The WPA Code of Ethics for Psychiatry

In October 2020, the WPA General Assembly adopted the Association's first Code of Ethics for Psychiatry1. Developed by the Standing Committee on Ethics and Review, the Code was drafted and revised, with input from psychiatric societies worldwide, over almost a decade prior to being finalized and adopted. Its four sections cover ethical issues in the major areas of psychiatric endeavor: the clinical practice of psychiatry, 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 The Code now stands as WPA's official statement on the ethics of psychiatry, having superseded the Declaration of Madrid. The formulation of this Code of Ethics was stimulated by the recognition that WPA's previous ethics documents, beginning with the Declaration of Hawaii in 1977 and culminating in the Declaration of Madrid in 1996, were incomplete in their coverage of the principal areas of psychiatric ethics. Thus, they lacked one of the primary attributes of an ethics code, i.e., a systematic approach to defining the parameters of professional ethical behavior2. To ensure coverage of the major areas of psychiatric ethics, the Standing Committee on Ethics and Review began by assembling all existing WPA documents related to ethics, as well as available ethics codes from Member Societies around the world. Key issues, especially if they were reflected in multiple sources – suggesting in­ternational relevance – were compiled and organized into relevant sections, and approaches reflecting the generally agreed-upon ethical principles were defined. With­in each of the four areas of psychiatric activity noted above, the Code's provisions were organized around five principles of medical ethics: beneficence, respect for patients (autonomy), non-maleficence, and the imperatives to improve standards of psychiatric practice and to apply psychiatric expertise to the service of society (including seeking equity in prevention, treatment and rehabilitation of psychiatric disorders). The resulting draft of the Code was then reviewed 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 ethics, the new WPA Code serves several functions2. Individual psychiatrists, especially in countries where national psychiatric societies have not yet formulated ethics codes, can draw guidance from the Code when faced with ethical challenges in their professional activities. The public and members of other medical specialties and other health professions can look to the Code to shape their expectations of their interactions with psychiatrists. Member Societies 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 boundaries of psychiatric practice and provide support for psychiatrists who may be pressured to act unethically to support political ends. The Code is not meant to supplant national codes of ethics, which can better address the particular circumstances of each country and incorporate societal values. However, Member Societies have been asked to endorse the principles embodied 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. Ethics in the clinical practice of psychiatry Ethics in psychiatric education Ethics in psychiatric research and pub­lication Ethics in psychiatric public health