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THE SHAME OF ISRAELI MEDICINE  
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Neve Gordon, Guy Shalev, and Osama Tanous
May 31, 2025
The New York Review of Books
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_ Faced with the destruction of Gaza’s hospitals and the systematic
deprivation of Palestinians’ right to health, Israel’s medical
establishment has disregarded the field’s most basic ethical
principles. _

A doctor at Kamal Adwan Hospital, in Beit Lahia, working in the dark
after the facility’s generators ran out of fuel due to Israel’s
electricity cuts, North Gaza, August 22, 2024, Abdo Abu
Salama/Anadolu/Getty Images

 

In late March 2024 Israeli soldiers raided Nasser Hospital in the
southern Gaza Strip. They arrested medical staff and patients, as well
as civilians who were sheltering in the hospital compound. H., an
orthopedic doctor, was partway through a shift when the soldiers began
beating him. They kicked him in the stomach, groin, and testicles,
told him to take his clothes off, handcuffed and blindfolded him, and
escorted him to the hospital yard. Then they drove him across the
Israeli border to the infamous
[[link removed]] Sde
Teiman military base
[[link removed]],
near the southern city of Be’er Sheva, where at the time hundreds of
Palestinians were being held blindfolded and shackled in overcrowded,
filthy cages, some forced to sleep on the floor without mattresses or
blankets.

In October 2024 H. gave an affidavit
[[link removed]] to
Physicians for Human Rights–Israel (PHRI), a nonprofit where one of
us, Guy Shalev, is the executive director and another, Osama Tanous,
is a board member. H. recounted that at one point during his
sixty-nine days at Sde Teiman his guards put him in a “disco room”
with no mattresses, where deafening music blared at all times.
Eventually they took him to an interrogation room, where, he
testified, “for six days they tortured me by tying my hands and feet
to a chair behind my back, hitting my stomach, and slapping me while I
was blindfolded.” After forty-three days at Sde Teiman, he was sent
to a prison not far from Tel Aviv to be interrogated.

There he saw a doctor, who affirmed that H. had developed inguinal and
abdominal hernias as a result of the beatings. “He said I needed
surgery and should not be interrogated,” H. said. But he was sent
back to Sde Teiman without treatment. “As soon as I returned to the
detention facility,” H. recounted, “the soldiers beat me up,
banged my head on the ground and rubbed my face in the sand, kicked me
and punched me.”

After another three weeks at Sde Teiman, they transferred H. once
again, to a prison facility in Ashkelon, near the Gaza border. There
he was seen by another doctor, who made him keep his blindfold on
during the examination. “We are colleagues in the same
profession,” H. said. “You are supposed to treat me humanely.”
In response, he remembered, the Israeli doctor “slapped me while I
was still blindfolded.” “You are a terrorist,” he recalls the
man saying.

A few weeks later, at the Israel Prison Service’s medical facility
in Ramleh, H. met with yet a third doctor, who confirmed in a
ten-minute exam that he needed a hernia operation—yet the doctor
insisted it was not urgent and H. was again returned, this time to
Ofer prison. H. recalls in the affidavit that at a court hearing last
July the judge extended his detention for forty-five days; neither
there nor in the following interrogations was he given access to a
lawyer. In August, when he appeared before a judge in a phone hearing,
he was told that he is considered “affiliated with a terror
organization.” Before the judge abruptly hung up the call, he told
H. that he would be remanded to Ofer until further notice. “I am a
doctor,” H. protested. Then the judge was gone.

*

H. remains incarcerated at Ofer awaiting trial—one of the over 380
health care workers
[[link removed]] from
Gaza who have been detained by Israeli forces since October 2023.
(According to Health Care Workers Watch, two dozen of them have been
subjected to enforced disappearance and remain missing.) Between July
and December 2024 PHRI gathered testimony from twenty-four of these
Palestinian medical professionals, who were held across civilian and
military prison systems in Israel. Practically all of them described
suffering torture in the form of severe beatings, continuous
shackling, and sleep deprivation. According to documents that PHRI
obtained through a freedom of information request, at least
sixty-three Palestinians died in Israeli custody between October 2023
and September 2024, including the doctors Adnan al-Bursh
[[link removed]], Iyad
al-Rantisi
[[link removed]],
and Ziad al-Dalou
[[link removed]],
as well as the paramedic Hamdan Abu Anaba
[[link removed]].
Since then, drawing on data gathered by rights organizations and the
Palestinian Authority, the group has determined that at least
twenty-seven further detainees have died in the past nineteen months,
bringing the total number to ninety. In comparison, nine inmates died
[[link removed]] in detention at
Guantánamo Bay over a period of more than twenty years.

The affidavits gathered by PHRI reveal some recurring themes. One is
the use of dogs to attack and humiliate prisoners. M.T., the head of
the surgery department at the Indonesian Hospital in northern Gaza,
told PHRI that soldiers from a counterterrorism unit called Force 100
raided his detention enclosure in Sde Teiman with dogs three days in a
row, “beating prisoners and allowing the dogs to urinate and
defecate on us.” K.S., a twenty-nine-year-old surgeon at al-Shifa
Hospital, recounted that “they beat us with batons, with their
fists, and let their dogs urinate on us. There are always dogs with
them…. They attacked me twice with dogs.”

Another repeatedly cited abuse was pervasive medical neglect. Echoing
other detainees, a twenty-seven-year-old general practitioner from
al-Aqsa Hospital named M.S. described the scabies outbreaks in his
prison ward. “Nobody is treating these infections,” he said,
“nor anything else.”

Those who did manage to see Israeli doctors often had experiences
similar to the ones that H. described. K.S. recalled a doctor telling
him his scabies “would heal on its own.” N.T., a
forty-nine-year-old surgeon who takes medication for hypertension, was
denied access to a physician for months after he was detained during
the March 2024 raid on Nasser Hospital. In his affidavit, he describes
being taken to Sde Teiman, handcuffed and blindfolded, and forced to
wear only underwear for the first seventeen days. He spent the next
month in a detention facility called Anatot, near the Palestinian
village Anata in the occupied West Bank, then the next two months at
Ofer, where he finally saw a physician. The doctor prescribed
medication—but only for ten days.

Neglect can be a death sentence. In his testimony M.T. recounted that
another prisoner, M., had a stroke in the enclosure where prisoners
with medical conditions were held. “A _shawish_ [an inmate
delegated as a go-between by the prison authorities] called for a
nurse,” M.T. recalled, “who told him, ‘You’re not a doctor,
don’t interfere.’” The following day they alerted the guard,
then a Shin Bet officer. “They warned him that the prisoner was
going to die,” M.T. said. At last a doctor showed up, “but M. was
already dead.” 

*

In 1989 the South African physicians William John Kalk and Yosuf
Veriava treated twenty political prisoners who had been hospitalized
in Johannesburg after participating in a hunger strike. When the
authorities asked them to send their patients back to detention, they
refused, fearing that the men might be tortured. Known in the
literature of medical ethics as “Kalk’s refusal,” their action
has since served as a moral roadmap for doctors unwilling to violate
their ethical obligations toward patients. In 1999 it was cited in the
Istanbul Protocol, the most important UN guideline for medical
professionals who are documenting cases of torture and ill-treatment,
which instructs doctors to refrain from returning a detainee to the
place of detention if an examination supports allegations of abuse.

Over the past year and a half, however, a different kind of refusal
has characterized medical institutions in Israel. Some hospitals
initially refused
[[link removed]] to
treat wounded Palestinian detainees. Later some doctors continued to
refuse on an individual level; many who did treat detainees failed to
demand that their blindfolds and shackles be taken off. When
Palestinian doctors working in Israeli hospitals were persecuted
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the medical establishment refused to support them. The overwhelming
majority of doctors—not to mention every Israeli hospital
[[link removed]] and
the Israeli Medical Association—refused to condemn the destruction
of Gaza’s health care system; some openly praised
[[link removed]] it and even called
for the demolition of hospitals in Gaza. As these offenses
accumulated, in most cases the country’s major medical-ethics
institutions refused to speak out.

Demonstrators in Ramallah holding up posters of the Palestinian
pediatrician Hussam Abu Safiya, the director of Kamal Adwan Hospital,
to protest his detention by Israel, January 14, 2025 Zain
Jaafar/AFP/Getty Images

The groundwork for these refusals has been laid for decades.
Palestinians in general and prisoners in particular have long been
dehumanized. The Israeli medical establishment has long had close ties
with the state and security apparatus, not least because most senior
officials come from the military Medical Corps.

Leading hospitals have taken pride
[[link removed]] in
joining war efforts: “In wartime, the civilian and military systems
became one,” Yoel Har-Even, vice president of global affairs at
Sheba Medical Center, said
[[link removed]] at the _Jerusalem
Post_’s Miami summit this past December.

But in the first days of Israel’s attack on Gaza, cases of medical
neglect and complicity escalated dramatically. On October 11, 2023,
Israel’s then–health minister, Moshe Arbel, instructed hospital
directors to refuse
[[link removed]] treatment to
“terrorists” and send them back to medical facilities belonging to
the prison authorities and the military. (In practice, government
officials and the mainstream media tend to apply the word
“terrorist” indiscriminately to Palestinian men between fifteen
and seventy.) That same day Ichilov Hospital
[[link removed]] in
Tel Aviv and Sheba Medical Center
[[link removed]] in Ramat Gan denied
treatment to Palestinian detainees; a right-wing mob,
meanwhile, stormed
[[link removed]] Sheba looking
for “terrorists.” Less than a week later, reportedly fearing
another such mob attack, Hadassah Hospital in Jerusalem refused
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admit an injured Palestinian man whom the military had brought to the
emergency room for serious gunshot wounds. “Sources within the
hospital” told _Haaretz_
[[link removed]] that
treating him would “hurt national feelings.”

Soroka Hospital, in Be’er Sheva, took this practice further. In the
ten months following Hamas’s October 7 attacks, according
to _Haaretz_’s reporting
[[link removed]],
hospital staff called the police on at least three undocumented
Palestinian women when they reached the emergency room. (Spokespeople
for the hospital stressed to the journalists that this was a policy
devised “in coordination with the police,” even after the police
themselves “denied that such a directive exists.”) In one instance
a pregnant Palestinian woman from the West Bank arrived experiencing
contractions. Since 2013 she had been living with her husband in
Rahat, a Bedouin town in Israel; her three children are Israeli
citizens. Once the physician had seen her, she was detained by the
police before even being formally discharged, taken to a West Bank
checkpoint, and left stranded there until her husband picked her up
and drove her to Jenin, where her parents live. She gave birth five
days later.

Even as hospitals turned away Palestinian detainees, their own
Palestinian employees—who comprise a quarter of all doctors
[[link removed]] and almost half of new
doctors and nurses in Israel—found themselves under suspicion
[[link removed]].
About a week after October 7 several people sent complaints alleging
that Abed Samara, director of the cardiac intensive care unit at
Hasharon Hospital in Petah Tikva, had expressed support for Hamas on
Facebook. On October 18 Yinon Magal—a television anchor, right-wing
influencer, and former Knesset member—insisted on his telegram
channel
[[link removed]] that
Samara had “changed his profile picture to a Hamas flag, agitating
and talking about the Muslims’ ‘Day of Judgment.’” The image
in question featured a green flag bearing the _Shahada_, a saying
repeated by every observant Muslim five times a day: “There is no
God but Allah and Muhammad is His Messenger.”

That same day the hospital suspended
[[link removed]] Samara
after fifteen years of service. Israel’s brand-new health minister,
Uriel Busso, insisted on social media that Samara had headed his
profile with “Hamas flags” and written “words of support for the
terrorist organization that slaughtered and murdered hundreds of Jews
in cold blood.” By the time the police and Shin Bet notified the
hospital
[[link removed]] that
the picture had been posted in 2022 and merely expressed religious
devotion, Samara had been subjected
[[link removed]] to
death threats and hundreds of hate messages and had decided he no
longer felt comfortable returning to work.

Other Palestinian doctors and nurses have confided in PHRI that they
fear posting anything that could be construed as political on their
private social media accounts. Hospitals, they testify, have been
suffused with an atmosphere of militarization, scrutiny, and
silencing. “Nowadays, to continue working in the hospital, you are
required to become inhumane,” one medical worker said in a report
[[link removed]] issued
by the Palestinian research center Mada al-Carmel. “You are not
allowed to express sympathy for anyone dying on the other side, even
if it is a child.”

*

Their Israeli colleagues have felt no such inhibitions about their own
speech. Palestinian doctors and nurses who spoke to PHRI described
overhearing coworkers suggesting that Israel should “ethnically
cleanse Gaza,” “transform Gaza into rubble,” and “flatten
it.” They have seen colleagues post messages on social media like
the one recirculated on October 21, 2023, by a senior surgeon from
Carmel Medical Centre in Haifa. Apparently first posted by someone
serving in Gaza, it invoked the famous prisoner exchange Israel
negotiated with Hamas for the release of the captured solider Gilad
Shalit:

The UN is asking for a proportional response. So here, some
proportions: for Gilad Shalit we released 1027 prisoners. One Jew is
equal to 1027 terrorists. 1350 murdered Jews times 1027 1,386,450 dead
in Gaza. This is the proportion we have become accustomed to; I was
happy to help.

This and other genocidal calls were not limited to the first weeks and
months after the October 7 massacre. Nineteen months into the war on
Gaza, Amos Sabo, a senior surgeon at Maccabi Healthcare
Services, posted on X
[[link removed]] that
he considered his reserve service a way of advancing public health by
“eliminating cockroaches and other loathsome insects.” A few
months earlier he wrote
[[link removed]]:
“Gaza should be erased. There are no uninvolved people there.”

Hospitals themselves have likewise rallied on social media around
Israel’s war in the Strip. In November 2023 Bnai Zion Medical Center
in Haifa circulated an Instagram post
[[link removed]] featuring doctors dressed
in military garb and stationed in Gaza, with the message “sending
regards from the front.” A Sheba Medical Center Instagram story from
June 2024 covered the “double life” of one of its doctors, who
splits his time between the operating room and the cockpit of an F16
fighting jet. There are parallels between combat flying and
surgery, the pilot says
[[link removed]]:

Both take you to the edge and both require precision, responsibility,
decision-making under pressure, and the ability to deal with failure.
There’s no such thing as “I almost hit the target”—either you
hit it, or you didn’t. If you weren’t accurate at altitude, you
crashed—if you cut a blood vessel one millimeter to the right, the
result could be catastrophic.

These posts appeared at a time when Israel’s aerial and ground
attacks were frequently killing scores of civilians a day and
producing an extremely precarious environment for health care workers
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to the UN, the number of health and aid professionals killed in
military strikes is unprecedented
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recent history.

In early November 2023—around the time the World Health Organization
(WHO) reported
[[link removed]] that
the Israeli military had already killed at least 9,770 Palestinians,
including an estimated 4,000 children, and injured an additional
25,000—dozens of Jewish Israeli doctors published an open letter
[[link removed]] calling on the military to bomb
Palestinian hospitals. The doctors were not dissuaded by the fact that
fourteen out of Gaza’s thirty-six hospitals had already stopped
functioning due to air strikes or shortages of fuel, oxygen, medicine,
medical equipment, and food. Nor were they deterred by international
humanitarian law
[[link removed]],
which stipulates that medical facilities “must be protected at all
times and shall not be the object of an attack.” Because “the
residents of Gaza saw fit to turn hospitals into terrorist nests to
take advantage of western morality,” these doctors reasoned, they
“brought destruction upon themselves.… Abandoning Israeli citizens
while granting protection to mass murderers simply because they are
hiding in hospitals is unthinkable.” One of the signatories, an
American-born Israeli gynecologist named Chana Katan, explained: “I
will do everything I can to defend and protect IDF soldiers and ensure
they return safely to their homes. It is the IDF’s duty to bomb the
terrorists hiding in hospitals in Gaza.” (UN officials
[[link removed]] as
well as human rights organizations, such as Human Rights Watch
[[link removed]],
repeatedly emphasized that Israel had not provided sufficient evidence
to substantiate its claims about militant groups’ use of
hospitals. An analysis
[[link removed]] of
Israeli visual material found those claims not credible.)

The acting head of the ethics committee at the Israeli Medical
Association, Tammy Karni, soon issued a concise statement
[[link removed]] in response to the doctors’ letter.
“Even in these sensitive days, in times of war, it is the role of
doctors to treat the wounded,” Karni felt the need to explain:

Upholding a moral position is what distinguishes the State of Israel.
Throughout history, Israeli doctors have not agreed to be dragged into
the conscientious and moral decline that our enemy has reached…. The
doctors of the IMA will not encourage crimes against humanity.

And yet less than three weeks later the IMA—a professional
association that represents 95 percent of physicians in Israel—would
itself sign on to a statement that, in effect, justified the Israeli
army’s assaults on Palestinian hospitals in the Strip. In
mid-November the Israeli military laid siege to al-Shifa Hospital
[[link removed]],
shelled its surroundings, cut off its supply of water and electricity,
and sent ground troops into the compound, which then housed 7,000
displaced people, 1,500 healthcare staff, and 700 patients, including
premature infants. Israeli military spokespeople had insisted
[[link removed]] that “Hamas’s
headquarters” were located in tunnels directly under the medical
facility—an accusation for which Israel failed to provide
substantiating evidence
[[link removed]],
despite eventually occupying the entire site.

Palestinians inspecting the damage at al-Shifa Hospital after Israeli
ground forces withdrew from the facility, Gaza City, April 1, 2024
AFP/Getty Images

Starting on November 8, 2023, officials with the WHO and UNRWA
had denounced
[[link removed]] the
siege for its “disastrous” effect on medical conditions. On
November 23 the ethics committees of six Israeli health
associations—including the IMA, the National Association of Nurses,
and the Israeli Psychological Association—sent a letter
[[link removed]] to
the WHO not to join it in condemning the siege but to castigate it for
its “silence” about Hamas’s alleged control of al-Shifa.
Parroting the government’s delegitimizing rhetoric
[[link removed]] about
the Palestinian health care system, the heads of the ethics committees
explained that “once terrorists or militants see that no objections
are raised when hospitals are used for combat, they will feel free to
do so on other occasions and in other locations as well.”

*

Meanwhile the members of these associations’ ethics committees have
remained largely silent as health care staff in Israel violate the
profession’s ethical principles. What began as an institutional
policy of refusing to admit detained Palestinians in October 2023 soon
turned into a pervasive practice of individual refusals by
practitioners: late that month, upon the arrival of a
fifteen-year-old detainee
[[link removed]] to a hospital
in Israel’s Center District, one nurse refused to provide medical
treatment, while another forcibly removed his intravenous drip and
demanded his immediate transfer from the hospital. The pattern
persisted for many months after the war started
[[link removed]]; a nurse at
Kaplan Medical Center in Rehovot refused to treat a detainee as
recently as this past February.

When detainees are admitted, their hands and legs are regularly
shackled to the bed in what the guards call “four-point restraints
[[link removed]].”
One doctor confided to one of us that coworkers “withheld
painkillers after invasive procedures, and then explained to
colleagues that pain medication is a privilege that Palestinian
detainees do not deserve.” After months of complaints submitted by
PHRI’s ethics committee, in February the IMA at last issued a letter
condemning “the restraint of prisoners and detainees in hospitals
across the country.”

In still other cases detainees have received only minimal treatment
[[link removed]] before
being sent back to a detention facility, even when their conditions
were life-threatening. On July 6, 2024, a detainee was transferred
from Sde Teiman to Assuta Hospital in Ashdod after suffering critical
injuries
[[link removed]] to
his neck, chest, and abdomen, as well as a ruptured rectum. The
medical examination indicated that he had been subjected to torture
and sexual violence while in custody. Immediately after the treatment,
however, he was sent back to his torturers. According to Human Rights
Watch
[[link removed]],
detainees at Sde Teiman could hear the screams of other inmates being
tortured; doctors at the field hospital—where patients routinely
arrived with injuries indicative of severe violence—would surely
have heard them, too. Physicians working there were prohibited
[[link removed]] by
military authorities from using their names or license numbers when
examining prisoners or signing medical reports. When doctors are asked
to conceal their identity in this way, the aim is usually to shield
them from future scrutiny over their complicity in the facility’s
abuses.

In April 2024 _Haaretz_ reported
[[link removed]] that
an Israeli physician had sent a letter to the ministers of defense and
health and the attorney general detailing the harsh conditions to
which Palestinian detainees were subjected at the facility and the
tacit assent expected from the medical staff. “Just this week,” he
explained, “two patients had their legs amputated due to injuries
from being cuffed. Sadly, this has become routine.” The doctor went
on to describe how patients were fed through straws, made to use
diapers for defecation, and kept handcuffed and blindfolded at all
times. “Since the early days of the field hospital’s operation,”
he wrote, “I have been grappling with challenging ethical
dilemmas…. We have all become partners in violating Israeli law. As
a physician, I am even more troubled by the violation of my
fundamental commitment to provide equal care to all patients—a
pledge I made upon graduating twenty years ago.” (In a response to
the paper’s reporter, the ministry of health insisted that “the
medical treatment provided at Sde Teiman complies with the
international rules and conventions to which Israel is committed.”)

Between February and April 2024 PHRI published two reports detailing
how incarcerated Palestinians had been systematically deprived of the
right to health. In both reports the group urged the IMA to ensure
that detainees receive medical care in line with Israeli law,
international treaties, and ethical medical standards. That April,
Yossef Walfisch, the new chairperson of the IMA’s ethics committee,
published a letter reiterating an IMA statement from that past
January, which had stressed that “Israeli physicians are required to
adhere by international conventions, medical ethics principles, and
the Geneva Declaration.” They “must provide all necessary medical
care, whether in hospitals, prisons, or military facilities, and
should be guided exclusively by medical considerations.”

He elaborated on that letter in an article
[[link removed]] on
Doctors Only, a website for the country’s medical community. Yet
even here Walfisch paired his lofty pronouncements about the
significance of providing everyone humane medical care with attempts
to deny the evidence of Palestinians’ horrific treatment. Again and
again he referred to Palestinian patients as “Hamas terrorists.”
Because the medical staff’s “safety takes precedence over any
other ethical consideration,” he explained, the professional bodies
responsible for incarceration ought to determine who should be
restrained and blindfolded, and although health care staff in prisons
and hospitals should strive for “a minimum of handcuffing,” on the
whole they should follow the authorities’ guidelines. He invoked Sde
Teiman but failed to say a single word about the beatings, torture,
and medical neglect there. Instead he revealed that, when he visited
the base’s medical team, he found staffers who “work day and night
to provide the most suitable treatment within the limitations of this
type of facility.” Echoing a self-congratulatory trope often used to
describe the Israeli military, he called them “among the most moral
doctors I have met.”

It is hard not to conclude that the IMA has failed grievously in its
obligations to defend medical ethics. It could have criticized Israeli
doctors who posted genocidal messages on social media, investigated
health professionals who allegedly facilitated torture, and defended
Palestinian doctors like Abed Samara who were wrongly persecuted for
supporting terror. Instead it has not just turned a blind eye to these
abuses but adopted Israel’s line of defense, blaming Hamas for
Israeli transgressions in Gaza that include not only egregious crimes
of starvation, murder, and forced displacement—widely acknowledged
by rights groups as amounting to genocide—but more specifically the
destruction of the Strip’s medical system, the killing of more
than 1,400 health care workers
[[link removed]],
and the unlawful detention of nearly four hundred others.  

In recent months the Israeli medical establishment’s silence has
grown all the more deafening. Not a single prominent medical official,
to the best of our knowledge, spoke up after reports emerged that, in
the early hours of March 23, Israeli forces had ambushed
and massacred
[[link removed]] fifteen
Palestinian paramedics and aid workers who were carrying out a rescue
mission in southern Gaza, then tried to cover up the crime by burying
the bodies in a sandy mass grave alongside their smashed ambulances
and fire truck; nor when it was revealed
[[link removed]] that
a military spokesperson had lied about the atrocity, falsely claiming
that the ambulances’ emergency lights were off when they arrived at
the scene and accusing the murdered paramedics of having “advanced
suspiciously.” No hospital director, dean of medical faculty, or IMA
official said a word even after two witnesses from the UN retrieval
team claimed that at least one dead aid worker had his hands bound,
nor after the doctor who carried out the postmortems said that several
had been killed by gunshots to the head and torso.

A month earlier, Sheba Medical Center was named the eighth-best
hospital in the world by _Newsweek_, a prestigious recognition that
reflects not just Sheba’s reputation but that of Israel’s health
care system as a whole. In a press release celebrating the
designation, it promised that its doctors would “keep striving…to
raise the standard of healthcare for all.”

*An earlier version of this article misattributed a quote from the
Israeli Medical Association’s January 2024 statement on the
treatment of Palestinian detainees. 

Doctors at Kamal Adwan Hospital working in the dark after the
facility’s generators ran out of fuel due to Israel’s electricity
cuts, North Gaza, August 22, 2024  Abdo Abu Salama/Anadolu/Getty
Images

IN RESPONSE TO:
_The Shame of Israeli Medicine
[[link removed]]_,
May 31, 2025

_To the Editors:_

We were deeply dismayed by many of the claims in your article entitled
“The Shame of Israeli Medicine,” published recently. Its glaring
omissions, selective interpretations, and misrepresentation of facts
call for an urgent and clear response.

To begin with, oddly, the piece makes no mention whatsoever of the
unprovoked October 7th Hamas massacre—the horrific attack that
precipitated the current war. Simply put, Hamas declared war on
Israeli civilians, not the other way around. The article also fails to
acknowledge the 251 hostages, many of whom were denied food, water,
and medical care, and who endured unimaginable cruelty. More than
fifty (both dead and alive) remain in captivity today. It is not only
possible—but essential—to grieve the devastation in Gaza’s
health care system while also recognizing the calculated violence
inflicted on Israeli civilians.

Secondly, the article adopts an overtly biased tone, presenting
unverified allegations as fact while ignoring any perspectives or
evidence that might challenge its narrative. In stark contrast, the
Israel Medical Association (IMA) has consistently acted to uphold
medical ethics and international humanitarian law.

For example in January 2024, the IMA issued a public statement
[[link removed]] affirming
that Israeli physicians must provide care to all
individuals—regardless of identity, affiliation, or actions—based
solely on their shared humanity. We reached out to hospital directors
facing pressure to cease treating terrorists and reaffirmed their
ethical responsibilities, offering the IMA’s full support.

When reports emerged that certain Israeli doctors had endorsed the
bombing of Palestinian hospitals, the IMA immediately condemned such
statements, reaffirmed that medical facilities must never be
deliberately targeted, and personally contacted each signatory to
reinforce the ethical obligations of the profession.

Ironically, the article references the Geneva Convention’s call for
the protection of hospitals but omits the critical clause stating that
such protection may cease if hospitals are used to commit harmful acts
against the enemy. This caveat is central to the debate. Claims that
Hamas utilized hospitals for military purposes have been substantiated
by reputable outlets, including _The New York Times
[[link removed]]_.
Testimonies from both Israeli intelligence and video footage from
Hamas members confirm that hospitals were used as command centers and
to hold hostages.

On the matter of prisoner restraint, the IMA’s ethical stance long
predates the current conflict. Our first statement was issued in 1997,
the issue was revisited in 2008 and an updated edition
[[link removed]] was
released in September 2023, prior to the war. Most recently, we
reiterated this position in a February 2025 letter to the Ministry of
Health.

The authors also criticize Israeli doctors for joining the IDF and
taking pride in defending their country. No one longs more to return
to the sanctity and relative comfort of clinical practice than these
physicians—treating patients of all ethnicity and religions. But in
the face of existential threats to the country, they are called to
serve. To imply that such service is incompatible with medical ethics
is both unjust and profoundly naive.

The claim that the IMA has “failed grievously in its obligations to
defend medical ethics” is not only unfounded—it is clearly both
false and offensive. We have long and consistently condemned any
unethical behavior by Israeli physicians, investigated individual
complaints, and reasserted our unwavering commitment to medical
neutrality and humanitarian principles (latest statement
[[link removed]]).

In times of war, nuance matters. _The New York Review of Books_ owes
its readers a more honest and comprehensive portrayal of the
complexities at hand.

Zion Hagay, M.D.
President, Israeli Medical Association (IMA)

Malke Borow, J.D.
Director, Division of Law and Policy, IMA

NEVE GORDON, GUY SHALEV, AND OSAMA TANOUS REPLY:

We do not contest the assertions by Zion Hagay and Malke Borow that
facts are important and that omissions, selective interpretations, and
misrepresentations “call for an urgent and clear response.”
Indeed, it was precisely the bias by omission and disregard for facts
that the IMA has demonstrated since October 7, 2023, that compelled us
to criticize its response to the destruction of Gaza and the
deprivation of Palestinians’ right to health. The IMA’s letter
simply offers further evidence that Israel’s premier health
association is unwilling to look at the evidence and draw the
necessary conclusions.

The facts are clear. Israel has killed over 55,000 Palestinians in
Gaza, including more than 15,000 children, and has wounded close to
120,000 Palestinians, many of whom have suffered life-altering
injuries. There are now between 3,105 and 4,050 child amputees in
Gaza—the largest such cohort in modern history. For eighteen months
the IMA chose to remain silent as the Israeli air force and infantry
systematically decimated the medical system in Gaza, killing 1,400
health care workers, with all of the multiplication of harm that such
attacks produce. As Hagay and Borow correctly note, the laws of war
include exceptions to the protections bestowed on medical units, but
considering that the Israeli military has bombed thirty-three of the
Strip’s thirty-six hospitals
[[link removed]], these
exceptions have simply become the rule. Parroting claims made for
decades by the Israeli military’s spokespeople—and often left
unsubstantiated—Hagay and Borow invoke international law not to
bolster the norm obliging warring parties to protect hospitals but as
a legal shield for Israel’s genocidal violence. The day after our
article appeared, Israel destroyed the only dialysis center in
northern Gaza, but Hagay and Borow decided that it was more important
to respond to our article than to protest the egregious harm to
Palestinian patients with kidney disease.

Hagay and Borow accuse our essay of “ignoring any perspectives or
evidence that might challenge its narrative.” In fact, we cite each
of the IMA’s three statements that Hagay and Borow mention from
after October 2023: its November 2023 letter criticizing a group of
Israeli doctors who called for the bombing of Palestinian hospitals;
its January 2024 statement about the treatment of wounded Gazans; and
its February 2025 notice on prisoner restraints in civilian, prison,
and military facilities.

 At no point did we suggest that the IMA’s February letter on
prisoner restraint was the association’s first-ever statement on the
matter—simply that it took the IMA until fifteen months into the
current war to take note of the surge in such cases since October
2023. Far from ignoring the IMA’s perspective, in other words, we
considered it closely—and found the statements in question vague,
belated, often misguided, and ultimately inadequate. Indeed, the
statements that Hagay and Borow cite—by referring to Palestinian
detainees, often held without charges, in dehumanizing terms that
implicitly justify the denial of care, or by ignoring the mounting
evidence of violations committed by Israeli doctors—strongly support
our claim that the IMA has failed grievously in its obligations to
defend medical ethics against the backdrop of continuous crimes and
violations of the right to health in Gaza, in Israeli prisons, and in
Israeli hospitals.

Meanwhile, Hagay and Borow themselves neglect to respond to the grave
violations of medical ethics we documented in our article. We cited
numerous reports demonstrating that Israeli prisons were transformed
into torture camps after October 7, including documents by B’Tselem
[[link removed]], Human
Rights Watch
[[link removed]],
and Physicians for Human Rights Israel
[[link removed]] (PHRI),
with which two of us are actively affiliated. PHRI’s research has,
as we showed, found ample evidence that over the past twenty months
doctors and other health professionals have repeatedly disregarded
their ethical obligations as they are spelled out in the UN’s
Istanbul Protocol: Manual on the Effective Investigation and
Documentation of Torture and Other Cruel, Inhuman or Degrading
Treatment or Punishment. As we mention in our article, during this
period ninety Palestinian prisoners have died in detention; postmortem
reports detail abuses ranging from broken ribs to starvation and
untreated pneumonia. These prisoners were likely examined at some
point by a medical professional, either in prison or in a civilian
hospital, who returned them to detention despite signs of abuse—a
phenomenon of which PHRI has documented numerous concrete cases.

And yet, to the best of our knowledge, the IMA has failed to
investigate and discipline a single doctor. It has likewise made no
public statement to suggest that it has investigated the allegations
raised in PHRI’s report
[[link removed]],
which is based on twenty-four affidavits
[[link removed]] gathered
from Palestinian doctors and health professionals who were detained
and suffered torture and medical neglect. If the organization has in
fact investigated the misconduct these medical professionals describe,
it ought to say as much, and release the findings as soon as possible.

Hamas’s attack on October 7, 2023, was indeed horrific, but Hagay
and Borow’s suggestion that the violence began on that day is
shocking. After all, about 75 percent of the Gaza Strip’s population
are refugees who were expelled from their villages and towns during
the 1948 Nakba and who, in breach of international laws and UN
resolutions, have been forbidden from returning to their homes. In
1967 Gaza was occupied by Israel, which for years has ruthlessly
controlled the population while denying Palestinians
self-determination. In 2007 Israel imposed a hermetic siege, caging
the Palestinians in what human rights organizations
[[link removed]] have
called the world’s largest open-air prison. In the process it
exerted extensive control over Gaza’s health infrastructure,
restricting access to treatment outside the Strip, limiting the entry
of medical supplies, and hindering the training of medical
professionals. These policies, and the multiple wars Israel has
launched on the besieged enclave, have persistently undermined the
quality and capacity of Palestinian health services in Gaza.

The IMA has the authority and responsibility to uphold medical ethics
among its members. This duty goes beyond issuing broad statements that
invoke universal values. It requires concrete policies, rigorous
implementation, staff training, and accountability measures. Of what
use are lofty statements—such as those on patient restraint—if
practitioners routinely ignore them, or if the IMA itself continues to
support the policies of the Israeli government, by both omission and
commission? One such deadly policy is Israel’s obstruction of
medical evacuations
[[link removed]],
which has adversely affected more than 12,000 sick and wounded Gazans
in need of urgent care unavailable in the Strip. Had the IMA insisted
on treating patients just kilometers away, how many lives might have
been saved?

Instead of reprimanding us, we suggest that Hagay and Borow engage
with our conclusion that Israel’s largest medical association has
disrespected the profession’s most basic ethical principles. The IMA
talks about medical ethics, universalism, and international
humanitarian law even as, in practice, it embraces the logic of the
Israeli government, according to which the lives, suffering, and
deaths of some groups are more valuable than those of others. But as
Arundhati Roy has put it, “not all the power and money, not all the
weapons and propaganda on Earth can any longer hide the wound that is
Palestine—the wound through which the whole world, including Israel,
bleeds.” It is high time that the IMA stops trying to hide this
wound.

_NEVE GORDON teaches at Queen Mary University of London. He is the
author of Israel's Occupation and coauthor, with Nicola Perugini,
of Human Shields: A History of People in the Line of Fire, both
published by University of California Press._

_GUY SHALEV is a medical anthropologist and the executive director of
Physicians for Human Rights Israel. (May 2025)_

_OSAMA TANOUS is a pediatrician, public health scholar, and board
member of Physicians for Human Rights Israel. (May 2025)_

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