Human rights and medical practice are rooted in fundamental principles including respect, dignity, fairness and equality.
We typically intervene in cases in which doctors are involved. For example, where there has been interference with medical impartiality or where doctors themselves have become victims of human rights violations.
We will also intervene on behalf of patients where they have been prevented from accessing health care or where there are serious infringements on patients' right to health.
Most recently, we have spoken out against:
- continuing attacks on medical personnel and facilities in areas of conflict
- the continuing assaults on the medical profession in Turkey
- the attacks on medical personnel and medical facilities in Sudan
- the prevention of access to healthcare in Israel.
Our ethics and human rights team also publishes advice and guidance on health-related human rights issues. The report 'Locked up, locked out: health and human rights in immigration detention' explores the role of doctors in protecting and promoting the health-related human rights of detained individuals. The ethics and human rights team also engages with and lobbies on health-related human rights issues.
What is medical impartiality and what is the BMA doing to defend it?
Medical impartiality is a fundamental ethical principle in medicine.
Defenders for Medical Impartiality (DMI) define medical impartiality as: "The international principle that no person or group shall interfere with the access to or delivery of medical services in times of conflict and civil unrest, and that medical personnel shall not discriminate or refuse care to anyone injured or sick during times of conflict and civil unrest."
The BMA believes a doctor’s right to safely practice medicine in humanitarian settings must be protected. All health professionals have a right to practice medicine without fear of reprisal or attack and doctors must be able to provide treatment to those in need irrespective of their political affiliations.
In recent years, global conflicts have seriously undermined medical impartiality. Health infrastructure, and medical personnel have been targeted by both governments and non-state individuals. Elsewhere, doctors have been subject to reprisals for treating the sick and injured.
BMA action to protect medical impartiality
The BMA has signed the Colombo Declaration, which condemns attacks on medical personnel and facilities in conflict situations and, in February 2019, we joined the Royal College of Emergency Medicine and 14 additional medical Royal Colleges in writing to the Foreign Secretary to request that the UK Government also signal its support for the declaration.
The Colombo Declaration – drafted in Sri Lanka in 2016 - condemns the targeting of medical facilities, patients and clinicians in areas of conflict and calls on United Nations member states to support the enforcement of UN Security Council Resolution 2286. This resolution demands that member states uphold and comply with the 1949 Geneva Conventions which criminalise targeted attacks on medical personnel and facilities under international humanitarian law.
Read the joint letter to the foreign secretary Jeremy Hunt MP
Sign the Colombo Declaration, or join the MSF #NotATarget campaign, a social media act of solidarity to stand up for the protection of civilians and civilian infrastructure, patients, medical staff and hospitals in conflicts.
Read more about the campaign on the MSF website
Cases involving doctors
Imprisonment of doctors in Turkey
In 2018 and 2019, the Turkish government arrested, charged and imprisoned a number of doctors for expressing concerns about the public health impacts of violent conflict. We wrote to a range of relevant authorities to express our concerns, as this is a gross violation of human rights, particularly rights to freedom of expression as protected by the United Nations Universal Declaration of Human Rights 1948 and the International Covenant on Civil and Political Rights, which was ratified by Turkey in 2003.
- Read our letters to the Turkish head of state, the Turkish ambassador, and the foreign secretary 2018-2019.
Breaches of medical neutrality in Turkey
In 2013, doctors and nurses in Turkey were arrested and threatened with the loss of their medical licenses for treating protesters who were injured during public demonstrations. Most recently, one doctor and three nurses were detained for providing treatment to a 12-year-old child during a curfew imposed as a result of the protest. We have written to relevant authorities to express our concerns about these breaches of medical neutrality.
- Read our letters to the Turkish head of state the Turkish health minister and the Turkish ambassador between 2013 and 2019.
- Read a BMJ editorial on attacks on medics in Turkey.
In August 2019, the BMA wrote to the Iranian ambassador and the foreign secretary to raise concerns about the detention of Dr Ahmadreza Djalali who has been denied access to healthcare while in detention and who is expected to be subject to the death penalty.
Withholding or obstructing access to healthcare and treatment contravenes both medical ethics and international law, particularly the right to health. Furthermore, there is growing international consensus that the death penalty equates to cruel, inhuman or degrading punishment, which violates the right to life – protected by Article 2 of the Universal Declaration of Human Rights.
- Read our letter to the Iranian ambassador, Hamid Baeidinejad – August 2019.
- Read our letter to the foreign secretary, Dominic Raab MP – August 2019.
Death penalty for pregnant doctor in Sudan
In 2014, Dr Meriam Yehya Ibrahim, who was eight months pregnant at the time of sentencing, was sentenced to death for converting to Christianity and refusing to make a public recantation of her faith. We wrote to the Sudanese president to condemn this blatant violation of Dr Ibrahim’s rights.
- Read our letter to the Sudanese president Omar Hassan Ahmad al-Bashir – May 2014.
- Read our letter to prime minister, David Cameron - May 2014.
Attacks on hospitals, targeting of health professionals
On 3 June 2019 the Rapid Support Forces (RSF) and other paramilitaries conducted a series of violent attacks on peaceful protesters, including physicians, which involved extrajudicial, arbitrary and summary killings, beatings and sexual and gender-based violence. During the attacks, security forces entered two hospitals, Almoalim and Royal Care hospitals, in pursuit of injured protesters.
A similar attack was made on Omdurman Hospital in January 2019. Reports of the attack state that security forces opened fire inside the hospital while looking for individuals who had been injured participating in protests earlier in the day. The intentional targeting of health professionals, including hospitals and medical facilities, is a clear breach of the Geneva Conventions of 1949 and of International Humanitarian Law, as well as accepted international human rights norms.
- Read our letter to the Sudanese ambassador, Mohammed Abdalla Ali Eltom – July 2019.
- Read our letter to the foreign secretary, Jeremy Hunt MP – July 2019.
- Read our letter to the Sudanese ambassador, Mohammed Abdalla Ali Eltom - February 2019.
- Read our letter to the foreign secretary, Jeremy Hunt MP – February 2019.
Canadian doctor begins hunger strike in Egyptian custody
In 2013, Dr Tarek Loubani and Professor John Greyson were arrested and detained without charge after being caught up in clashes in Ramsis Square, Cairo, between supporters of Egypt’s deposed president, security forces, and local residents.
- Read our letter to Egypt's interim president, Adly Mahmoud Mansour - September 2013.
- Read our letter to Egypt's minister of defense, General Abdel Fattah al-Sisi - September 2013.
- Read our letter to Egypt's public prosecutor, Hesham Mohamed Zaki Barakat - September 2013 .
Health care workers threatened and criminalised for treating protesters
In November 2018, physicians in Nicaragua were dismissed and, in some cases, criminalised for providing medical care to persons involved in anti-government protests. Furthermore, healthcare workers were, in some cases, forced to prioritise care for certain groups based on their political affiliations.
Shelling of medical facilities in Gaza
In 2014, health facilities and staff came under fire in Gaza. There were also reports that health personnel had been prevented from reaching injured persons.
Coalition bombing of MSF hospital in Afghanistan
On 3 October 2015, coalition forces bombed the Médecins Sans Frontières (MSF) trauma facility in Kunduz, Afghanistan. During the attack, 12 hospital staff members and at least 10 patients, including three children were killed. Thirty-seven people, including 19 staff members were injured. The BMA wrote to the Foreign Office to request that the UK government call on President Obama to agree to an independent investigation.
Doctors' deaths in Syrian custody
In December 2013, Dr Abbas Khan and Dr Osama Baroudi died in custody after being arrested for providing medical treatment to injured civilians during the conflict in Syria. Their arrest, detention and death represent significant breaches of international human rights standards, including rights to a fair trial.
- Read our letter to Syrian president, Bashar al-Assad - December 2013.
- Read our letters to Syrian ambassador, Bashar Ja'afari - December 2013.
Attacks on medical facilities and unlawful detention of doctors
In 2011, Physicians for Human Rights documented attacks by the Bahraini security forces on medical institutions, including arrests and detention of medical workers providing care to protesters. More than two years after the start of the protests, the Bahraini government has not addressed medical neutrality violations.
Cases involving patients
The right to health
The right to the enjoyment of the highest attainable standard of physical and mental health was first set out in the 1946 Constitution of the World Health Organization (WHO), whose preamble defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".
The preamble further states that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition." The 1948 Universal Declaration of Human Rights also mentioned health as part of the right to an adequate standard of living (art. 25). The right to health was again recognised as a human right in the 1966 International Covenant on Economic, Social and Cultural Rights.
Prevention of access to healthcare by security forces
In July and October 2018, we wrote to the Foreign Secretary and to the Nicaraguan Embassy to highlight our concerns about interferences with patients' rights to health in Nicaragua after learning that physicians had been pressured to prioritise care to specific groups and, in some circumstances, to refuse care to anti-government protesters. The rights of the injured and wounded to appropriate medical treatment are set out in a range of binding international laws, treaties and declarations. The actions of the Nicaraguan security forces in preventing the injured from seeking or receiving treatment are a gross violation of international law.
- Read our letter to the Nicaraguan ambassador, Guisell Morales-Echaverry - October 2018.
- Read our letter to the Nicaraguan ambassador, Guisell Morales-Echaverry – July 2018.
Prevention of access to healthcare
In August and November 2018, we wrote to the Foreign Secretary, Jeremy Hunt and the Israeli ambassador to raise concerns about increasingly severe restrictions placed by Israeli authorities on patients seeking to travel outside Gaza to access life-saving treatment. Withholding access to healthcare and treatment contravenes both medical ethics and international law, particularly the right to health as enshrined in the International Covenant on Economic, Social and Cultural Rights (Article 12) and Article 25 of the UN Universal Declaration of Human Rights.
- Read our letter to the Foreign Secretary, Jeremy Hunt MP - November 2018.
- Read our letter to the Foreign Secretary, Jeremy Hunt MP - August 2018.
BMA condemns the plight of refugees in Calais
On 13 July 2016, then BMA council chair Mark Porter wrote to the French ambassador, Sylvie Bermann condemning the recent decision by the French authorities to prevent aid convoys from entering the refugee camp in Calais to deliver basic supplies. Highlighting the plight of the refugees currently stranded in Calais, Dr Porter called on the French authorities to allow unrestricted access to those organisations who wished to provide aid to this highly vulnerable group of people.
Mistreatment of prisoners, prevention of access to healthcare
According to Amnesty International, detainees at Raja’l Shahr Prison are routinely deprived of access to necessary medical care and treatment. Withholding access to healthcare and treatment contravenes both medical ethics and international law, particularly the right to health as enshrined in the International Covenant on Economic, Social and Cultural Rights (Article 12) and Article 25 of the UN Universal Declaration of Human Rights.
Anti-homosexuality law in Uganda
In 2014 Uganda enacted new legislation which means that homosexuality now carries a life sentence in Uganda. It was alleged that medical doctors would use their expertise to provide support for the enforcement of the legislation
Doctors' involvement in human rights violations
State affiliated doctors participate in executions
In August 2018, the BMA received reports that state-affiliated doctors were facilitating the execution of young prisoners in Iran. In one instance, a 19-year-old named Abolfazi Chezani Sharahi was executed for a crime he committed when he was 14-years-old, following medical opinion that he was mentally 'mature' at the time of the offence.
The involvement of physicians in any form of torture and other cruel, inhuman or degrading punishment is unlawful, unethical and in gross contravention of the professional codes set down by the World Medical Association in its International Code of Medical Ethics.
Medical involvement in force-feeding at Guantánamo
In April 2013, the US Department of Defense sent 40 additional military medical personnel to Guantánamo Bay Naval Base to carry out the force-feeding of detainees on hunger strike. In June, it was reported that as many as 44 of the hunger strikers were being force-fed by military medical teams. The force-feeding of a mentally competent adult hunger striker by medical staff is a gross violation of internationally accepted ethical standards, as articulated by the World Medical Association declarations of Malta and Tokyo.
- Read our letters to reported suppliers and a response from Nestlé, August 2013.
- Read our letter to the US President and Secretary of Defense, June 2013.
- Read our letter to the Guardian about the Guantánamo case, June 2013.
- Read a BMJ editorial on force-feeding at Guantánamo Bay, July 2013.
Health ministry sources drugs for lethal injections
In June 2013, Vietnam formally reintroduced the death penalty by lethal injection. Any involvement of physicians in any form of torture and other cruel, inhuman or degrading punishment, including assessing individuals as ‘fit’ for capital punishment is unlawful, unethical and in gross contravention of the professional codes set down by the World Medical Association in its International Code of Medical Ethics.