IFMSA @ UNESCO 10th World Conference on Bioethics, Medical Ethics & Health Law!

The UNESCO 10th World Conference on Bioethics, Medical Ethics & Health Law was held last week in snowy Jerusalem, Israel. The conference included a diverse array of sessions addressing different ethical and legal issues (the full program is available here). The IFMSA delegation to the conference included Deborah Hall (AMSA-USA) and Elizabeth Wiley (IFMSA Supervising Council, AMSA-USA).

The Opening Session, chaired by Prof. Amnon Carmi, featured Dr. Xavier Deau, President of the World Medical Association (WMA), speaking on “The ethical side of Health Technology Assessment (HTA).” Among the many issues Dr. Deau addressed during his opening remarks and presentation, he emphasized that “human values should always prevail over financial considerations.”

During the conference, Liz and Deb presented on the potential implications of trade agreements on health in a session titled, “Negotiating Away Health? Legal and Ethical Implications of the Trans Pacific Partnership (TPP) and the Transatlantic Trade & Investment Partnership (TTIP) with several IFMSA and WMA Junior Doctors Network co-authors. TPP and TTIP negotiations currently include forty countries representing more than half of the global gross domestic product (GDP), although these agreements will likely serve as a model for all future trade agreements globally. The presentation emphasized the many ways that this new generation of trade agreements may reshape health, health care, medical education and the social determinants of health including:

• Undermining evidence-based public health laws and regulations
• Reducing access to medicines through stringent intellectual property (IP) provisions
• Increasing commercialization of higher education including medical education
• Increasing commercialization of health care services
• Compromising environmental protection and efforts to curb climate change

Of particular concern is the secrecy surrounding current negotiations; the lack of transparency is not consistent with democratic principles. The presentation invited discussion among audience members and can be found here.

Many conference sessions addressed different facets of bioethics, medical ethics and health law education relevant to medical students and junior doctors. Highlights included:

• Quality improvement and quality assurance in medical education (systems-based improvements, root cause analysis);
• Conflict of interest in medical education – balancing high ethical standards in a corporate-dominated learning environment;
• Teaching the history of medical ethics to develop ethical decision-making frameworks among trainees;
• Strategies used by pharmaceutical manufacturers to circumvent direct-to-consumer advertising regulations in Israel;
• Ethical issues surrounding deportation of sick undocumented immigrants;
• Integrating different learning theories including problem-based learning and adult education theory into medical ethics training;
• Importance of cultural and contextual considerations in medical ethics education;
• Ethical dimensions of end-of-life care and decision-making;
• Substance abuse, addiction and preparing trainees to effectively manage pain (combatting “opiophobia”)
• Ethical issues surrounding reproductive decision-making and assisted reproductive technology
• Use of media and social media in bioethics and medical ethics training

Dr. Peteris Apinis, President of the Latvian Medical Association and Editor of the World Medical Journal, presented on medical ethics in post-USSR Eastern Europe in a session titled, “Some of the Medical Ethical Aspects of Eastern Europe After the Collapse of the USSR.” Dr. Apinis highlighted some of the challenges which emerged following the collapse of the Soviet Union and subsequent economic crisis including reliance on foreign aid for medical supplies and equipment, clinical drug trials, profit-driven prescribing by physicians and use of the sick role for secondary gain (social benefits). He also addressed the migration of physicians from Eastern to Western Europe following the USSR collapse – a trend which is now improving. Finally, he spoke about some of the emerging concerns around accuracy and quality of information posted by physicians on social media.

The next 11th UNESCO World Conference on Bioethics, Medical Ethics and Health Law Conference will be 20-22 October 2015 in Naples, Italy. This is a great opportunity for IFMSA members to present and engage in discussions around bioethics, medical ethics and health law. If you have questions about the conference or the process of submitting an abstract based on this year’s experience, please do not hesitate to contact Liz ([email protected]) or Deb ([email protected]) or, of course, Diogo Martins, LO-UNESCO ([email protected]).

Finally, special thanks to Prof. Amnon Carmi, President, UNESCO Chair in Bioethics, for his support for IFMSA participation at this year’s conference.