There is increasing pressure on the public hospital system in Australia and constant debate about the level and allocation of health care resources, leading to changing models of hospital management and medical practice. It follows that there is likely to be pressure on doctors working in public hospitals and other health care institutions to make clinical decisions on economic or other non-medical grounds rather than what is best for the patient. The World Medical Association has recognised this as an international issue, leading to the release in March 1999 of the WMA Statement on Professional Autonomy of the Physician. The AMA maintains that all doctors have an obligation to speak out when they believe that the quality of patient care is compromised.