Amnesty International, January 1996.
Health professionals and the exposure of human rights violations
Amnesty International Declaration on the Role of Health Professionals in the Exposure of Torture and Ill-treatment
Preamble: Human rights and medical ethics standards have evolved in recent years and, currently, strong legal and ethical prohibitions on torture and other human rights violations exist. These include the United Nations (UN) Universal Declaration of Human Rights, the Declaration on the Protection of all Persons from Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (Declaration against Torture), the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, the Body of Principles for the Protection of All Persons under Any Form of Detention or Imprisonment, regional human rights treaties and a number of statements adopted by doctors' and nurses' organizations. Torture and other cruel, inhuman or degrading treatment, however, continues and the need for positive action by health professionals to expose these abuses is as great as ever. The following declaration articulates the steps implicit in the ethics of medicine and nursing which Amnesty International believes should be taken by health professionals to fulfil their role as protector of the vulnerable, particularly those deprived of liberty.
Recalling that the Declaration of Tokyo of the World Medical Association (1975) obliges doctors not to condone, countenance or participate in torture;
Recalling that the United Nations Principles of Medical Ethics Relevant to the Role of Health Personnel, particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (1982) states that it is a gross contravention of medical ethics for health personnel, particularly physicians, to assist, actively or passively, in acts of torture;
Further recalling that the International Council of Nurses has declared in The Role of the Nurse in the Care of Detainees and Prisoners (1975) that nurses having knowledge of physical or mental ill-treatment must take appropriate action including reporting the matter to appropriate national and/or international bodies;
Noting the fundamental obligation stemming from the Hippocratic Oath and the World Medical Association's International Code of Medical Ethics (1949) for doctors to practice for the good of their patient and never to do harm;
Recalling the important role of health professionals in protecting particular vulnerable individuals such as children through exposing instances of serious abuses coming to their attention;
Recalling that torture and other cruel, inhuman or degrading treatment or punishment are contrary to international law;
Calls on health professionals witnessing torture or other cruel, inhuman or degrading treatment or punishment, or the effects of such violations, to report their observations to their immediate manager and to their professional association. In the event of inaction by the persons so informed (or where, in the judgment of the health professional, it would be too dangerous to report to these persons), the health professional should report his or her observations to an international professional, humanitarianor human rights organization.
Declares that the health professional making such a report should be given support by individual colleagues and by their national and international professional associations. Such associations should take firm action when a health professional is disciplined in any way or otherwise victimised for reporting human rights violations, including making strong representations to the authorities to quash such disciplinary measures and to provide legal assistance to the threatened individual.
Calls on national professional associations to adopt and publicise statements opposing professional involvement in human rights violations and to ensure that their members know of their ethical responsibility to report torture and ill-treatment and of the commitment of the association to support members reporting abuses.
Calls on international professional associations and the United Nations and its relevant agencies to publicise the ethical responsibility of health professionals to report human rights violations inflicted on their patients.
Calls on international professional bodies to make clear statements about the serious breach of professional ethics occasioned by a health professional's purposely omitting, modifying, or falsifying relevant information in the medical history of an alleged victim of torture or ill-treatment, such as to preclude or to make difficult the treatment of the patient, to prevent redress for the victim or to impede the bringing to justice of those responsible for the torture or ill-treatment.
Further calls on international professional bodies to investigate, and where appropriate, impose sanctions on, national associations which collude in the infliction of human rights violations in their countries.
Adopted by Amnesty International, January 1996
World Medical Association: Declaration of Tokyo
"The doctor shall not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman or degrading procedures, whatever the offence of which the victim of such procedures is suspected, accused or guilty, and whatever the victim's beliefs or motives, and in all situations, including armedconflict and civil strife."
World Medical Association: International Code of Medical Ethics
"A physician shall, in all types of medical practice, be dedicated to providing competent medical services in full technical and moral independence, with compassion and respect forhuman dignity."
United Nations: Principles of Medical Ethics
"It is a gross contravention of medical ethics, as well as an offence under applicable international instruments, for health personnel, particularly physicians, to engage, actively or passively, in acts which constitute participation in, complicity in, incitement to or attempts to commit torture or other cruel, inhuman or degrading treatment or punishment."
International Council of Nurses: The Nurse's Role in the Care of Detainees and Prisoners
"Nurses having knowledge of physical or mental ill-treatment of detainees and prisoners must take appropriate action including reporting the matter to appropriate national and/or international bodies."
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