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Declarations on Ethical Standards - Terms of Reference For The Review Committee

THE MANDATE OF THE COMMITTEE:

In accordance with the WPA Statutes, the Review Committee's specific purposes are to review complaints, to initiate investigations on the violation of the ethical guidelines for the practice of psychiatry as stipulated in the WPA ethical guidelines, i.e. the Declaration of Madrid and its additional guidelines and to make recommendations on courses of action to the Executive Committee.

In fulfilling this mandate the Review Committee will work closely with the Ethics Committee of the WPA and seek its advice in all matters of ethical concern.

STRUCTURE AND FUNCTIONS OF THE REVIEW COMMITTEE:

  1. The Review Committee shall limit itself to considering alleged violations of the WPA ethical guidelines, i.e. the Declaration of Madrid and its additional guidelines.

  2. The Review Committee specifically and the WPA in general shall promulgate and distribute information on the Declaration of Madrid to other relevant organizations.

  3. The Review Committee shall establish its own rules of procedures to be approved by the Executive Committee and incorporated in the Manual of Procedures of the WPA.

  4. Any procedure approved for the operation of the Review Committee may subsequently be extended or amended in the light of experience.

  5. The membership of the Review Committee shall consist of a fair representation of Member Societies and of the official languages and of members that have an expressed knowledge and interest in the ethical aspects of psychiatry. Members shall be appointed on a 6 years' basis on staggered terms to ensure continuity.

  6. The members of the Review Committee shall serve in their personal capacity.

  7. The chairperson of the Review Committee will report to the WPA Executive Committee.

  8. There shall be a co-chairperson who will assist the chairperson in the work of the Review Committee.

  9. The Review Committee may delegate one or more of its members to carry out any task connected with the investigation of a complaint brought before it.

  10. The Review Committee shall meet as the circumstances require, and meetings shall be convened by the chairperson.

  11. Decisions of the Review Committee shall be taken by a majority vote of the members voting.

  12. The Review Committee may only consider complaints submitted within 12 months after the termination of the situation or where the complainant has not received a satisfactory resolution of the problem.

  13. The Review Committee shall work in close collaboration with the Member Societies, affiliated Member Societies, and Zone Representatives in the review of cases.

  14. The Review Committee shall on an ad hoc basis have access to legal advice on specific issues, but not on general issues, from legal experts available to the WPA (i.e. from its Sections or a member of the International Association of Medicine and Law).

  15. The Review Committee shall develop collaboration with the ombudsman, patients' advocate or similar bodies, if any, in the complainant's region or the region under investigation. Furthermore, the Review Committee shall contact these bodies, when appropriate, wherever such institutions are available.

  16. The WPA shall allocate a reasonable amount of resources for the activities of the Review Committee.
PROCEDURE FOR REVIEW:

  1. The Review Committee shall consider individual and/or systemic complaints of violation of the WPA ethical guidelines, i.e. the Declaration of Madrid and its additional guidelines that are submitted either through a Member Society, by a complainant or by a professional body acting on behalf of the complainant.

  2. A complaint for investigation shall be sent to the chairperson who will forward all information to the other members of the Review Committee and acknowledge the receipt of the complaint.

  3. Receivability:
    Upon the receipt of the case for investigation, a preliminary review by the Review Committee takes place to assess whether the complaint brought forward falls outside the mandate of the Review Committee. Where appropriate, the complainant may in such cases be recommended to contact other relevant bodies.

  4. Information required to start a case: The following information is considered necessary for the Review Committee's investigation of a complaint,

    1. regarding the specific case:
      - case history or a summary of a case history
      - information on the legal formalities related to psychiatric admission or discharge
      - judicial or medical decisions, if any, regarding the specific case
      - the actual complaints and allegations

    2. general information (cf. The Declaration of Madrid, Item 1) on:
      - the Mental Health Act or Mental Health Ordinance of the region
      - the mental health service delivery system
      - level of funding to mental health and priority setting
      - relevant local legal regulations, and

    3. on a case by case basis:
      - other relevant information considered necessary to evaluate the case.

  5. A complaint cannot be subject to investigation by the Review Committee while there is a pending legal process, or legal procedures have been instituted by the complainant concerned, a Member Society or a professional body acting on behalf of the complainant.

    Depending upon the court decision, the Review Committee may subsequently consider the case.

    The Review Committee may however decide to bring such cases to the attention of the Executive Committee and recommend that actions be taken despite the ongoing legal process.

  6. The acknowledgement of receipt of the complaint may be accompanied by a request for a proforma consent to go further and a request for detailed information concerning the case as required.

  7. Upon receipt of a consent form and further information the Review Committee shall decide as to whether it is a case of violation of the WPA ethical guidelines.

    1. If it is decided that it is not a case of violation of the WPA ethical guidelines, i.e. the Declaration of Madrid and its additional guidelines the complainant will receive a letter stating this and explaining why, and, if appropriate, the Member Society or professional body in question will be informed that the allegations brought forward to the Review Committee are considered unsubstantiated or beyond the mandate of the Review Committee. The Member Society or professional body will not be asked for any comments.

    2. If the Review Committee considers that the information available is sufficient to constitute a violation of the WPA ethical guidelines, letters will be sent to:

      - the relevant Members Society, if any, and Zone Representative for further comments
      - the relevant professional body acting on behalf of the complainant for further comments
      - the ombudsman, or other appropriate body, if any, in the region concerned for collaboration and comments
      - the complainant, informing about the steps to be taken

      i. If the above-mentioned bodies respond, the Review Committee will study the responses, and if they are found sufficient, send its recommendations to the Executive Committee for actions to be taken, and thus consider the case closed.

      ii. If the above-mentioned bodies do not respond, or if the information received is considered insufficient, the Review Committee will subsequently write to other relevant societies or organizations for information or comments.

      iii. If it is not possible to receive sufficient information in order to decide whether a violation of the WPA ethical guidelines has taken place, a site visit may be recommended.

    3. The Review Committee shall, after completing its investigation, make a report, containing a summary of the facts established and the comments received. The report shall contain the Review Committee's opinion of the complaint as being a violation of the WPA ethical guidelines and the Review Committee's recommendations of actions to be taken. This report shall be sent to the President of the Executive Committee.

    4. The Review Committee's investigation of a case is limited within the amount of resources allocated by the WPA for the activities of the Review Committee.

  8. In cases where circumstances do not permit that informed consent be obtained, the Review Committee may bring the case to the attention of the Executive Committee for consideration of actions to be taken.
REVIEW INITIATED BY THE REVIEW COMMITTEE:

It is within the mandate of the Review Committee to initiate review in the absence of a complaint. In these situations the Review Committee may act upon information available of alleged violations of the ethical guidelines.

The procedure shall be as follows:
  1. write to Member Societies, affiliated Members Societies, Zone Representatives and other relevant organizations for further information

  2. collect information from other sources as appropriate c. based upon the information available make recommendations to the Executive Committee
TIME LIMIT FOR RESPONSE:

Member Societies, affiliated Member Societies, Zone Representatives and other organizations shall be given a 2 months' time limit for response. All things considered, an effort should be made to allow for sufficient time to study a case, but on the other hand the aim is to have the case finalized within a year.

CONFIDENTIALITY:

All proceedings before the Review Committee are confidential. No information shall be given to external bodies, the media or the general public, and no other external action shall be taken without the approval of the Executive Committee.

ANNUAL REPORT:

The Review Committee will prepare an annual report of its activities to the Executive Committee, stating the number of cases that have been brought before the Review Committee and the results of their investigations.

SITUATIONS WHERE NO MEMBER SOCIETY EXISTS:

As the Review Committee works on behalf of the WPA, its appropriate area of work is with Member Societies. As regards complaints submitted from regions where no Member Society exists, such complaints will have to be dealt with without the help of a Members Society, eventually in cooperation with the Zone Representative. Such cases will have to be dealt with on a case basis, and the Review Committee, depending upon the nature and number of such cases, will decide how to handle them.

BUDGET

The WPA shall provide a budget for the Review Committee's work. The Review Committee recommends that a Voluntary Fund against the Abuse of Psychiatry be established to be used in cases of investigation.

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