LAUSR

In October 2020, the WPA General As­ sembly adopted the Association’s first Code of Ethics for Psychiatry. Developed by the Standing Committee on Ethics and Review, the Code was drafted and revised, with in­ put from psychiatric societies worldwide, over almost a decade prior to being final­ ized and adopted. Its four sections cover ethical issues in the major areas of psychi­ atric endeavor: the clinical practice of psy­ chiatry, psychiatric education, psychiatric research, and psychiatric participation in the promotion of public health, including public mental health. The Code now stands as WPA’s official statement on the ethics of psychiatry, having superseded the Declara­ tion of Madrid. The formulation of this Code of Eth­ ics was stimulated by the recognition that WPA’s previous ethics documents, begin­ ning with the Declaration of Hawaii in 1977 and culminating in the Declaration of Ma­ drid in 1996, were incomplete in their cov­ erage of the principal areas of psychiatric ethics. Thus, they lacked one of the primary attributes of an ethics code, i.e., a system­ atic approach to defining the parameters of professional ethical behavior. To ensure coverage of the major areas of psychiatric ethics, the Standing Committee on Ethics and Review began by assembling all exist­ ing WPA documents related to ethics, as well as available ethics codes from Mem­ ber Societies around the world. Key issues, especially if they were re­ flected in multiple sources – suggesting in­ ternational relevance – were compiled and organized into relevant sections, and ap­ proaches reflecting the generally agreed­ upon ethical principles were defined. With­ in each of the four areas of psychiatric activ­ ity noted above, the Code’s provisions were organized around five principles of medical ethics: beneficence, respect for patients (autonomy), non­maleficence, and the imperatives to improve standards of psy­ chiatric practice and to apply psychiatric expertise to the service of society (includ­ ing seeking equity in prevention, treatment and rehabilitation of psychiatric disorders). The resulting draft of the Code was then re­ viewed by the WPA Executive Committee and revised in response to its comments, and subsequently circulated to all Member Societies for their input. Initial discussion at the WPA General Assembly in Berlin in 2017 was followed by clarification of the goals of the document, which was then approved by the Executive Committee and the General Assembly in 2020. As with other codes of professional eth­ ics, the new WPA Code serves several func­ tions. Individual psychiatrists, especially in countries where national psychiatric socie­ ties have not yet formulated ethics codes, can draw guidance from the Code when faced with ethical challenges in their pro­ fessional activities. The public and mem­ bers of other medical specialties and other health professions can look to the Code to shape their expectations of their interac­ tions with psychiatrists. Member Socie­ ties of the WPA can compare their existing codes with the new WPA Code to identify gaps that may need to be addressed, and those Societies without codes can use the Code as the foundation of their efforts to develop their own. Finally, the Code will alert governments to the ethical bounda­ ries of psychiatric practice and provide sup­ port for psychiatrists who may be pressured to act unethically to support political ends. The Code is not meant to supplant na­ tional codes of ethics, which can better ad­ dress the particular circumstances of each country and incorporate societal values. However, Member Societies have been asked to endorse the principles embod­ ied in the WPA Code and to confirm that their codes are not in conflict with them. Individual psychiatrists will continue to be subject to the provisions of their national societies’ codes. We encourage psychiatrists to review the Code, which is easily accessible on­ line. Its provisions are framed as affirma­ tive statements of psychiatric behavior. Here, we provide some illustrative exam­ ples from each of its sections: