Dr Osahon Enabulele
… Commits to providing updated ethical guidance for medical practice
By Chioma Obinna & Dickson Omobola
The Immediate Past President of the World Medical Association, WMA, Dr. Osahon Enabulele, has expressed satisfaction with a new report that provides a comprehensive overview of the crimes committed in the field of medicine under the Nazi regime.
The Immediate past President of the WMA, who spoke on behalf of the WMA at the launch of the report of The Lancet Commission on Medicine, Nazism and the Holocaust, said the world needs strong ethical guidance in these troubling times of unending conflicts.
Enabulele said the report illustrates the extent to which research carried out during the Nazi era continues to have an impact in recent times.
His words: “The WMA welcomes the fact that there is now a report that reveals the extent of the involvement of the medical profession. The new report presented by 20 scholars and physicians, provides a comprehensive overview of the crimes committed in the field of medicine under the Nazi regime.
“It traces the development of medical research during the Nazi era and portrays individual perpetrators, as well as individual victims and imprisoned physicians, who, for example, treated their fellow inmates under the most agonizing conditions, including in concentration camps.
“The report illustrates the extent to which research carried out during the Nazi era continues to have an impact today. It is still so important to sensitise the medical profession to the extent to which many findings originate from this period. This report therefore provides an excellent springboard for the work we need to continue, going forward.
“The great horror of the Nazi period and the unspeakable involvement of Nazi doctors in the medical atrocities and unethical human experimentation carried out by the Nazis are some of the most extreme and well-documented examples of medical involvement in human rights abuses in history.
“The WMA recognises the importance of studying the worst of humanity to be able to identify and prevent similar patterns in the present and future, and to promote the highest ethical standards of care in our medical profession.
“It is in this light that the WMA remains appreciative of the subsequent Nuremberg trials that took place, and which came with it the development of guidelines for ethical research and medical treatment, especially in terms of informed consent.
“The establishment of the WMA in the year 1947, and the development of the Declaration of Geneva (DoG-The Physician’s Pledge), and other important policy documents of the WMA, were largely, direct consequences of the war crimes committed by physicians.
“The Goal was to re-establish trust among patients for physicians, as well as strengthen the patient-physician relationship, in a way that is more person-centred and recognizes the inalienable rights of the patient.
“Shortly after the WMA’s establishment, the International Code of Medical Ethics, ICoME, was developed to provide more detailed ethical guidelines. Most recently revised in 2022, the ICoME continues to serve as a foundation of ethical principles.
“The development of the ICoME was followed in 1964 by the adoption of the Declaration of Helsinki, DoH, which provides ethical guidelines for medical research involving human subjects, and which is currently undergoing a revision. These are probably the most widely used and recognized guidelines for physicians and other healthcare professionals involved in research with human subjects.
“The DoH was developed in response to the horrors of human experimentation carried out by Nazi physicians and researchers. It provides a concise set of ethical guidelines for dealing with conflicts that may arise between two key aspects of medical practice and research: the obligation to not harm and the essential need to ensure the efficacy and safety of medical interventions by testing them on human subjects.
“All three of these core ethical documents of the WMA are intended to prevent breaches of ethical conduct among physicians in the future
“Aside from the above three core ethical documents of the WMA, the development of the Declaration of Taipei on ethical considerations regarding health databases and biobanks is another example of how the WMA stays on top of recent developments.
“The WMA General Assembly also adopted the Declaration of Berlin on Racism in Medicine at its October 2022 General Assembly held in Berlin, Germany.
“I am happy to note that despite the reality of the location where these unfortunate historical medical atrocities were perpetrated, the German Medical Association (one of WMA’s constituent members) has demonstrated a huge awareness of the tremendous obligation it has to ensure that the breaches of medical ethics that occurred during the Nazi era are never permitted to happen again
“Indeed, along with other constituent members of the WMA, the German Medical Association has played important roles in the revisions of all these three core ethical documents, including chairing some of the international working groups tasked with revising these ethical documents of the WMA.
“Seventy-six (76) years after its formation, the WMA is today a strong global organization with 115 members and a widely acknowledged defender of medical ethics worldwide.
“The WMA remains committed to these ethical guidelines and ensures they are continuously updated to remain relevant and to accommodate for changes in the research environment, medical technologies, and other changes that impact healthcare delivery/ medical practice.
“The WMA is very convinced that the world needs strong ethical guidance, especially in these troubling times of unending conflicts, violence against physicians, and despicable attempts by some repressive governments to undermine the fundamental freedoms, professional autonomy and clinical independence of physicians. The WMA remains irrevocably committed to providing this guidance.
“The WMA assures of its strong commitment to strengthening her partnership with progressive bodies like the Lancet Commission, in the task of expansion and spread of this important historical knowledge and lessons, including its integration into undergraduate and postgraduate medical educational curriculum.
“Finally, as we look forward to the launch of the Lancet Commission’s report, we wish to reiterate our strong condemnation of the Hamas terrorist attack on Israel. We equally restate our fervent call on all parties to cease hostilities and to adhere to the principle of medical neutrality.”