WONCA Working Party: Ethical Issues

Dr Issam Shaarani (Lebanon)

Email Convenor

Dr Issam Shaarani, a Lebanese Family Medicine Specialist, is a Senior Lecturer at Beirut Arab University (BAU), Faculty of Medicine and the Medical Director of the Ambulatory Health Care Center at BAU. He is also a clinical associate at the American University of Beirut Medical Center.

Dr Shaarani is involved in many public health projects at the national level, related to integrated health planning, gender-based violence and health care provision to underprivileged population.

Besides practicing and teaching Family Medicine, Dr. Shaarani is responsible with other Faculty members for developing and delivering the curriculum of Ethics and Professionalism at BAU Faculty of Medicine. He also teaches evidence-based medicine and research methodology for the undergraduate medical students. He is a member of the Graduate Medical Education Committee, and is working currently on launching a Family Medicine residency training program.

His main research interests are physician-patient interaction, social determinants of health, e-professionalism, and refugees’ health, where he has many ongoing research projects.

Aims of the WONCA Working Party on Ethical issues

1. Development of a core curriculum on medical ethics on behalf of WONCA to be implemented in curricula for basic medical education worldwide (in cooperation with EURACT and the WP on Education) 
2. Preparation of a core curriculum for trainers and faculty on how to teach ethics at all three levels of medical education.
3. Development of a statement on the ethics of teaching in the primary care setting.
4. Development of an instrument to assess professional attitudes of students and trainees which can be used by medical schools or colleges.
5. Compilation of a brochure with difficult situations as they occur in the daily practice of GPs challenging their professional attitudes. This brochure could be used as a source for teaching purposes globally.
6. Publication of selected dilemmas and analyses of ethical issues in respected journals.
7. Preparations of recommendations for WONCA on relevant topics such as industry relationships or sponsorships.

• Continue existing activities
• Formation of an executive group of colleagues among the list of interested members
• Develop and implement a Website
• Start working on the compilation of ethical dilemmas.
• Start working on the core curricula for trainers and trainees

Working Party on ethical issues plan for Vienna 2012

The group plans to raise awareness of the importance of professional attitudes at every level of medical education and supports the idea to establish General Practice and Family Medicine as the leading discipline to teach medical ethics/professional attitudes, to students or colleagues. Further, the group would like to provide a reference for how to teach medical ethics and would like to design an assessment instrument for professional attitudes ready to get implemented in daily practice; in addition, the group aims to support the publication of ethical dilemmas relevant and of interest to colleagues worldwide.

During WONCA Europe 2012 in Vienna, we are planning to look back at the last 12 years and to assess what has been achieved in the field of ethical issues in General Practice/ Family Medicine. There will be ample room for seminars or workshop on this topic. We invite all colleagues to submit abstracts for this conference which has as a main theme The art and science of General Practice and Family Medicine. This theme aims to point out the difficult working situation of General Practitioners worldwide which base their decisions on sound scientific evidence but are challenged by achieving its implementation at the individual patient level. This requires skills and tolerance and sometimes a degree of understanding which could be considered “the art of practicing medicine”.

History of the Working Party on Ethical issues

At the WONCA Europe Conference 2000 in Vienna, Austria, the programme contained a special symposium entitled Challenges to our Professional attitudes. This full day symposium covered areas and time periods from the past to the present time where the medical profession in general or individual colleagues in particular have been or were involved in developments based on unique political situations: the Holocaust in Europe, the Apartheid in South Africa, torture of prisoners in areas of war, or the death penalty in the United States. Experts and eyewitnesses of these developments gave stunning insight into the circumstances how physicians could get involved and sometimes were even eager to get involved. 

This symposium attracted a full auditorium and it was Prof Lotte Newman, the former chairman of the Royal College of General Practitioners and the former president of SIMG/ WONCA Europe who suggested that a Special Interest Group (SIG) on ethical issues in General Practice/Family Medicine be founded. This suggestion was picked up by the WONCA World executive and Prof Lotte Newman and Prof Manfred Maier were appointed convenors of this newly founded WONCA interest group. 

The world conference 2001 in Durban, South Africa, was used to build a list of colleagues interested in participating actively in this new Special Interest Group. In 2002, at the occasion of the WONCA Europe conference, in London, the group gathered to formulate the terms of reference: “to attempt to illustrate the nature of ethical issues encountered by WONCA and its members and to explore the principles, values and beliefs which inform decisions”.

Since then, the proceedings of the special symposium from WONCA Europe Vienna 2000 were published. The list of interested colleagues increases continuously and the group has tried to identify GP working groups on ethical issues around the globe. In addition, the group has reviewed the teaching situation for professional attitudes worldwide, has introduced a forum for discussion of ethical issues and tries to motivate colleagues to initiate similar activities back home in their association or home country. These activities are promoted at almost every WONCA Europe conference and all WONCA world conferences by organizing a special symposium on selected topics such as inequities in health, conflicts of interests, end of life care, etc. So far, the activities of the group, which became a Working Party at the WONCA world conference 2010, in Cancun, Mexico, usually attract an interested crowd. After the retirement of Prof Lotte Newman, Prof Micky Weingarten from Israel jumped in and was a tremendous help in every way to keep the Working Party running and to make it attractive for colleagues globally.