The Israeli Medical Association and doctors’ complicity in torture
Doctors and Human Rights
John S Yudkin, emeritus professor of medicine, University College London
BMJ, 10 October 2009
The Israeli Medical Association needs to take well documented allegations of torture by doctors in Israel seriously.
A recent BMJ news report outlined the reasons behind the call by 725 doctors from 43 countries for the former chairman of the Israeli Medical Association (IMA), Yoram Blachar, to step down as president of the World Medical Association (WMA).1 The doctors’ petition, addressed to Edward Hill, chairman of the WMA Council, documented a series of reports, going back to 1996,2 of cases in which Israeli doctors have been accused of complicity in torture and where the IMA had failed either to respond to or fully to investigate the charges. Although Dr Blachar is no longer the IMA president and concludes his term as WMA president this month, the petition still raises important questions concerning the IMA’s commitment to investigate and tackle possible complicity of Israeli doctors in the torture of prisoners and detainees.
In March this year I contrasted the powerful position statement on torture posted on the IMA’s website with the failure of that body to respond to allegations in a report, published in May 2007, by the Public Committee Against Torture in Israel.3 4 5 The report comprised detailed testimonies of nine torture victims and included names of medical personnel involved in their management in prison or referral hospitals, several of the personnel being IMA members.6 The reasons for medical involvement varied, but the report included an account by a 29 year old man with a sacral ulcer. During his interrogation, he was intermittently tied over a four day period with all of his limbs arched back over a chair with a sharp edge to the seat. His testimony recounted visits to a hospital where he was examined, and after the intervention of his guards the doctors prescribed analgesics and returned him to prison. Six weeks later he was referred to a different hospital for investigation of the permanent foot drop that had subsequently developed.
The IMA, which fulfils not only the functions of a union and a guild, like the British Medical Association, but also the role of ethical overseer similar to that of the UK General Medical Council, had, by early this year, failed to investigate the allegations in the report.3 However, in response to concerted pressure, the chairman of the IMA’s ethics board reported in March 2009, having contacted and spoken to “most of those listed,” all of whom denied either any connection with the prison services or, in the case of the three who were so employed, any involvement in interrogations, torture, or medical approval for this.6
Responding to this open letter the directors of Physicians for Human Rights-Israel and of Public Committee Against Torture in Israel posed a series of questions to the chairman of the ethics committee, outlining why they believed that the investigation had not been “a professional, detailed and thorough examination of serious and specific claims raised in the Report” (see Web Extra material on bmj.com). They requested confirmation that investigations had included “inquiries beyond the telephone conversations mentioned in the letter,” such as conversations with doctors working at the hospitals where the prisoners had been treated, reviews of medical files, and documentation of examinations and treatment from the time of arrest. They pointed out that such inquiries would circumvent the inability of many of those providing testimony to name the individual doctors involved and that even the awareness of those doctors that torture had taken place should have led to their reporting the fact to the authorities.
They also challenged the ethics committee chairman’s implication that it would be easier to check such allegations were there “some shred of evidence other than the word of the prisoners,” pointing out that the denial of an allegation of rape or sexual harassment would not be sufficient grounds for refusing to investigate it. The letter concluded by calling for a comprehensive and exhaustive investigation of the events described in the report, specifically regarding physicians’ conduct, and for the IMA to act to instil the rules of medical ethics among physicians in public hospitals and in detention facilities. To date the IMA has not responded to this letter.
The question that needs considering—by the IMA president, its ethics committee, and its members—is whether the security risks facing Israel can be allowed to override human rights. Furthermore, Dr Blachar, as the president of the WMA, had an unparalleled opportunity to re-examine, from a neutral standpoint, the role of the Israeli medical profession in defending human rights. Failure to investigate to the level of accepted international norms could imply an anxiety that the claims have veracity. Furthermore, the BMA should demand from the Israeli Medical Association a more vigorous response in investigating these testimonies. The BMA has put on record its serious concerns regarding reports of medical complicity in torture at Guantanamo Bay and so would not be singling out Israel for censure.7
A common response to criticism of Israeli policies or practice is that it is a consequence of antisemitism. Any such comments coming from Jewish critics warrants the label of “self hating Jews.”8 The roots of such interpretations are easy to understand, but, as with the response to the Goldstone report on the Gaza conflict,9 10 this may merely be an attempt to silence critics. Dr Blachar has written to doctors who are members of Physicians for Human Rights-Israel to say that, because criticism of the IMA expressed in international forums or “slinging mud at the doctors of Israel” provides “fertile ground for anti-Israeli and anti-Zionist anti-Semitism,” the IMA has decided to sever all ties with Physicians for Human Rights-Israel, an action that could have dire consequences for the provision of care to some of Israel’s most vulnerable groups.11 12 13
The WMA’s Tokyo declaration provides a powerful statement on the need to end all medical complicity with torture.14 The new president of the WMA should work with member associations to develop guidelines on their role in investigating and censoring doctors who contravene this declaration.
Cite this as: BMJ 2009;339:b4078
4. Israeli Medical Association. Prohibition of physician participation in interrogations and torture (position paper). 2007.
5. Public Committee Against Torture in Israel. Ticking bombs: testimonies of torture victims in Israel. 2007.
7. British Medical Association. Medical involvement in torture and ill-treatment at Guantanamo. 7 Apr 2009.
8. Ravid B. Netanyahu’s paranoia extends to ‘self-hating Jews’ Emanuel and Axelrod. Haaretz. 4 Aug 2009.
10. Derfner L. Rattling the cage: a wake-up call from Judge Goldstone. Jerusalem Post. 16 Sep 2009.
12. Even D. IMA cuts ties with PHR over call for ouster of Israeli head of World Medical Association. Haaretz. 11 Aug 2009.
13. Livneh N. First and foremost a doctor. Haaretz. 14 Aug 2009.
14. World Medical Association. Guidelines for physicians concerning torture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment, May 2006 (Declaration of Tokyo).