (global) public. As written, however, the intention behind the statement is lost. The statement appears to take an equal emphasis on the teaching of medical ethics as well as human rights. Although we believe human rights is an important component of an overall ethics curriculum, the statement may be better served by focussing solely on medical ethics. Ethics is a core component of medical professionalism - the profession develops and maintains ethical codes of behaviour to which its members are expected to adhere. As part of becoming a doctor, medical students need to understand the history behind medical ethics and how to apply ethical reasoning to their daily activities. 

In addition, some of the the language used throughout the statement casts a negative view of the medical profession. For example,



  • Paragraph 3 refers to medical ethics as a 'bargain' between the health professions and society; 

  • Paragraph 4 focusses on physicians facing 'opportunities to infringe the human rights of their patients';  

  • Paragraph 7 refers to the unethical human experiments carried out by Josef Mengele - this reference is completely out of context to the wider statement.  

It may be best to rewrite the statement. We believe the important points that should be incorporated include the following:

  • medical ethics should be taught and assessed at every medical school; 

  • all faculty involved in undergraduate and graduate teaching should embed the principles of medical ethics within their teaching; 

  • medical ethics education should ideally include a combination of theoretical and practical ethics so students understand the basic foundation of ethics and apply ethical reasoning and decision-making in a variety of settings including clinical, academic, research, administrative, public health and humanitarian; 

  • graduates should also be able to communicate effectively with patients, their family and other health care professionals about ethical issues; 

  • ethics education should be appropriately funded with competent teachers; 

  • role modelling and mentoring by more senior doctors is important to ethics education;

  • ethics must be embedded in the clinical process and modelled by respected teachers for it to be fully adopted as a matter of course. 

We strongly recommend the statement use positive language and adhere to highlighting the importance of teaching ethics in medical schools and how on-going ethics education is essential throughout a doctor's medical career - as an undergraduate and post-graduate, in vocational training and as part of continuing medical education.

BMA

The content of the core curriculum is beyond the scope of this document but there is something the MEC might wish to consider.  Would we like to set out such a programme?  Who would we want to collaborate with over?


DMA

DMA generally has a very positive view of the document and applauds the authors for taking this initiative. The DMA suggests that the following elements could be added to the document:

-  A desciption of the requirements for the examination in “medical ethics”

- Perspectives and suggestions for ideas for sanction possibilities towards doctors who act unethically

-  Suggestions for the establishment of a body with authorisation to watch this



- Suggestions for prevention/prophylactic activities.

FMA

Finnish Medical Association supports the proposed update of this WMA policy. In our view, the core of medical ethics, helping patients and altruism, could be even more visible in the statement. In addition, we propose to add few aspects of medicine and medical ethics to the text that are not explicitly mentioned in the draft.

NzMA

We welcome the work the WMA is doing in this important area and are strongly supportive of the recommendations in the proposed statement. The NZMA agrees that medical ethics and human rights must be taught as part of the curriculum at medical school. We also agree that it is essential for medical schools to have sufficient faculty skilled at teaching ethical enquiry and human rights to make such courses sustainable. We share the WMA’s view that medical ethics and human rights should be included within postgraduate and continuing medical education. Our association develops and publishes the Code of Ethics for the New Zealand Medical Profession,1 a document that sets out key ethical principles and recommendations that are at the core of professional medical practice. We believe that our Code of Ethics provides a strong basis for supporting the teaching of medical ethics and human rights to medical students and doctors.
Finally, we note that the preamble uses the terms ‘doctors’ and ‘physicians’ interchangeably. We suggest that the draft use a single term, preferably ‘doctors’.

SAMA

The WMA is a signatory of the World Federation for Medical Education International Standards in Medical Education
In the document ‘Basic Medical Education WFME Global Standards for Quality Improvement’ the question of ethics is addressed – attached. Furthermore the context of education and the quality of the staff and all other matters pertaining to medical education are addressed http://wfme.org/standards/bme/78-new-version-2012-quality-improvement-in-basic-medical-education-english/file .
Unlike the proposed WMA statement that ‘insists’ on the teaching of ethics and having sufficient skilled faculty to do so the WFME has a staged approach of a basic requirement, ‘must’, and a developmental standard, ‘should’.
When one ‘insists’ there is also the question of what action to take if there is non-compliance.
In short we we short Ifrom comments:rk madethsi believe that this matter has already been dealt with appropriately and if there is an insistence that a statement should be made there should be sensitivity to the developmental nature of medical education and regional variations as described in the preamble of the WFME.

SwMA

This proposed statement is a welcome extension of the current, very short WMA Resolution on the inclusion of medical ethics and human rights in the curriculum of medical schools world-wide. However, to make the document more easily accessible we believe that it would benefit from some simplification of wording. We also recommend that the actual recommendations at the end of the statement are numbered 1-3.


CGCM

Medical ethics is an untenable part of the baggage of the physician and is an essential part of professionalism and social commitment of the physician to respond to conflicts and issues that arise in the daily exercise of the medical profession. The doctor must also have training in values that ensure quality technical and human care and to compromise with the values, interests and autonomy of patients.
Values education is essential in medical training hence the need for medical schools to care for training. Values education influences the society of physicians, allowing them to identify and critically examine their own moral convictions, recognizing the human and ethical aspects of medical practice and using this knowledge to improve their clinical practice and personal interaction skills with patients. There is much evidence to support the need for ethics and human rights teaching in medical schools in an established and structured manner and not voluntarily and informally.
Therefore it is essential to train and educate physicians about the knowledge of medical ethics, as a moral and professional commitment and to respond to the needs that will arise in this area for patients and society.

* Numbering will be deleted (or adjusted) when the revised text is adopted.



No

Texto propuesto

MEC 200/Curriculum of Medical Schools/Apr2015


Specific Comments

Additions: bold/underlined

Deletions: lined-out

Comments only: [italic]

Texto propuesto revisado por la BMA MEC 201/Curriculum of Medical Schools REV/Oct2015

1

Los currículos de las escuelas de medicina están elaborados para preparar a los jóvenes a entrar en la profesión médica. Cada vez más, junto con los conocimientos centrales incluyen evaluación crítica y práctica reflexiva, lo que permite que los futuros médicos comprendan y evalúen la importancia de la evidencia de investigación publicada y cómo evaluar su propia práctica en relación con las normas y estándares nacionales e internacionales.

.


Medicine is fundamentally a moral enterprise. Without actual or potential suffering of patients there would be no need for the science or practice of medicine. [FMA]
Medical school curricula are designed to ready young persons prepare medical students to enter the profession of medicine. Increasingly, as well as in addition to core biomedical and clinical knowledge, they teach skills including critical appraisal and reflective practice. These additional skills enabling help to enable future doctors to understand and assess the importance of published research evidence, and how to evaluate their own practice against norms and standards set nationally and internationally.

[CMA]

Medical school curricula are designed to ready young persons to enter the medical profession of medicine. Increasingly, in addition to as well as core knowledge, they teach skills such as including critical appraisal and reflective practice, enabling future doctors to understand and assess the importance of published research evidence, and how to evaluate their own practice against norms and standards set nationally and internationally (SwMA)



Los currículos de las escuelas de medicina están elaborados para preparar a los estudiantes de medicina a entrar en la profesión médica. Cada vez más, además de con los conocimientos centrales biomédicos y clínicos enseñan habilidades que incluyen evaluación crítica y práctica reflexiva, lo que permite que los futuros médicos comprendan y evalúen la importancia de la evidencia de investigación publicada y cómo evaluar su propia práctica en relación con las normas y estándares nacionales e internacionales.


2

De la misma manera que la anatomía, fisiología y bioquímica son una base sólida para entender el cuerpo humano, su funcionamiento, cómo puede fallar y cómo los diferentes mecanismos pueden utilizarse para reparar estructura y funciones dañadas, existe una necesidad clara de que los médicos en formación comprendan el contexto social y ambiental en el que ejercerán su profesión. Esto incluye una sólida comprensión de los determinantes sociales de salud.


In much the way same that anatomy, physiology and biochemistry are a solid base for understanding the human body, how it works, how it can fail or otherwise go wrong, and how different mechanisms can be used to repair damaged structure and functions, there is a clear need for physicians in training to understand the social, cultural and environmental contexts within which they will practice. This includes a solid understanding of the social determinants of health. [CMA]
This includes a solid understanding of the social determinants of health, health policies, and their effects on emergence of ethical problems.(TuMA)

In much the way same way that anatomy, physiology and biochemistry are form a solid base for understanding the human body, how it works, how it can fail or otherwise go wrong, and how different mechanisms can be used to repair damaged structure and functions, there it is a clear need necessary for physicians in training to understand the social and environmental context within which they will practice. (SwMA)



De la misma manera que la anatomía, fisiología y bioquímica son una base sólida para entender el cuerpo humano, su funcionamiento, cómo puede fallar y cómo los diferentes mecanismos pueden utilizarse para reparar estructura y funciones dañadas, existe una necesidad clara de que los médicos en formación comprendan el contexto social, cultural y ambiental en el que ejercerán su profesión. Esto incluye una sólida comprensión de los determinantes sociales de salud.


3

La ética médica incluye el acuerdo logrado entre las profesiones de la salud y las sociedades a las que sirven sobre los límites que se deben aplicar a las libertades que tiene cada médico y sus pacientes, al igual que establecer un sistema o conjunto de principios a través del cual nuevos tratamientos u otros asuntos clínicos serán considerados antes de tomar una decisión sobre si los elementos son aceptables para la práctica médica. Hay una compleja mezcla de ética médica y deberes para los pacientes y los derechos de los que gozan éstos como ciudadanos.



Medical ethics includes the bargain made between the health care professions and the societies they serve on the limits that should apply to the freedoms enjoyed by the individual physician, and his/her patients, as well as establishing [note: this is more properly contextualized as “medical professionalism” and its inclusion here could be confusing] establishes a system or set of principles to which physicians are expected to adhere. These principles can also be sued to evaluate through which new treatments or other clinical issues will be sieved interventions before decisions are made on whether elements are acceptable within medical practice. There is a complex intermingling of medical ethics and the duties of physicians to their patients, and the rights patients enjoy as citizens. [CMA]
Medical ethics refers to enabling medical professions to perform their responsibilities of safeguarding health and safety of people and society they serve and includes… [ChMA]
… as well as establishing a system or set of principles through which new treatments or other clinical issues will be sieved evaluated before decisions are made on…(NzMA)
Medical ethics includes the bargain made between the health care professions and the societies they serve on the limits that should apply to the freedoms enjoyed by the individual physician, and his/her patients. as well as establishing It also establishes a system or set of principles through which new treatments or other clinical issues will be sieved before decisions are made on whether or not elements are acceptable within medical practice. (SwMA)
Medical ethics includes the bargain social contract made between the health care professions (TuMA)

La ética médica incluye el acuerdo logrado entre las profesiones de la salud y las sociedades a las que sirven, en base a los principios establecidos, sobre los límites que se aplican a la atención médica, al igual que establecer un sistema o conjunto de principios a través del cual nuevos tratamientos u otras intervenciones clínicas serán considerados antes de tomar una decisión sobre si los elementos son aceptables para la práctica médica. Hay una compleja mezcla de ética médica y deberes de los médicos hacia los pacientes y los derechos de los que gozan éstos como ciudadanos.


4

Al mismo tiempo, los médicos tienen oportunidades de violar los derechos humanos de sus pacientes y de las poblaciones, por ejemplo al imponer tratamientos sin consentimientos y también serán los primeros en observar y detallar la violación de estos derechos por otros, incluido el Estado. Esto coloca responsabilidades muy específicas en el médico en cuestión.

At the same time physicians may face opportunities to challenges in ensuring that they do not infringe on the human rights of their patients and of populations, for example by imposing treatments without consent, . Physicians may and will also often be the first to observe and to itemize the infringement of these rights by others, including the state. This places very specific responsibilities upon the observing physician. [CMA]
At the same time physicians face opportunities to infringe the human rights of their patients and of populations, for example by imposing treatments without consent, and will also Physicians may sometimes often be the first to observe and to itemize the infringements of these patients´ human rights by others, including the state. This places very specific responsibilities upon the observing physician.

(SwMA)



Al mismo tiempo, los médicos tienen desafíos y oportunidades en relación con los derechos humanos de sus pacientes y de las poblaciones, por ejemplo las oportunidades de imponer tratamientos sin consentimientos y también serán a menudo los primeros en observar y detallar la violación de estos derechos por otros, incluido el Estado. Esto coloca responsabilidades muy específicas en el médico en cuestión.


5

También se puede sostener que el médico tiene el deber de utilizar sus conocimientos para mejorar el bienestar y la salud de los pacientes y la población. Esto significa considerar los cambios sociales y de la sociedad, incluidas las materias legislativas y solo se puede hacer bien si el médico puede tener una visión holística dentro de parámetros clínicos y éticos.


It can also be argued that doctors Physicians have a duty to use their knowledge to improve the wellbeing and health of patients and the population. This will mean considering taking into consideration social and societal changecontexts, including legislative matters legislation and regulations, and can only be done well if doctors can take a holistic view within clinical and ethical parameters. [CMA]
Add to the end of paragraph All countries should be urged to establish regulations and systems to ensure physicians could execute above mentioned rights. [ChMA]
It can also may be argued that doctors have a duty …(SwMA)

… and it can only be done well if doctors can take a holistic view within clinical and ethical parameters. (SwMA)


This will mean considering social and societal change, including legislative matters and policies affecting health level of individuals and society as a whole, and can only be done well if doctors can take a holistic view within clinical and ethical parameters. (TuMA)

El médico tiene el deber de utilizar sus conocimientos para mejorar el bienestar y la salud de los pacientes y la población. Esto significa considerar los cambios sociales y de la sociedad, incluidas la legislación y reglamentación y solo se puede hacer bien si el médico puede tener una visión holística dentro de parámetros clínicos y éticos.
Los medicos deben presionar a los gobiernos para asegurarse que la legislación apoye la práctica médica con principios.


6

Dada la naturaleza central de la evaluación y cuestionamiento éticas en establecer la práctica médica de manera que sea aceptable para la sociedad y que no viole los derechos civiles, políticos y humanos, es esencial que todos los médicos reciban una formación para realizar una evaluación ética de cada caso clínico en el que tengan participación, al mismo tiempo que comprendan su función en la protección de los derechos de las personas.


Given the core nature of ethical evaluation and questioning medical ethics in establishing medical practice in a manner that is acceptable to society and that does not violate civil, political and other human rights, it is essential that all physicians are trained to perform an ethics ethical evaluation of every clinical case in which they play a role scenarios, while simultaneously understanding their role in protecting the rights of individuals. [CMA]
Physician´s ability to act and communicate in a way that respects the values of the individual patient is a prerequisite for successful treatment (FMA)

It is essential that all physicians are trained to perform an ethical in the ethical evaluation of every clinical case in which they play a role, while simultaneously understanding their role in protecting the rights of individual human beings. (NzMA)


Given the core nature of ethical evaluation and questioning in establishing good medical practice in a manner that is acceptable to society and that does not violate civil, political and other human rights, it is essential that all physicians are trained to perform an ethics ethical evaluations in of every clinical cases in which they play a role, while simultaneously understanding their role in protecting the rights of individuals. (SwMA)


Dada la naturaleza central de la ética de la salud en establecer la práctica médica de manera que sea aceptable para la sociedad y que no viole los derechos civiles, políticos y humanos, es esencial que todos los médicos reciban una formación para realizar una evaluación ética de cada caso clínico, al mismo tiempo que comprendan su función en la protección de los derechos de las personas.

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It is essential for doctors to learn the ethics of collegiality. The enhancement of patient safety requires that the deficiencies in other colleague´s know-how or working methods are not left without notice and intervention. (FMA)

La capacidad de los médicos para actuar y comunicar de una manera que se respeten los valores del paciente es un requisito previo para un tratamiento exitoso. Los médicos también deben poder trabajar eficazmente en equipos con otros profesionales de la salud, incluidos otros médicos.

7

La falla del médico al reconocer sus obligaciones éticas frente al paciente y las comunidades afecta la reputación de los médicos en un país y puede tener un impacto global. Los experimentos humanos contrarios a la ética, realizados por Mengele y otros, causaron un inmenso sufrimiento humano y también marcaron la reputación de los médicos a través del mundo. Esto llevó a la creación de la AMM y a algunas de sus políticas principales. Para asegurar que esto no se repita nunca, es esencial que a todos los médicos se les enseñe a comprender y respetar la ética médica desde el comienzo de sus estudios en las escuelas de medicina.


… It led to the establishment of the WMA, and the first document was ethics of research and human subject protection. some of its core policy documents[ChMA]
Failures of individual physicians to recognize the ethical obligations they owe their to patients and communities can damages the reputation of doctors locally and globally throughout a country, and can have a global impact. The unethical human experimentation carried out by Mengele and others caused immense human suffering, and also scarred the reputation of doctors worldwide. It led in part to the establishment of the WMA, and some of its core policy documents. To ensure that this can never be repeated it is essential that all doctors are taught to understand and respect medical ethics and human rights from the beginning of their medical school careers. [CMA]
Failures of individual physicians to recognize the ethical obligations they owe their patients and communities damages the reputation of doctors throughout a country, and can have a global impact. The unethical human experimentation carried out by Mengele and others causesd immense human suffering, and also scarresd the reputation of doctors worldwide. It The unethical human experimentation carried out in the past led to the establishment of the WMA, and some of its core policy documents. To ensure that this can never be repeated it is essential that all doctors are taught to understand and respect medical ethics from the beginning of their medical school careers. [JMA]
The unethical human experimentation carried out by doctors by Mengele in the past have caused immense human suffering, and scarred the reputation of doctors worldwide.   [DMA]
Failures of individual physicians to recognize the ethical obligations they owe their patients and communities can damages the reputation of doctors locally, nationally and even globally throughout a country, and can have a global impact. The unethical human experimentation carried out by Mengele and others during World War II caused immense human suffering, and also scarred the reputation of doctors worldwide. It led to the establishment of the WMA, and some of its core policy documents. To ensure that this can is never be repeated it is essential that all doctors, from the very beginning of their medical school careers, are taught to understand and respect educated in medical ethics and human rights from the beginning of their medical school careers. (SwMA)
Failures of individual physicians to recognize the ethical obligations they owe their patients and communities damages the trust relationship between society and medicine, and the reputation of doctors throughout a country, and therefore can have a global impact on human health. (TuMA)

La falla del médico al reconocer sus obligaciones éticas frente al paciente y las comunidades puede afectar la reputación de los médicos a nivel local y global. Los experimentos humanos contrarios a la ética, realizados por médicos, incluido Josef Mengele, causaron un inmenso sufrimiento humano y también marcaron la reputación de los médicos a través del mundo. Esto fue un factor clave en la creación de la AMM y a algunas de sus políticas principales. Para asegurar que esto no se repita nunca, es esencial que a todos los médicos se les enseñe a comprender y respetar la ética médica y los derechos humanos desde el comienzo de sus estudios en las escuelas de medicina.


8

En muchos países, la ética y los derechos humanos son parte integral del currículo médico, pero esto no es universal. Muy a menudo la enseñanza es proporcionada por voluntarios y puede fallar si ellos no pueden o no están disponibles para enseñar.


In many countries ethics and human rights are an integral part of the medical curriculum, but this is not universal. Too often Some teaching is by volunteers, and can might fail if those volunteers are unable or unavailable to teach. Even for those teaching by professionals, there exists an issue of lack of core curriculum for medical ethics and human rights. [ChMA]
In many countries medical ethics and human rights are an integral part of the medical curriculum, but this is not universal. Too often teaching is undertaken by volunteers, and can fail if those volunteers are unable or unavailable to teach, or do not appreciate the clinical context for these issues. [CMA]
Too often teaching is by volunteers, and can fail if those volunteers are unable or unavailable to teach or if the teaching is idiosyncratic and not on the terms accepted by the WMA. (NzMA)
In many countries ethics and human rights are an integral part of the medical curriculum, but this is not universal always the case. Too often Sometimes teaching is by volunteers, and can fail if those volunteers are unable or unavailable to teach. The teaching of medical ethics forms a fundamental basis of medical practice and is too important to be left to chance. (SwMA)


En muchos países, la ética y los derechos humanos son parte integral del currículo médico, pero esto no es universal. Muy a menudo la enseñanza es proporcionada por voluntarios y puede fallar si ellos no pueden o no están disponibles para enseñar, o si dicha enseñanza es indebidamente idiosincrática o está basada de manera inadecuada en casos clínicos.


9

La enseñanza de la ética médica es demasiado importante para la calidad de la práctica médica como para dejarla al azar y es tan fundamental para la base de la práctica como lo es la comprensión de la anatomía y la fisiología. Debe ser una materia obligatoria y examinada del plan de estudios de cada escuela de medicina.


[ChMA: I am wondering whether such description clear? Suggest not use “too…..to…” which is possible to make reader confuse the importance of teaching of medical ethics]
The teaching of medical ethics is too important to the quality of medical practice to be left to chance, and forms as fundamental a basis of that medical practice as does an understanding of anatomy and physiology. It must should become an obligatory and examined part of the syllabus formalized curriculum within every medical school. [CMA]
The teaching of medical ethics is too important to the quality of medical practice to be left to chance, and forms as fundamental a basis of that practice as does an understanding of anatomy and physiology. It must become an obligatory and examined part of the syllabus within every medical school. (REWORDED AND MOVED TO END OF PARAGRAPH 8.) (SwMA)

It must become an obligatory and examined part of the syllabus within every medical school. This is repeated at the recommendations section, which is a better place. (TuMA)

La enseñanza de la ética médica es tan fundamental para la base de la práctica médica como lo es la comprensión de la anatomía y la fisiología. Debe ser una materia obligatoria y parte examinada del currículo médico de cada escuela de medicina.





Recomendaciones





Recomendaciones


10

La AMM insiste en que la ética médica y los derechos humanos sean enseñados en cada escuela de medicina como materia obligatoria y examinada del curso.

The WMA insists that calls for medical ethics and human rights are to be taught at every medical school as obligatory and examined parts of the course formalized curriculum. [CMA]

The medical schools must work out a content and use teaching methods that arouse the students interest in medical ethics and human rights. Medical ethics must be integrated in relevant subjects throughout the medical study. as obligatory and examined parts of the course.

Comment

It is important that medical ethics and human rights are taught in an attractive and relevant way. An uninteresting obligatory course taught by unengaged teachers could have an adverse effect on the students’ future ability to reflect on medical ethics and human rights when practicing medicine. It is also important that medical ethic is integrated in other subjects throughout the medical study.

(NMA)
The WMA insists that medical ethics and human rights are taught at every medical school as obligatory and examined parts of the course throughout the medical education. (TuMA)

La AMM insiste en que la ética médica y los derechos humanos sean enseñados en cada escuela de medicina como materia obligatoria y examinada del currículo, además debe continuar en todas las etapas de la educación médica de postgrado y del desarrollo professional continuo.

New





The WMA recommends that;


    1. knowing professional codes and relevant regulations,

    2. internalizing professional values together with their justifications,

    3. respecting and advocating right to health,

    4. to be able to evaluate the nature of ethical problems with their macro, mezzo and micro determinants, including inequities, social determinant of health, and health policies,

    5. to be able to making ethical analysis, and making decision to act that protects right to health and professional values,


should be the main learning objectives of medical ethics education.
The WMA strongly emphasizes that the success of an educational program with learning objectives described above is only possible with an approach integrating medical ethics into medical education both vertically and horizontally, where all faculty actively contribute to it. (TuMA)

[See later on the development of a consensus statement on the contents of a core curriculum]

11

La AMM insiste en que las escuelas de medicina se aseguren de que tengan suficiente profesorado cualificado en enseñar la ética y los derechos humanos para que los cursos sean sustentables..

The WMA insists that calls for medical schools to ensure that they have sufficient clinical faculty skilled at teaching ethical enquiry and human rights to make these courses sustainable. [CMA].
The WMA insists that medical schools ensure that they have sufficient faculty sufficiently skilled at teaching ethical enquiry and human rights to make courses sustainable. (SwMA)


La AMM considera que las escuelas de medicina deben asegurarse de que tengan suficiente profesorado cualificado en enseñar la ética y los derechos humanos para que los cursos sean sustentables.

12

La AMM elogia la inclusión de la ética médica y los derechos humanos en la educación médica de postgrado y continua.

The WMA commends calls for [CMA] the inclusion of medical ethics and human rights related courses [ChMA] within post graduate and continuing medical education.

La AMM elogia la inclusión de la ética médica y los derechos humanos en la educación médica de postgrado y continua.

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The WMA should invite scholars of medical ethics and human rights around world to reach a consensus on the core content and have it accessed to every medical school. [ChMA]

[La AMM agradecería la elaboración de una declaración sobre sonsenso que establezca los components centrales de un currículo ético y de derechos humanos para los estudiantes de medicina.]

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The World Medical Association reiterates the importance of a system-based education in the sphere of Medical Ethics both for medical students and in advanced training of physicians. (RMS)




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The World Medical Association strongly recommends its member National Medical Associations to make provisions for drafting Medical Ethics courses, embedding them into curricula of medical schools with a sufficient number of hours, determining the assessment criteria and arranging for certificates of course completion to be issued by the medical school. The same refers to post-graduate courses for physicians. Assessment in Medical Ethics should be based on a two-grade scale, since the assessing tutor carries a direct responsibility for the assessed physician’s access to professional activities with regard to maintaining ethical standards. A physician must maintain ethical norms, but also actively engage in their development in connection with the development of medical technologies. (RMS)

[véase párrafo sobre la declaración deconsenso]

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The World Medical Association strongly recommends that employers include on their requirements list the certificate of a successful completion of a Medical Ethics course, and that National Medical Associations control this. (RMS)

[La mayoría de los países no tienen dichos certificados]

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The World Medical Association strongly recommends that National Medical Associations make provisions for establishing Medical Ethics Committees within their structures if they do not have them yet. The independence of opinions in the Committee would best be achieved by having a secretary with no voting rights, and by making decisions through a closed vote, e.g. online. While every country is entitled to design individual courses in Medical Ethics, the WMA, with input from NMAs’ Medical Ethics Committees, can design the core content and guidelines for such courses. (RMS)

[Las asociaciones médicas nacionales deben apoyar la creación de programas de enseñanza en ética médica y derechos humanos, y deben considerar si la creación de un comité de ética de la AMN tendría una función para ofrecer esta ayuda.]

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17.09.2015



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