Preface

The history of the World Medical Association should be compulsory reading for national member associations, members of the WMA Council, officers, officials, associate members, and for all interested in the problems of organized medicine. It is a mine of information set out clearly in chapters with a reference section. Here can be found answers to the many questions asked about the WMA, its history, what it is, how it is organized, what are its objectives, what it has accomplished and hopes to accomplish, and how it is financed.

Here is the fascinating story of how an idea born in the House of the British Medical Association in 1945 became a fact in Paris in 1947, and how the WMA has become the recognized authority to speak for the doctors of the world in international affairs.

Those closely connected with the WMA will read this book with considerable pride, and it will bring back a host of memories of old friends, extremely hard work, hot discussions conducted in four languages going on to midnight, wonderful hospitality, long tiring journeys across half the world, but most of all of a group of doctors sustained by faith in an ideal. This ideal is to sustain and increase the importance of the WMA in order to foster the essential unity of doctors all over the world - doctors differing in language and culture and in many other ways but united in their service to mankind irrespective of creed or colour or politics; and to educate, encourage, and assist them in a struggle to preserve their professional traditions from encroachment by many hostile forces.

Background and preliminary organization

During World War II, the BMA House had been the focal spot at which doctors of all the allied nations congregated from time to time to discuss problems of medical practice and peacetime and to compare the conditions of medical service and medical education in their respective countries. In July, 1945 an informal conference of doctors from several countries convened in London to initiate plans for an international medical organization to replace l'Association Professionnelle Internationale des Médecins", which having been organized in 1926 and having reached a maximum membership of 23 countries, had suspended operations with the advent of World War II. Accordingly, a second conference was held in London in September 1946. Medical associations of 31 countries were invited and 29 of them sent representatives. An Organizing Committee was appointed and directed to draft a Constitution, and plan for the First General Assembly. This Conference decided that the name of the new organization should be "The World Medical Association" and that it should have broader activities and wider membership than the former l'Association Professionnelle Internationale des Médecins. APIM officers attending the Conference agreed to dissolve the APIM in favor of the WMA, and generously turned over its remaining funds to the WMA.

Those named to the Organizing Committee were:

- Dr F. de Court, France
- Dr Pierre Glorieux, Belgium
- Dr Dag Knutson, Sweden
- Mr Otto Leuch, Switzerland
- Dr John A. Pridham, Great Britain
- Dr T. Clarence Routley, Canada
- Prof. I. Shawki Bey, Egypt
- Dr Lorenzo Garcia Tornel, Spain
- Dr A. Zahor, Czechoslovakia

The Conference further agreed that a provisional joint Secretariat should be established in London and Paris. Dr Charles Hill, Secretary of the BMA, was designated as the English Secretary, and Dr Paul Cibrie, Secretary of La Confédération des Syndicats Médicaux Français, as the French Secretary. Dr Otto Leuch was appointed as temporary Treasurer.

The second meeting of the Organizing Committee was held in Paris in November 1946. Further progress was made on the Constitution and Bylaws and it was decided to invite the American Medical Association to name one of its members to serve on the Organizing Committee. Dr Louis H. Bauer - the first Secretary General of the WMA - was named by the AMA to serve on the Committee, and Dr Elmer L. Anderson to serve a alternate.

The final draft of the Constitution and Bylaws was approved at the third meeting of the Organizing Committee held in London, April 1947, and plans were made to hold the First General Assembly in Paris, September 1947. The draft set dues at 20 Swiss centimes per member of the national medical association with a minimum subscription of 1,000 SFrs, and a maximum of 10,000.

The fourth and final meeting of the Organizing Committee was held in Paris 1946 the day before the convening of the General Assembly (September 18, 1947). The proposed Constitution and Bylaws was adopted on the first Assembly day with minor amendments. The meeting became the First General Assembly of the WMA, and 27 national medical associations represented became the founder member associations.

These associations were:

- Federal Council of the BMA in Australia
- Osterreichische Arztekammer (Austria)
- Fédération Médicale Belge
- Canadian Medical Association
- Chinese Medical Association (dropped in 1952)
- Ustredni Jednota Ceskych Lekaru (ceased to exist in 1948)
- Den Almindelige Danske Laegeforening (Denmark)
- Medical Association of Eire (changed to Irish Medical Association)
- La Confédération des Syndicats Médicaux Français
- British Medical Association
- Association Médicale Panhellenique (Greece)
- Laeknafelga Islands (Iceland)
- Indian Medical Association
- Palestine Jewish Medical Association (later changed to Israel Medical Association in 1949)
- Federazione Nazionale degli Ordini dei Medici d'Italia
- Syndicats des Médecins du Grand Duché de Luxembourg
- Koninklijke Nederlandsche Maatschappij tot Bevordering der Geneeskunst (Netherlands)
- Den Norske Laegeforening (Norway)
- Palestine Arab Medical Association (ceased to exist in 1949)
- Naczelna Izby Lekarska (dropped in 1949)
- Medical Association of South Africa
- Colegio Oficial de Médicos de Espana
- Sveriges Lakarforbund (Sweden)
- Fédération des Médecins Suisses
- Turkish Medical Chamber (later replaced by the Union of Turkish Physicians)
- American Medical Association

Prof. Dr Eugène Marquis, France, was elected as the first President of WMA, Dr Jar. Stucklik, Czechoslovakia, was elected President-Elect, Dr Otto Leuch, Switzerland, was elected Treasurer, and Dr Charles Hill, UK, was elected as temporary Honorary Secretary. The first Council, composed of 10 members, was elected, and the World Medical Association was fully launched.

The Constitution, as adopted, provided, among other things, for membership of national medical associations fully representative of the medical profession in their countries or territories, but only one member association from each country. The General Assembly was vested with the general control of the policies and the affairs of the association, and was to meet annually in a different country. The executive body, the Council, was directed to administer the affairs of the association and report annually to the Assembly. The Council to consist of three elected officers, and ten members elected by the Assembly.

English, French and Spanish were declared the official languages of the association, and a bulletin or journal was to be published and known as the official organ of the WMA.

In order to facilitate financial support from its member associations during a period when monetary exchange was restricted by many national governments, Switzerland and the USA were considered the most advantageous locations for the Headquarters Secretariat of the new association. In 1948, the executive board, known as the Council, established the Secretariat of the WMA in New York City in order to provide close liaison with the United Nations and its various agencies. Dr Louis H. Bauer was appointed as Secretary General. The WMA Secretariat remained in New York City until 1974 when for reasons of economy, and in order to operate within the vicinity of Geneva-based international organizations (WHO, ILO, ICN, ISSA, etc.) it was transferred to its present location in Ferney-Voltaire, France.

In July 1964 the WMA was incorporated as a non-profit educational and scientific organization under the laws of the State of New York, USA. This Incorporation established the legal and financial status of the WMA in the USA, with elected members of Council to serve as the Association's Board of Directors. It also made possible to obtain a tax-free status recognition on funds donated to the WMA and for donors of financial contributions. WMA's Incorporation was adopted at the XIXth World Medical Assembly held in London, UK, 1965.

The annual meeting of delegates was changed in 1962 to "World Medical Assembly" following revision of the Constitution and Bylaws at the XVIth General Assembly.

WMA Headquarters since foundation to 1974: NEW YORK CITY, USA

From 1975 to present: FERNEY-VOLTAIRE, FRANCE

The golden years in medical ethics (Helsinki and others)

During the post World War II and immediately after its foundation, the WMA showed concern over the state of medical ethics in general and over the world. The WMA took up the responsibility for setting ethical guidelines for the world physicians. It noted that in those years the custom of medical schools to administer an oath to its doctors upon graduation or receiving a license to practice medicine had fallen into disuse or become a mere formality. The WMA was of the opinion that the establishment of a suitable oath or pledge to be administered as a part of the graduation or licensing ceremony would help to impress on newly qualified doctors the fundamental ethics of medicine and would assist in raising the general standards of professional conduct.

These facts moved the WMA to appoint a study committee to prepare a "Charter of Medicine" which could be adopted as an oath or promise that every doctor in the world would make upon receiving his medical degree or diploma. To this effect, member associations were requested to submit the text of the oath or promise made by the doctors of their countries at the time the medical degree or diploma was issued. It took two years of intensive study of the oaths and promises submitted by member associations to draft a modernized wording of the ancient oath of Hippocrates which was sent for consideration at the II General Assembly in Geneva in 1948. The medical vow was adopted and the Assembly agreed to name it the "Declaration of Geneva." Member associations were invited to recommend the use of this vow to the medical schools and faculties of their countries.

A report on "War Crimes and Medicine" received at the II General Assembly prompted the Council to appoint another Study Committee to prepare an International Code of Medical Ethics. The draft was submitted to the midyear Council Session of 1949. The Council was of the opinion that the draft Code would be incomplete unless the text of the "Declaration of Geneva" were added to it. This was done and the amended draft was transmitted to the delegates at the III General Assembly who discussed it item by item in detail. With minor amendments by the General Assembly the International Code of Medical Ethics was adopted.

With the adoption of these two documents, the WMA was on its way to take on other ethical problems confronted by the medical profession. From 1949 to 1952, violations of medical ethics, and crimes committed by doctors in time of war were denounced to the WMA. The need to implement safeguards in human experimentation was brought to the attention of the WMA. At the same time, news were reaching WMA about the various activities incompetent organizations were promoting in the field of medical ethics and medical law. This information caused the Council to establish a permanent Committee on Medical Ethics (1952).

Since its establishment in 1952, the Committee on Medical Ethics has done a tremendous job in receiving, considering, discussing, accepting or refusing dozens of ethical matters brought to its attention. Some of them have been adopted as declarations or statements of the WMA, and most of these have been kept them in line with the rapid developments of medical science. Some are being worked on at this moment, and no doubt others will follow in due course after mature reflection, whenever novel circumstances dictate.

These documents have all received world-wide distribution and application. By solid accomplishments in the field of medical ethics, the WMA has earned the right to call itself the international voice of organized medicine. But medical ethics is not a simple matter of making declarations or drafting codes. The WMA must remain alert to violations of the codes and prepared for swift action to counteract such violations. Thus, WMA has and continues to extend its help and influence on behalf of physicians who are being hindered in the ethical performance of their practice.