John Yudkin on doctors, torture and medical ethics in Israel
Sunday, 14 March, 2010 - 21:21
There has been a recent controversy in medical media regarding the torture of detainees and prisoners in Israel and Palestine, and what role doctors have played in facilitating this. The ethical code on doctors and torture, agreed by the World Medical Association (WMA), of which the Israel Medical Association (IMA) is a member, is very clear on what is expected of doctors required to be involved in torture, or confronted with evidence of its conduct. In the light of this code, Israeli doctors and the IMA can be accused of complicity in torture.
A Report (pdf file) published in May 2007 by the Public Committee Against Torture in Israel (PCATI) comprised detailed testimonies of 9 torture victims, and included names of medical personnel involved in their management in prison or referral hospitals, several being IMA members. 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, over a 4-day period he was intermittently tied by 4 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 which had subsequently developed.
The Tokyo Declaration states that ‘A physician shall not countenance, condone or participate in the practice of torture…in all situations, including armed conflict and civil strife.’ It requires any breach of the Geneva Conventions to be reported to the relevant authorities. The General Assembly of the WMA in 2007 made it clear that this obliged doctors to document cases of torture of which they become aware. It is the task of the Ethics Board of the IMA to investigate breaches of this code when they are reported, whether or not these breaches are illegal according to Israeli law.
Following concerted pressure, in March 2009 the Chairman of the IMA Ethics Board reported having contacted and spoken to ‘most of those listed,’ all of whom denied either any connection with the prison services or, for the three who were so employed, any involvement in interrogations, torture, or medical approval for this. In May 2009, PCATI and Physicians for Human Rights-Israel posed a series of questions of the IMA Ethics Board Chairman outlining why they felt the investigation had been inadequate. They asked whether investigations had included conversations with doctors working at the hospitals where the prisoners had been treated, and reviewing medical files from the time of arrest. They also challenged the implication of the Chairman of the Ethics Board 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. I repeated the call for a thorough investigation in an article in the British Medical Journal in October 2009. To date, the IMA has not responded either to the letter from the two organisations or to my article.
It might be that the IMA’s position on torture is less rigorous than that outlined in the Tokyo Declaration, such that, according to their guidelines, some of the doctors identified in the Report might not be considered as complicit in torture. Nevertheless, unless the IMA is seen thoroughly to investigate such testimonies, questions will remain both concerning the doctors identified and the IMA itself.
There are indications that the use of torture in Israeli prisons, and the complicity of doctors, are continuing. Dr Ruchama Marton, Founder and President of Physicians for Human Rights-Israel, has recently recounted another testimony to the British Medical Journal. She described the case of “M,” a Palestinian man arrested in April 2008 and detained in Israel. His affidavit states:
Interrogated for 20 days, most of the time seated on a chair fixed to the floor, hands tied behind his back. Beaten and shaken, while shackled to the chair. Threatened that his house would be demolished and mother would be arrested. Indeed she was. Following severe beatings, he fainted and sustained cuts to his head and face. He suffered severe pains in his jaw to the extent he was unable to eat. He was taken to a hospital by an ambulance. In presence of ambulance paramedics and a doctor, interrogator instructs colleagues not to tell what happened, but to say “M” fell down the stairs. Hospital doctors treat him while still shackled. “M” receives stitches to head and face. Doctor is asked by interrogators not to order hospitalization. The doctor obeys. “M” was brought back to prison. Interrogators ordered “M” to wait inside the ambulance 3 hours to avoid having “M” examined by the prison doctor (the one who asks too many questions). “M” was finally released to another doctor, (the doctor who doesn’t ask questions). When “M” complains to the prison doctor he is told to shut up, sent shackled to confinement cell without medicine. Medication administered only following Red Cross visit.
This account does implicate the complicity of doctors in the prisoner’s abuse, and the response of the IMA will be an important litmus test.
Further reading: Ha’aretz
http://www.haaretz.com/hasen/spages/1156250.html
John S Yudkin is an academic and clinician who is Emeritus Professor of Medicine at University College London. He is a Patron of JNews – Alternative Jewish Perspectives on Israel and Palestine.
This article may be reproduced on condition that JNews is cited as its source.
John Yudkin on doctors, torture and medical ethics in Israel
A Report (pdf file) published in May 2007 by the Public Committee Against Torture in Israel (PCATI) comprised detailed testimonies of 9 torture victims, and included names of medical personnel involved in their management in prison or referral hospitals, several being IMA members. 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, over a 4-day period he was intermittently tied by 4 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 which had subsequently developed.
The Tokyo Declaration states that ‘A physician shall not countenance, condone or participate in the practice of torture…in all situations, including armed conflict and civil strife.’ It requires any breach of the Geneva Conventions to be reported to the relevant authorities. The General Assembly of the WMA in 2007 made it clear that this obliged doctors to document cases of torture of which they become aware. It is the task of the Ethics Board of the IMA to investigate breaches of this code when they are reported, whether or not these breaches are illegal according to Israeli law.
Following concerted pressure, in March 2009 the Chairman of the IMA Ethics Board reported having contacted and spoken to ‘most of those listed,’ all of whom denied either any connection with the prison services or, for the three who were so employed, any involvement in interrogations, torture, or medical approval for this. In May 2009, PCATI and Physicians for Human Rights-Israel posed a series of questions of the IMA Ethics Board Chairman outlining why they felt the investigation had been inadequate. They asked whether investigations had included conversations with doctors working at the hospitals where the prisoners had been treated, and reviewing medical files from the time of arrest. They also challenged the implication of the Chairman of the Ethics Board 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. I repeated the call for a thorough investigation in an article in the British Medical Journal in October 2009. To date, the IMA has not responded either to the letter from the two organisations or to my article.
It might be that the IMA’s position on torture is less rigorous than that outlined in the Tokyo Declaration, such that, according to their guidelines, some of the doctors identified in the Report might not be considered as complicit in torture. Nevertheless, unless the IMA is seen thoroughly to investigate such testimonies, questions will remain both concerning the doctors identified and the IMA itself.
There are indications that the use of torture in Israeli prisons, and the complicity of doctors, are continuing. Dr Ruchama Marton, Founder and President of Physicians for Human Rights-Israel, has recently recounted another testimony to the British Medical Journal. She described the case of “M,” a Palestinian man arrested in April 2008 and detained in Israel. His affidavit states:
This account does implicate the complicity of doctors in the prisoner’s abuse, and the response of the IMA will be an important litmus test.
Further reading: Ha’aretz
http://www.haaretz.com/hasen/spages/1156250.html
John S Yudkin is an academic and clinician who is Emeritus Professor of Medicine at University College London. He is a Patron of JNews – Alternative Jewish Perspectives on Israel and Palestine.
This article may be reproduced on condition that JNews is cited as its source.