WONCA Working Party: Ethical Issues

Dr Tania Moerenhout (New Zealand)

Tania Moerenhout combines a clinical role as GP at Broadway Medical Centre in Ōtepoti Dunedin (Aotearoa New Zealand) with a Lecturer position at the Bioethics Centre of the University of Otago.

Originally from Belgium, she has completed a PhD in Philosophy with a focus on the ethics of electronic health record use at the University of Ghent. She teaches a postgraduate course in Digital Health Ethics and is involved in teaching ethics to medical students. Her research also focuses on digital health ethics, mainly in the areas of remote monitoring technology in older adults’ care, the ethics of virtual consultation services and telehealth, and ethical technology assessment.

Tania became Chair of the WPEI in November 2021 and is keen on moving forward with the group to achieve the aims in collaboration with other Working Parties and SIGs and with the wider WONCA community. 

Email Chair

The Executive Committee will consist of two members for each WONCA World Region. At the moment, there are still three positions to fill. Anyone who is interested in a position as executive member may contact the Chair for further information.

Africa

• Keymanthri Moodley - South Africa
• Walter Jaoko - Kenya

Asia Pacific

• Tania Moerenhout (Chair) Aotearoa New Zealand
• TBD

East Mediterranean

• Amal AL Ali - Qatar
• Issam Shaarani - Lebanon

Europe

• Ignaas Devisch - Belgium
• Andrew Papanikitas - United Kingdom

Iberoamericana-CIMF

• Carmen Nadal Agost - Chile
• TBD

North America

• Ross Upshur - Canada
• TBD

South Asia

• M. Tariq Aziz - Pakistan
• K Sri Ranjan - Sri Lanka

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.

Objectives of the WONCA Working Party on Ethical Issues

• Extend the Executive Committee to include 2 members for each WONCA World Region or 14 in total
• Update and extend our membership
• Hold an Annual Meeting each year and regular Executive meetings throughout the year
• Start research and other projects to work on the development of a core curriculum on medical ethics
• Organise workshops during WONCA conferences
• Organise webinars on current ethical topics and dilemmas

Upcoming Events

Annual Meeting

Our next Annual Meeting will be held as a pre-meeting at the WONCA World conference in Sydney (26 to 29 October 2023).

Workshop

The WPEI will hold a workshop at the WONCA World conference in Sydney.

Webinar

We are looking into organising a webinar soon – watch this space!

Activities 2021-2022

Activities of the WPEI came to a halt to a large extent during the Covid-19 pandemic. We have used these difficult times as an opportunity to rethink what we can achieve with the Working Party. The Executive Committee is in the process of being extended to 14 members, 2 for each WONCA World Region (see Executive Members). We have also organised regular online meetings with the Executive Committee and have set up our first Annual Meeting with all members.

Activity 1 – First Annual Meeting

The WPEI has held its first Annual Meeting on 28 June in the Foundling Museum, ahead of the WONCA Europe conference in London. All members were welcome to join the meeting in-person or online. Besides discussing the recent past and plans for the future, the main topic of conversation was the development of a core curriculum in medical ethics. Several suggestions to take this work further will be followed up by the Executive Committee. We also want to thank the faculty of history and philosophy at the Society of Apothecaries of London for hosting the meeting at the Foundling Museum in London. 

Activity 2 – Workshop at the WONCA Europe Conference

We organised a workshop titled Teaching ethics to medical students: where are we and where do we go from here? A journey to a core curriculum in medical ethics at the WONCA Europe conference in London. Here, we discussed the ‘what, how and when’ of teaching ethics to medical students. We included a brief interview with Monica Lalanda, an ED physician who uses comics to teach ethics. This interview can be found HERE.

Activity 3 – Editorial in the British Journal of General Practice (BJGP)

Three members of the Executive Committee (Andrew Papanikitas, Ross Upshur and Tania Moerenhout) wrote an editorial for the BJGP titled Global primary care as an incubator for good ethical practice to accompany the activities at the WONCA Europe conference in London. 

Abstract: The global COVID-19 pandemic has exposed the fragility of national and international healthcare organisations, and tested the morality and integrity of health care across the world. On the frontline of care, physicians and healthcare workers were exposed to risks and poorly protected, with burnout rates high, moral injury substantial, and many contemplating leaving the profession. Would reflection on the ethics of family medicine provide a means of re-engaging with the meaning of being a family doctor? Does this have wider implications for ethics education around the world? Inspired by the joint conference of the World Organization of Family Doctors (WONCA) and the Royal College of General Practitioners in London in 2022, we consider these questions and invite a global cross-disciplinary dialogue.

Link: https://bjgp.org/content/72/720/310

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 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. 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”. The SIG became a Working Party at the WONCA world conference 2010, in Cancun, Mexico. 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. 

More recently, Dr. Manfred Maier (Medical University of Vienna) and Dr. Issam Shaarani (Beirut University, Lebanon) chaired the WPEI, continuing with workshops at WONCA conferences and keeping the conversation on ethical topics going. In 2018-2019, these included ethical considerations of physicians’ involvement with politics, ethical perspectives on providing primary care for the underprivileged, ethical issues associated with traditional medicine in Africa, and ethical challenges of sharing information through electronic health records. 

During the Covid-19 pandemic, the activities of the WPEI largely came to a halt. The Executive Committee used this period to reflect on the future of the WPEI and to set out goals for the mid- and long-term. With a new Chair starting in November 2021, the Executive members now hold regular meetings and focus a large part of their work on the development of a core curriculum in medical ethics. This will take several years to complete. In the meantime, other activities will continue, such as workshops during WONCA conferences, and new events will be launched, such as webinars on ethical topics. The WPEI has also held its first Annual Meeting in a long time at the WONCA Europe conference in London (2022).