Group Proposes Worldwide Ethics Principles

PHILADELPHIA -- (Jan. 19, 1999) An international group of health leaders released a "Shared Statement of Ethical Principles for Those Who Shape and Give Health Care" in today's issue of Annals of Internal Medicine. The ad hoc working group, composed of 15 leaders from four nations, representing medicine, nursing, health care management, higher education, ethics, law and philosophy, met in Tavistock Square, London, in February 1998 to draft an initial statement. The "Tavistock" group is now soliciting comment, suggested revisions and ideas for implementation from individuals and health organizations worldwide.

Many professional health organizations have codes of ethics, but "separate, discipline-based codes of ethics can divide the health care system," said Donald Berwick, MD, president of the Institute for Healthcare Improvement, Boston, one of the initiators of the project. "Modern health care," he says, "is a system of dependencies which badly needs shared ethical principles to bring all players into a consistent moral framework."

The Tavistock group hopes that, after international, interdisciplinary dialogue, the final principles will be concrete and useful enough to affect daily decisions of health caregivers, health care organizations, insurers, employers, governments and the public.

The group proposed five ethical principles of health care:

-- Health care is a human right.

-- Care of individuals is the core of health care delivery but must be done in the context of improving the health of groups and populations.

-- Health care includes the prevention of illness and alleviation of disability.

-- All providers and management in the health system must cooperate.

-- All in the health system are responsible for improving the quality of the system.

Each of the principles is accompanied by interpretive statements, and the Annals issue contains a background piece on how the group concluded that health care needs a unified, international shared code of ethics.

The statement can be accessed on January 19, 1999, on the American College of Physicians-American Society of Internal Medicine (ACP-ASIM) Internet Web site at www.acponline.org. The statement is also being published in the January 23, 1999, issue of the British Medical Journal and on that journal's Web site, www.bmj.com.

Initial funding for the group's work has come from the American Academy of Arts and Sciences and the Institute for Healthcare Improvement, with subsequent funding by The Robert Wood Johnson Foundation, and W.K. Kellogg Foundation.

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Note to Editor: For a copy of "A Shared Statement of Ethical Principles for Those Who Shape and Give Health Care: A Working Draft from the Tavistock Group" in the Jan. 19, 1999, issue of Annals of Internal Medicine, please call 1-800-523-1546, ext. 2656 or 1-215-351-2656.

To speak with Dr. Berwick, please call 617-754-4852.