Gideon Levy
Selected Articles from Ha'aretz

The Silence of The Doctors

August 9, 1998

What still shocks us? What still has the power to make us do something instead of taking a know-nothing attitude? What are the moral responsibilities of those in charge of our health?

Yusuf Al Arir was a 60-year-old prisoner from Gaza who spent 27 years of his life in Israeli prisons. He was hospitalized at the Sheba Medical Center, underwent bypass surgery, spent about a month in the cardiac and respiratory intensive care units, and died a few hours after being returned to his cell. During the entire period of his hospitalization, including treatment in intensive care, when he was hooked up to an artificial respirator, he was chained to his bed with leg restraints. The story was first reported in Ha'aretz-IHT last Thursday.

For almost a month, heads of departments, physicians, nurses and others at Sheba, all of whom swear by Israeli medicine, saw this elderly man, 20 times a grandfather, in a serious condition, chained to his bed. Most of the time he was alone with his guards. No one from his family, not his wife (apart from two hasty visits) or his children, was allowed to tend to his needs. A prisoner is a prisoner, especially if he is a Palestinian security prisoner.

The dedicated, skilled medical staff at Sheba saw all this - and did nothing. According to a hospital spokesman, only one physician, Dr. Salim Hajj Yihyeh, tried to persuade officials of the Prisons Service to unchain Al Arir. That effort, of course, was too little, too late. No one from the hospital's administration or from the wards where Al Arir was treated took determined action to get their patient's restraints removed. No one stood up and told prison authorities that the hospital would not countenance a situation in which a patient who was unable to breathe on his own was chained to his bed.

They all saw and they all were silent. Although medical staff at hospitals have the final say on almost everything that happens to their patients, and in some cases also to their visitors, they suddenly took a "know-nothing" stance, giving up their sovereignty and their responsibility, cloaking themselves in silence and excuses. A spokesman at the Health Ministry indirectly justified the behavior of the Sheba personnel: "The physicians are responsible for health, and the security men for security," he explained. The spokesman said that the ministry has no regulations on the chaining of prisoners, reflecting the health system's rank indifference on the subject.

The Prisons Service, on the other hand, reacted with supercilious self-righteousness. Knowing that the Al Arir story was about to break, it issued a statement to the effect that henceforth the procedures would be revised, but only with regard to the chaining of terminal patients. Did the Prisons Service have to wait for Al Arir to die? And was Al Arir, a post-bypass patient, a "terminal" case?

Yusuf Al Arir was neither the first nor the last patient to be chained to his bed. A few years ago, Dr. Ahmed Tibi made public the shocking story of a prisoner named Intassar al-Kak, from the Silwan neighborhood of Jerusalem. She was forced to give birth in the obstetrics ward of Meir Hospital in Kfar Sava while chained to the bed. Less than two years ago I saw, at Hadassah Hospital in Ein Kerem, a 14-year-old boy named Muataz Jardath, from the village of Sa'ir in the West Bank, chained to his bed and guarded by two soldiers to make sure he did not try to move. His parents were denied visiting rights for a few days. The just-published annual report of the Physicians for Human Rights group cites other cases of prisoner-patients being chained to hospital beds.

In short, the phenomenon is witnessed by many physicians in nearly every hospital. They are signatories to the Hippocratic Oath and to the 1975 Tokyo Declaration of the World Medical Association, which states: "The doctor shall not countenance, condone nor participate in the practice of torture or other forms of cruel, inhuman or degrading procedures, whatever the offense of which the victim of such procedures is suspected, accused or guilty," including armed conflict and civil strife. Nevertheless, the majority of our physicians do not lift a finger in the face of what they see.

Whereas in Northern Ireland it was police physicians who informed the public of the torture being administered in interrogation rooms, in Israel physicians are the ones who give torture the kosher seal. It is clear from the testimony of many Palestinian interrogees that the physicians' only goal is to prevent the disruption of the interrogation due to the collapse of prisoners. Apart from that, their health and well-being are of no interest to them. The Israel Medical Association is mute on the subject.

Our health system, a source of pride for its professional achievements, has failed one of its supreme ethical tests. With the power and status these first-class physicians enjoy in Israeli society, they could play a key role in the preservation of human rights. Instead, most of them prefer to immerse themselves in their world of research and medicine, shutting their eyes to the atrocities they witness. They will never be able to say "I did not see," "I did not know," or "What could I do?



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