Adopted by the 50th World Medical Assembly Ottawa, Canada, October 1998
	Preamble
	1.	In October 1990, the World Medical Association (WMA) adopted a WMA Declaration on Chemical and Biological Weapons (17.Y) in which it condemned, and asked all governments to refrain from, the development and use of these weapons, and urged National Medical Associations to join the WMA in actively supporting the Declaration. In this Declaration the WMA acknowledged the dangers and health hazards of the use of these weapons, including the indiscriminate and long lasting effects on civilian populations and on the environment, and argued that existing health care services, technology and manpower may be helpless to relieve the suffering caused by the weapons.
	2.	The effects of nuclear weapons may be even more catastrophic, more indiscriminate, and longer lasting than chemical and biological weapons. These effects, based on studies of affected populations and on studies of the consequences of radioactive fallout from nuclear test explosions in the atmosphere, have been widely documented over the years.
	3.	At least 40% of the population of Hiroshima and 26% of the population of Nagasaki were killed in the nuclear attacks on these two cities. Modern nuclear weapons are much more destructive, and the casualties today would be much higher.
	4.	Apart from the immediately lethal effects of blast, heat and radiation, many of the survivors would perish from the latent effects of ionising radiation (leukaemia, cancer, and genetic effects) as well as the infectious diseases like cholera, tuberculosis and dysentery arising from the breakdown in local services.
	5.	Sunlight-absorbing particulate matter generated by fires following a massive nuclear attack involving many weapons exploding at many different sites would reduce the penetration of sunlight to the earth's surface and change the physical properties of the earth's atmosphere, leading to prolonged periods of darkness and devastating effects on agricultural production.
	6.	The bombings of Hiroshima and Nagasaki killed many health professionals, destroyed all hospitals and infrastructure, such as electricity and water supply, and made it impossible for medical services to function at a time when they were most needed.
	7.	The International Court of Justice (ICJ), in its recent advisory opinion on the legal status of nuclear weapons, declared that the threat or use of nuclear weapons is contrary to the United Nations Charter and to the rules of international law applicable in armed conflict, and in particular to the principles and rules of humanitarian law.
	8.	The ICJ, in view of the current state of international law, however, could not conclude definitively whether the threat or use of nuclear weapons would be lawful or unlawful in an extreme circumstance of self-defence, in which the very survival of a State would be at stake.
	9.	The WMA Declarations of Geneva (17.A), of Helsinki (17.C) and of Tokyo (17.F) make clear the duties, responsibilities and sacred mission of the medical profession to preserve and safeguard the health of the patient and to consecrate itself to the service of humanity.
	Recommendations
	10.	The WMA considers that, with its unique position of influence in society, it has a duty to work for the elimination of nuclear weapons. Therefore the WMA:
		i)	condemns the development, testing, production, deployment, threat and use of nuclear weapons;
		ii)	requests all governments to refrain from the development, testing, production, deployment, threat and use of nuclear weapons and to work in good faith towards the elimination of nuclear weapons; and
		iii)	requests all National Medical Associations to join the WMA in supporting this Declaration and to urge their respective governments to work towards the elimination of nuclear weapons.