The war between Hamas in Gaza and Israel has been treated very gingerly by most of the major medical journals. Except The Lancet.

The war between Hamas in Gaza and Israel has been treated very gingerly by most of the major medical journals. Except The Lancet. This prestigious British publication ran an incendiary letter from a score and more of academics and doctors with Palestinian sympathies and subsequently a strong defence of its editorial policy.

In its editorial, The Lancet declared that:

“It is surely the duty of doctors to have informed views, even strong views, about these matters; to give a voice to those who have no voice; and to invite society to address the actions and injustices that have led to this conflict. Our responsibility is to promote an open and diverse discussion about the effects of this war on civilian health.”

The Lancet’s sympathies are clearly with the civilian population of Gaza, who “have no Iron Dome, the Israeli air defence system designed to intercept and destroy Hamas rockets. The children, women, and men of Gaza have had no protection from shelling that has so far claimed 852 civilian lives.” A number of readers attacked the editors for taking sides – to which their response was:

“In the conflict taking place in Gaza, our position is very clear. We do not support any side whose actions lead to civilian casualties. The role of the doctor is to protect, serve, and speak up for life. That, too, is the role of a medical journal.”

The incendiary letter by Paola Manduca et al spoke of Israeli “lies” and described the 95% of Israeli academics who did not openly oppose the war as “complicit in the massacre and destruction of Gaza”.

Enraged Israeli doctors responded immediately. The President of the Israeli Medical Association, Leonid Eidelman, and the Director General of the Israeli Ministry of Health, Arnon Afek, compared the letter to Nazi doctors’ anti-semitism and denounced it as “a clearly political and biased letter”. They pointed  out that Israeli hospitals treat Israelis, both Arabs and Jews, without distinction and even treat Palestinians. Another denounced “the dehumanisation and bigotry” of Manduca et al’s letter and urged The Lancet “to reassess its practice of biased publishing in the service of polarising political interests of one group”.

The Israeli correspondents stressed the implacable hostility of Hamas towards Israel, its refusal to allow Gazans to receive Israeli health care and the thousands of rockets which it has launched at Israel. Eidelman and Afek wrote:

“We agree with Manduca and colleagues that the military action ‘terrifies those who are not directly hit and wounds the soul, mind and resilience of the younger generation’. This is certainly the case regarding the children of the 6 million Israelis (including Arabs), of a population of 8 million, who live in terror of the rocket attacks. The younger generation is also being harmed by Hamas itself, who not only indoctrinates them with hatred but uses them as child labour in building tunnels, resulting in the deaths of 160 children.”

In summary, hundreds of civilians are dying but the politics of the conflict are so bitter that no one who expresses an opinion escapes unscathed. “The role of the doctor is to protect, serve, and speak up for life,” wrote the editors of The Lancet – a noble sentiment with which everyone will agree. But unfortunately it is a bit more complicated than that… 

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Creative commons
ethics of war
Gaza
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publication ethics
The Lancet

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Michael Cook

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