By Zohar Lederman
The ongoing slaughter of Palestinians in Gaza (and to a lesser degree in the West Bank) is morally abhorrent and is in clear and undeniable violation of international humanitarian law. The war and its effects on Palestinians have been largely ignored by bioethicists, and the little that has been published is mostly either painfully superficial or, even more painfully, historically, legally, and ethically inaccurate, indefensible or plainly biased. Ethicists should do much more by way of thinking, writing, and advocating for Palestinians; they should stand with them in solidarity, as they should stand with any other civilian groups that are experiencing grave injustices.
Of a much smaller scale, yet still urgent and meaningful, the most right-wing government in Israeli history has been supporting and implementing ethically questionable interventions and policies potentially denigrating the rights of Jews and non-Jews living in Israel. It is not enough for ethicists to simply describe the complexity of the resulting ethical dilemmas. Rather, they should critically review these policies and decry any injustices, particularly (in the bioethics context) if they potentially lead to negative health outcome; some, indeed, have admirably done so even before the current war. When governments or their policies are unjust, it is the responsibility of ethicists to speak truth to power.
My recent publication focuses on the potential violation of the right to medical confidentiality of survivors of sexual assault in Israel, both during the Hamas attack on October 7th and during their captivity. It argues against the courts’ decision to allow the disclosure of medical information that may eventually lead to the identification of the survivors. Under certain conditions, the right to medical confidentiality may be overridden. One of these conditions is that the benefits to the same patients or others, or to public interest in general, outweigh the importance of respecting one’s medical confidentiality. Another condition is transparency: that patients know, or at least have the possibility to know, that their confidentiality may be violated. These conditions do not seem to apply in the present case.
The article links to a more general discussion in ethics. A minority of bioethicists still maintain that medical ethics in times of war are different in kind from medical ethics in times of peace. This article provides further proof that they are wrong.
In the face of atrocities unfolding in front of our own eyes, be it in Gaza, Sudan, Ukraine, Yemen and others, ethicists cannot be an idle bystander. We must write about them, and we must protest them. We must behave as if our actions matter. Otherwise, there is no hope.
Paper title: War Crimes, Sexual Assault, and Medical Confidentiality in Israel
Author: Zohar Lederman
Affiliations: Department of Emergency Medicine, University of Hong Kong
Competing interests: Zohar is a member of the ethics committee of Physicians for Human Rights-Israel.