The British Medical Association has launched a handbook on human rights that says doctors cannot merely document abuse but must challenge it. It says medical education must change in response to human rights issues.
"Few health organisations have envisaged their role as encompassing a sociopolitical dimension that could address the root causes of human rights violations. ThisI has begun to change, and there is growing evidence of a willingness within medical bodies to become involved in political action and education," says the introduction to The Medical Profession and Human Rights, Handbook for a Changing Agenda .
The book covers human rights abuses ranging from medical involvement in torture and judicial executions, neglect or abuse in institutions and the treatment of prisoners through to unethical research and the use of biological and chemical weapons.
The handbook was prompted in part by the influx of asylum seekers into Western Europe. It is strongly critical of the hardening attitudes towards asylum seekers in the United Kingdom - in particular prolonged detention, the voucher system and the dispersal of asylum seekers around the UK.
It says that the teaching of medical ethics in UK medical schools has improved since the regulatory body for medicine, the General Medical Council, recommended teaching ethics as part of the core curriculum in a 1993 report. But a 1997 survey found great variation in the quality of undergraduate ethics teaching and a lack of teachers and good materials.
The handbook recommends that forensic doctors, prison doctors and those employed in closed institutions should have access to training in ethics, international conventions and human rights. It also says human rights organisation should consider making available anonymous case histories and other material for undergraduate education.
A doctor who spoke out
At 24, Wendy Orr worked for 13 months as a district surgeon in Port Elizabeth in South Africa. In her foreword to the British Medical Association's handbook on ethics, she writes: "I worked in the building in Port Elizabeth in which Steve Biko was assaulted and sustained the head injuries that killed him... I worked there in 1985, when the struggle against apartheid oppression was reaching a peak."
Dr Orr faced two choices. "I could continue being the 'good' doctor, recording and treating injuries, but doing nothing to prevent them, or I could do something that no district surgeon had done before (or has done since) - take my evidence to the Supreme Court and seek an urgent interdict to prevent police from assaulting and torturing detainees. "We had never talked about these issues at medical school," she says.
Dr Orr took the second course. The interdict was granted, and assaults and torture in that area fell dramatically. But Dr Orr was sidelined and later resigned. She concludes: "Medical associations have a crucial role to play in educating doctors about human rights issues, encouraging the introduction of human rights into curricula for medical students, developing guidelines for conduct, supporting doctors who do uphold human rights and sanctioning those who do not."