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Doctors “must be free to judge”

The trust between doctor and patient may be damaged by managers trying to put unreasonable restraints on a physician’s clinical independence.

That is the thrust of a new declaration to emerge from the World Medical Association’s annual General Assembly in South Korea.

It says that the trust essential component of a patient-doctor relationship depends on physicians being allowed to exercise clinical judgment.

But it also accepts that doctors must take into account the structure of the health system they work under and availability of resources.

WMA chairman Dr Edward Hill said: “We see this not only as an essential component of high-quality medical care, but also as an essential principle of medical professionalism.”

The declaration says that administrators may consider physician professional autonomy to be incompatible with prudent management of health-care costs.

But the restraints on clinical independence, including refusing demands by patients or their families for inappropriate medical care, may not be in the best interests of patients.

The new statement declares that the central element of professional autonomy and clinical independence is the assurance that individual physicians have the freedom to exercise their professional judgment in the care and treatment of their patients without undue influence by outside parties or individuals.

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