Showing posts with label Israeli Medical Association. Show all posts
Showing posts with label Israeli Medical Association. Show all posts

23 December 2017

Why does Sir Michael Marmot defend the Israeli Medical Association against accusations of involvement in the torture of Palestinians?

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The World Medical Association's Complicity in Israel's use of Torture 

When you read a description of Sir Michael Marmot's career you realise that he has been showered with honours.  We are told that 'Marmot has a special interest in inequalities in health and its causes'.  Perhaps he considers being tortured to be some form of accolade?

You might have thought that the President of the World Medical Association would be in the forefront of the fight to prevent doctors participating in torture.  Unfortunately this is not the case.  When it comes to Israel Marmot and the WMA have deliberately and persistently acted to support the Israeli Medical Association in its active support for doctors who participate in the torture of prisoners.

As Dr Derek Summerfield shows below, the WMA has persistently refused to look at evidence of the IMA’s culpability.  This is the stuff of Nuremburg and crimes against humanity.

Victor Brack, the SS doctor who headed the 'Euthenasia' T4 Action which murdered up to 3/4 million disabled people, who was hanged at Nuremburg
At Nuremburg in 1946 in what became known as The Doctors Trial 20 Nazi doctors stood trial for war crimes, crimes against humanity and membership of the SS.  7 of them including Viktor Brack, who headed the Euthenasia T4 programme were hanged.  The crimes they committed included performing medical experiments on children, twins in particular, without anesthetic.

You might have thought that the WMA would have taken the lessons of Nuremburg to heart.  In fact as Derek Summerfield, a tireless campaigner and honorary senior lecturer at the Institute of Psychiatry shows, the WMA is complicit in Israel’s use of torture.  Indeed not just in Israel.  It also turned a blind eye to the complicity of American doctors in the use of torture by the CIA as has the American Medical Association. Will the US torture doctors face any consequences?

Even more disturbing is the recent decision of Israel’s High Court (which also sits as the Supreme Court) to effectively approve the use of torture by Shin Bet, Israel’s MI5.  Israel’s courts have a shocking record when it comes to torture.  In previous decisions under the ‘liberal’ Chief Justice Landau, it approved ‘moderate physical pressure’  Under pressure it rowed back on this but still approved torture in ‘ticking time-bomb’ cases i.e. where the bomb was about to go off.

In reality this 'loophole' allowed torture of Palestinian prisoners to be an every day reality.  It was only when the State used torture on a few Jewish terrorists in the wake of the Dawabshh murders in 2015, that the issue became a topical one in Israel.
It is even more ironic that torture as an instrument of state policy has been approved by both Israeli Labour and Likud administrations.  There has been only one exception to this.  When the former head of Irgun and notorious Menachem Begin became Prime Minister he issued strict instructions against the use of torture and Shin Bet officers were even dismissed for torturing suspects.  Today that would be inconceivable.

Now however the High Court, despite the clearest evidence, indeed the admission of the torturers themselves, refused to intervene.  It is indeed a shameful decision but it is in line with the record of this colonial court.  The much vaunted ‘independence’ of Israel’s High Court is a myth.  Today it is stuffed with settler judges but even in the past it rarely if ever intervened to prevent the clear racism inbuilt into the Zionist state.
Tony Greenstein
Derek Summerfield The Electronic Intifada 17 November 2017


Activists come together to protest against Israel’s torture on Palestinian prisoners [Friends of Al Aqsa/Facebook]
It is now more than 20 years since Amnesty International first concluded that Israeli doctors working with Israel’s security services “form part of a system in which detainees are tortured, ill-treated and humiliated in ways that place prison medical practice in conflict with medical ethics.”
Since then there have been repeated attempts – of which this author has been part – to have the global medical ethics watchdog World Medical Association (WMA) hold the Israeli Medical Association (IMA) accountable for these practices.

But with the latest attempt foundering last year and despite changes in leadership over the years, the conclusion that now has to be drawn is that, when it comes to Israel, the WMA is not fit for the purpose for which it was created after World War II.

The WMA is mandated to ensure that its member associations abide by its codes, in particular its seminal 1975 anti-torture WMA Declaration of Tokyo. This obliges doctors not just to not participate directly in torture but also to protect the victims and to speak out whenever they encounter it.
The significant precedent for our action against the Israeli association was the expulsion from the WMA of the Medical Association of South Africa during the apartheid era on precisely the grounds that doctors became a part of a system in which torture was routine, just as Amnesty International concluded was the case in Israel.

Since then, Physicians for Human Rights-Israel has often stated that if the IMA refused to allow doctors to serve in security units commonly deploying torture the practice would come to a halt. The medical presence in these units offers moral legitimation to Israel’s interrogators.

Global action

RAMALLAH, WEST BANK - MAY 19: Israeli security forces detain to Palestinian protesters during a demonstration to show solidarity with hunger striker Palestinian prisoners in Israeli jails at the Ni'lin village in Ramallah, West Bank on May 19, 2017. ( Issam Rimawi - Anadolu Agency )
The first attempt to hold the IMA accountable came in 2009, when some 725 physicians from 43 countries appealed to the WMA, attaching the published findings from a number of human rights organizations including Amnesty, the Public Committee Against Torture in Israel and the United Against Torture coalition. That effort ended when it became clear that then-president of the WMA, Yoram Blachar, who was also president of the IMA, would not take any action, indeed refused to even acknowledge receipt of the submission.

Rather than investigating the claims made in the appeal, Blachar filed a libel suit in London against the individual who headed the 2009 campaign (and is also the author of this article). We rebutted the suit, which alleged we had duped signatories into signing the petition. Signatories helped us with our successful rebuttal by asserting to the libel lawyers that they were no dupes. Noam Chomsky was among those in public support of our effort.

The latest of these attempts to hold the IMA accountable came last year when 71 UK-based doctors made a fresh appeal to the WMA. This time, the submission also leaned on the 2011 Physicians for Human Rights-Israel report “Doctoring the Evidence, Abandoning the Victim: The Involvement of Medical Professionals in Torture and Ill Treatment in Israel” regarding the work of Israeli doctors in security units where torture of detainees was routine.

Why, the 2016 submission asked, were the doctors posted to these units not protecting detainees and protesting their treatment? And why has the Israeli Medical Association not acted on such reports, as it should according to the standards set down by the World Medical Association?


A boy wears tape on his mouth reading “Break the silence” during a protest against the torture of Palestinian prisoners in the West Bank city of Ramallah in November 2013. Issam Rimawi APA images
A hope dashed

This time, we hoped that the international reputation of prominent British medical academic Sir Michael Marmot, who at the time was WMA president, could be brought to bear on a case that has been a standing reproach to the idea that global regulation of the ethical behavior of doctors is even-handed and effective.

Marmot did send us an acknowledgment of receipt (unlike his predecessor) but within days of receiving this, we were staggered to see a letter from Marmot to the Simon Wiesenthal Center published on the center’s website.

Addressed to Dr. Shimon Samuels, director for international relations at the Wiesenthal Center, the letter startlingly stated that, vis-à-vis past claims, “investigations have revealed no wrongdoing or mishandling of the cases by the Israeli Medical Association.”

This is entirely untrue. For many years, Physicians for Human Rights-Israel has tried to get the IMA to conduct such an investigation but found the association consistently unwilling. “Persistently repeated attempts,” the rights group concluded in 2011 in Doctoring the Evidence, “calling the IMA’s attention to cases arousing suspicion of doctors’ involvement in torture and cruel or degrading treatment, have not been dealt with substantively.”

The IMA did in 2009 look into testimonies of victims of torture collected in 2007 by the Public Committee Against Torture in Israel, but concluded, after a few phone calls, that the accusations were without merit and flawed because they had no evidence “other than the word of the prisoners.” That conclusion effectively delegitimized victim complaints from the outset.

Not fit for purpose

Marmot’s letter to Samuels in effect gifted the IMA a signal propaganda victory. He did not just make inaccurate statements: he effectively offered the IMA instant and public exoneration. Coming from the WMA president himself, presumed to be speaking for the whole organization, this was a real propaganda coup and one taken up by media outlets like The Jerusalem Post, whose report was duly headlined “World Medical Association affirms trust in Israeli doctors in response to BDS campaign.”
With repeated attempts to have the WMA take the IMA to task for a conclusive body of evidence showing the Israeli medical establishment is – at the very least – enabling a system of torture of prisoners, the focus must now shift to the WMA itself.

Unfortunately, as the case with Israel illustrates, the WMA seems unwilling to act against those with powerful friends like the US. It is far less hesitant in raising concerns with other less powerful countries like Iran or Bahrain, to name but two.

We therefore have to conclude that the world’s medical body is complicit with these Israeli abuses and that its purported mission to uphold ethical standards across the globe is a sham.
This is bad news for Israeli doctors thrust into ethically compromised roles. It is worse news for Palestinian detainees with little to protect them.

Derek Summerfield is a London-based medical academic involved in human rights campaigning on Israel/Palestine for 25 years.

al_zubaydah_who was waterboarded 83 times under the supervision of CIA doctors

Sir Michael Marmot, the World Medical Association, the Israeli Medical Association, and medical complicity with torture in Israel

In February last year the British Medical Journal published our letter relating the extraordinary response by UK academic Sir Michael Marmot, President of the World Medical Association (the official organisation monitoring medical ethics internationally) to the submission by 71 UK doctors of an evidence-based appeal about longstanding complicity with torture by Israeli doctors shielded by the Israeli Medical Association (IMA).  
The WMA is mandated to ensure that its member associations, which include the IMA, abide by its declarations- in particular the anti-torture Declaration of Tokyo which forbids doctors any involvement with torture and obliges them whenever they encounter it to protect the victim and to speak out. Within a week of our submission the Zionist organisation Simon Wiesenthal Centre (whose website states "we stand with Israel"), not an involved party in this matter, had published a letter on their website from Marmot on WMA notepaper to their Director of International Relations which claimed that “investigations have revealed no wrong doing” by the IMA. 
This is evidentially untrue, as the evidence base to which we point makes transparently clear. This apparent exoneration of the IMA by no less than WMA President gifted them a signal propaganda victory, widely reported. For example, the Jerusalem Post newspaper report was headlined “WMA affirms trust in Israeli doctors..” 
Indeed our experience since the original submission to the WMA in 2009 signed by 725 doctors from 43 countries, attaching a raft of incriminating evidence from such as Amnesty International, has been that the WMA will speak out about some countries but never about Israel, whatever the evidence. In the present case Marmot has still not replied to the 71 signatories, and has rebuffed 3 requests by the BMJ for a response. How are we then to understand this refusal to justify actions taken in the name of the WMA Presidency? The circumstances related above, not least the immediate endorsement of the IMA sent to the Wiesenthal Centre, suggests a partisan dereliction of duty which violates the WMA’s own mandates. There is no question that so goes to the heart of the global public reputation of doctors as their complicity with torture- this is why the WMA was created after World War 2.
This matter is a litmus test of whether internationally agreed medical ethical codes actually matter, and can hold transgressors to account, even when they have powerful friends. All the evidence suggests that they are largely window dressing: there is no effective and even-handed regulation of the ethical behaviour of doctors worldwide, even about torture.
By way of postscript to the egregious events above, I had the opportunity to attend a public interview at Battersea Arts Centre of Sir Michael Marmot on Monday 11 December by the satirist and commentator Mark Thomas. It was apparently the first in a series of 8 Mark Thomas is doing on "The NHS at 70". At question time I threw in a tightly worded query about his behaviour in the episode above.  Marmot quickly lost his cool and began expostulating loudly, saying: "you have just told at least 6 lies....I have been doorstepped, its all lies, I spoke to Physicians for Human Rights and they said their publications are a bit old and everything is alright now...I spoke to the IMA ..." The best word for his response is venal.
He will of course remain perfectly pleased with the role he played: our campaign created a moment when the IMA had need of some external support, and there was the WMA Pres no less to give it to them, doing his duty: "everything is alright now...". This is what has built impunity in Israel.
Some years ago Noam Chomsky told me that the IMA demonstrated what he called "utter moral degeneracy".
Our campaign continues. An Electronic Intifada article on this issue can be found on this link:

Rights groups slam Israel Supreme Court for giving ‘green light’ to torture

December 21, 2017 at 3:33 pm

The Israeli Supreme Court has been accused of redefining torture so as to permit it after a major new ruling was greeted with dismay by local and international human rights groups.

Last week the court – sitting as the High Court of Justice – denied a petition brought by The Public Committee Against Torture in Israel (PCATI) on behalf of Palestinian prisoner Asad Abu Ghosh.
According to the petition, Abu Ghosh was tortured with “severe mental and physical violence” during a Shin Bet interrogation in 2007, including “beatings, being thrown against a wall, stress positions including the ‘banana’ position, sleep deprivation, and extreme mental duress”.

The High Court was presented with high-level and independent legal-medical opinions confirming the physical and mental damage caused to Abu Ghosh at the hands of his interrogators.

While allegations of torture by Shin Bet agents are commonplace, impunity is the norm; more than 1,000 complaints filed since 2001 did not produce a single criminal investigation. What made this case unusual, however, was that the state admittedcertain pressure methods” had been used.

Despite this, and the evidence presented by PCATI, the High Court still threw out the petition, accepting an earlier decision of the Attorney General not to open a criminal investigation against the interrogators, and thus granting the agents impunity for their actions.

For PCATI, how the court reached its decision is as disturbing as the verdict itself – and one paragraph in particular stands out. “The definition of certain interrogation methods as ‘torture’ is dependent on concrete circumstances,” wrote Judge Uri Shoham, “even when these are methods recognised explicitly in international law as ‘torture’ [my emphasis]”.

The High Court’s decision is being described by some as the most important legal development for interrogations and torture in some two decades; as a report in The Jerusalem Post put it, “essentially, the court took the state’s side on all of the key issues before it”.

In 1999, the High Court ruled that Shin Bet agents could not use “physical means” in their interrogations. However, the justices also held that agents who used such methods could be immune from criminal responsibility in the case of a “ticking bomb” scenario.

Unsurprisingly, since then Palestinians have continued to be tortured by Shin Bet interrogators relying on the “ticking bomb” exception – but as Israeli NGO B’Tselem put it, such methods “were not limited to exceptional cases and quickly became standard interrogation policy”.

This state of affairs has been widely documented, including by the UN Committee Against Torture in May 2016, by interrogators themselves, and in studies like the one published by the ‘Reproductive Health Matters’ medical journal in 2015, which found that “Israeli authorities are systemically involved with torture and ill-treatment of a sexual nature”.

As Israeli legal affairs analyst Yonah Jeremy Bob noted recently, Israel’s Supreme Court was “unique” in having established “a category of ‘moderate physical pressure’ that could legally be used on [prisoners]”. He added: “No democratic country in the present era has defended the legality of such methods or established normative legal principles relating to them quite like Israel.”

Now, this latest High Court decision leaves Palestinian prisoners even more vulnerable to abuse. According to PCATI, the ruling “permits de facto use of torture methods”, including even those forbidden in the High Court’s 1999 judgement, and also “blocks the way for victims who have suffered from physical and psychological trauma to seek redress”.

For Amnesty International, whose 2016/17 annual report found that Israeli forces and Shin Bet agents “subjected Palestinian detainees, including children, to torture and other ill-treatment with impunity”, the Supreme Court decision is troubling.

“We have serious concerns that in taking this decision the Court dismisses, yet again, credible and relevant evidence of systematic torture of Palestinian detainees”, said Magdalena Mughrabi, 
Amnesty’s Deputy Director for the Middle East and North Africa.

In doing so, she added, the court is “sending another green light” to Shin Bet interrogators “that it is acceptable to use methods of coercion, including the combined use of stress positions, beatings and sleep deprivation that amount to torture against Palestinian detainees”.

For Dawoud Yusef, head of the Advocacy and Lobbying unit at Palestinian prisoners’ rights group Addameer, “there is very little surprise in regard to the ruling in the case of Abu Ghosh”.

Not only did the original case in 1999 leave the definitions for ‘moderate physical pressure’ and a ‘ticking bomb’ situation open”, he said, “it also gave the authorities a license to torture”.

Nonetheless, Yusef continued, the new ruling “represents a key legal addition to the 1999 case”, by fleshing out some of the details of what had previously only been implicit definitions.

“From the [Abu Ghosh] case, a ticking bomb situation does not have to mean that an attack is imminent or that the person in question has the direct information to prevent such a situation. Secondly, the case categorises the banana position, pressure on his fingers, and a beating as simply being ‘moderate physical pressure’.”

Thus, Yusef asked, “the question now is: what will the Israeli state actually consider as torture, and how low can the bar go regarding a ‘ticking time bomb’ situation?”

The Supreme Court’s dismissal of PCATI’s petition joins a long list of examples where Israeli judges have declined to strike down legislation and policies which violate international law.

Addressing the Abu Ghosh ruling, a spokesperson for B’Tselem said that “vital to Israel’s ability to act with impunity is the Supreme Court routine of granting a veneer of legality to almost all violations of Palestinian human rights, and in this case, a particularly grave one”.

For PCATI, at the core of this new ruling is “a refusal… to admit that certain methods, which are recognised internationally as torture, are indeed torture in Israel as well”. While this may ultimately “put the court on a collision course with the International Criminal Court”, in the meantime, as PCATI noted, the “torturers” of Palestinian prisoners will continue to enjoy “absolute impunity”.

25 March 2016

Israeli Medical Association backs refusing to treat Palestinian 'terrorists'

Israel’s new triage guidelines – purely for international consumption

In my previous post on the extra-judicial execution of a wounded Palestinian it was noticeable that 2 Israeli ambulances did nothing to tend to someone who was clearly severely injured on the ground.   Their only concern was a superficially wounded soldier.

Palestinian Red Crescent
It is clear that the new guidelines from the Israeli Medical Association, whilst formally adhering to the triage rules, whereby you tend to the most severely wounded first, is not in practice being adhered to.
Israeli doctors are complicit in the shoot to kill policies of Israel’s military.  The new guidelines are purely for international consumption.

Tony Greenstein

Israeli medics are leaving wounded Palestinians to bleed to death

Israeli soldiers invade hospital demanding records
Dan Cohen March 23, 2016

Last December, an Israeli medic announced on his Twitter account that he would not treat injured Palestinians he deemed “terrorists.”

“As a ZAKA volunteer for close to twenty years. I am announcing publicly, I will not offer aid to a terrorist/murderer that hurt innocents, whatever his condition may be. Before I treat the victims,” he wrote.

Soon after, he claimed to have carried out his promise. On the scene at Jerusalem’s Jaffa Gate where a Palestinian man who attacked an Israeli was shot, beaten with a metal rod and kicked by civilians, the medic boasted on Twitter that he did not treat the dying Palestinian man.

“For all of those asking, when I arrived today to the scene of the terror attack at Jaffa Gate in Jerusalem. I treated those wounded by stabbing and no! I did not go to give aid to the terrorist may his name be erased! despite the fact that his condition was mortal,” he wrote.

This is not an aberration, rather, it is an instance of increasing turmoil in the Israeli medical community over the concept of triage, the internationally recognized protocol for medical treatment based on severity and likely benefit from immediate treatment. 

Changing Israeli Protocol on Triage

In 2008, the website of the Israeli Medical Association listed a Talmudic dictum in its section on ethics.

“In cases where human caused violence results in casualties for the perpetrators of such violence (the enemy), the obligations towards these parties should be clearly defined. Here, the principle to be implemented is “the poor of your city come first,” it read.

When Hadas Ziv, Physicians for Human Rights Israel’s ethics committee coordinator, found this in October 2015, the committee wrote a complaint to IMA’s ethics committee that “statements from medical teams on the ground indicate that they do not prioritize the injured according to their medical condition,” and requested that the licenses of the offending medical staff be revoked. The IMA does not have the authority to revoke medical licenses themselves, but as a professional organization it is able to make recommendations to the Ministry of Health. After PHRI’s letter, the IMA did remove the directive from its website.

In response to the removal of the instruction breaching triage, the aforementioned ZAKA medic and a handful of others made online announcements that they would continue to discriminate in defiance of the IMA.

Rather than expelling the medic who refused to treat a dying Palestinian, ZAKA, the medical organization he works for, confirmed that this breach of triage is the protocol they are training.

“Usually already in the initial stage the attacker is identified, and our policy is to give precedence to the attacked with medical treatment,” ZAKA wrote on Twitter.

A Twitter poll started after the medic’s announcement indicates public support for attacking triage, with 88% of the 59 polled in support.

On October 18, Ziv filed a complaint over changes to the triage protocol with the Ministry of Health, but more than five months later, she has not received a response and the MOH has been silent on the issue.

A Pattern of Denying Medical Aid to Palestinians

In November 2015, the NGO Euro-Mediterranean Human Rights Monitor released a report documenting five separate incidents of denial of medical aid to Palestinians by Magen David Adom, which is officially recognized by the International Committee of the Red Cross, accusing it of violating the Geneva Conventions. “Such discrimination in providing medical treatment, even when a crime has been attempted, is prohibited and illegal under the International Convention on the Elimination of All Forms of Racial Discrimination.”

A video taken after a stabbing attack in the occupied West Bank last Thursday shows Israeli medics treating an injured Israeli soldier while two Palestinians lie on the ground, severely injured. Both Palestinians, Ali Jamal Muhammad Taqatqa, 19, and Ali Abd al-Rahman al-Kar Thawabta, 20, died of their wounds.

In video footage of the killing of 18-year-old Hadeel al-Hashlamoun in Hebron, an Israeli settler named Ofer – who local activists claim has no medical training and operates a fake ambulance – can be seen discouraging Israeli medics from treating her. Other videos show Israeli medical personnel standing idly as she bleeds to death, meanwhile medics from the Palestine Red Crescent Society were refused access to treat her. Amnesty International called her death an “extrajudicial execution.”

In another incident, 21-year old Yasmin al-Zarou was gunned down by Israeli soldiers, who then interrogated her as she bled on the ground. Israeli medics stood over her and even pushed her outstretched hands away as she asked for help.

Widespread Support

Last October, Deputy Minister of the Interior Yaron Mazuz publicly backed the change to triage. “The first priority should be give in to the residents of Israel, mostly to those who were injured from the attacks. Is it unacceptable that we would treat terrorists before residents of the state,” he said on Israel’s Channel Two.

But for Ziv, the MOH’s silence is unusual and deeply troubling.

“Even worse than the right-wing populist politicians who are just looking for headlines – fine, they understand nothing in medical ethics,” Ziv told me in a telephone call. “What worries me is that the Minister of Health [Ya’aldoesn’t see it as its role to say something very clear cut, and I wonder why is that so.”

Attacks on triage are also gaining support in Shaare Zedek, one of Israel’s top hospitals. Speaking at at a conference on the ethics of terror attacks, Dr. Ofer Merin, Executive Director of the Trauma Unit & Deputy Director of Medicine at Shaare Zedek hospital in Jerusalem, told the audience that adoption of this practice was inevitable – however in euphemistic terms.

“When we reach the ‘day of judgement’ in which we won’t be able to treat everyone, I think – and I say this with complete caution – that if it is impossible to treat everyone, I think there is no avoiding the moral statement that we need to give the innocents different rights than the person who harmed them intentionally,” he said.

Writing in the UK medical journal The Lancet, Merin subtly proposed the idea of abandoning triage in April 2015. “The moral issue of concurrently treating a terrorist and his victim is even more complex. Is it actually realistic to expect the staff to disregard the fact that the terrorist intended to kill the innocent person lying wounded in the same trauma unit?”

Ultimately, he concluded that “Punishment is not the role of the medical staff; rather, their duty and obligation is to preserve life and restore health. Judgment should be the exclusive provenance of the legal system and physicians should practice their art without discrimination and with a clear conscience.”

But the recent violence appears to have created the pretext for Merin to warn that the hospital would soon have no choice but to embrace racist medical practices.

Top state-funded rabbis have also endorsed this practice, abandoning the euphemistic terminology of a moral dilemma, and have even encouraged Israeli police and soldiers to execute wounded Palestinians deemed “terrorists” on the spot.

Rabbi Chaim Kanievsky, a top haredi authority, instructed paramedics from United Hatzalah to “not treat injured terrorists,” and that “If the terrorist was in a life threatening condition, they should leave him or her to die.”

“It is forbidden to leave a murderer alive,” Chief Rabbi of Safed Shmuel Eliyahu told the Galei  Yisrael radio station.

In another instance, Eliyahu said, “Only in a case where you really have no other choice…keep him alive, interrogate him and then send him to hell as soon as possible.”

Rabbi Ben-Tzion Mutzafi, another top haredi rabbi, ordered his students to bludgeon wounded Palestinians to death. “It is commanded to take hold of his head and hit it against the ground until there is no longer any life in it,” he said.

Rabbis Eliyahu and Mutzafi even called for soldiers and police who let Palestinians live to be prosecuted.

“The political situation in Israel is horrific,” Ziv lamented. “The atmosphere, environment and political leadership all influenced other systems in our [Israeli] society. Education has changed, courts have changed – the medical system is not immune to that.”

9 February 2016

Sir Michael Marmot & the Hypocrites (not Hippocratic) Oath – the World Medical Association's Support for Torture in Israel

Bombard the WMA and Complain to the GMC about Sir Michael Marmot’s Complicity in Israel’s Use of Torture

Professor Sir Michael Marmot (UCL Institute of Health Equity) was elected as President-Elect of the World Medical Association in 2014. 

One of Shin Bet's torture techniques - the banana  posture - that the World Medical Association covers for
Sir Michael Marmot - President of the WMA - Follows in the WMA's tradition of turning a blind eye i.e. approving Israel's Use of Torture


In his Presidential address to the World Medical Association, Sir Michael Marmot said that: "No one cares as much about health as we do in the medical and health professions. Of course, the WMA represents the interests of doctors and must continue to do that. But we also represent the interest of our patients and the populations that we serve.’
First page of Complaint by 71 British doctors regarding IMA's Approval of Torture in Israel
One can only assume that when Marmot spoke about representing the interest of patients and populations that he didn’t mean to include Palestinian patients.  How else to explain the fact that the complaint by 71 British doctors, including the eminent Psychiatrist Dr Derek Summerfield, Dr Chris Burns-Cox, Baroness Tonge, Ghada Karmi, Dr Swee Ang and Sir Iain Chalmers amongst others, was rejected out of hand?
Armed police women in front of Hunger Striker Alqiq room
What we see is the usual deference to Israel, the United State’s major ally in the Middle East, when it comes to the question of torture.  This isn’t too different from the silence of the WMA over the complicity of US doctors in the CIA’s use of torture.
There is no disputing that Israel tortures Palestinian prisoners - it even admits to it!  But the WMA doesn't want to know about the complicity of its Israeli section
Contrast this with the vigorous protests against the war crimes of the Turkish state under the dictator Erdogan.  It is of course extremely welcome that the WMA is holding the Turkish government to account for their atrocities in the Kurdish areas of SE Turkey and Cizre in particular. But it is sheer hypocrisy to complain about the behaviour of the Turkish state and then turn a blind eye to the actions of Israeli doctors.  Apart from anything else, it diminishes the force of the WMA’s complaints against  Turkey.
Israeli Medical Association's Response to Criticism of It Turning a Blind Eye to Torture in 2009
'If we would be provided with some shred of evidence other than the word of the prisoners'  The evidence of torture victims, especially if they are Palestinians, doesn't count
One has to ask why it is that Sir Michael Marmot, President of the WMA, on the 25th January, just 7 days after acknowledging a letter from 71 British doctors, who complained of the complicity of the Israeli Medical Association and Israeli doctors in the use of torture, rejected the complaint without any investigation whatsoever.
Armed Guards at Barzilai hospital Watch over Hunger Striker Mohammed Allan
Israel's use of torture is no secret. Torture has long been official policy in Israel [See e.g. Israel Admits Torture] and in recent months, what is termed, 'enhanced interrogation techniques' have even been used against far-right Jewish terrorists.

Mohammed Allan - Hunger Striker and Administrative Detainee
The WMA has a moral and ethical duty not to cover up Israel's use of torture any more than it should cover up the use of torture by Egypt, Saudi Arabia and other allies of the United Statesin the Middle East.
A post I left on the WMA's FB page suggesting that their criticism of Turkey might be a tad hypocritical
The WMA should either live up to its professed beliefs and to take actions against Israel's Medical Association or admit that its concern for human rights is selective and designed not to antagonise the Israeli state and its western sponsors. It is noteworthy that the Physicians for Human Rights Israel has echoed the call by 71 British doctors.  The actions of Michael Marmot are therefore all the more despicable.

The disgraceful letter sent by Marmot to the Israeli Medical Association - Attacks those who have complained in the past as the usual suspects and lies about the WMA having conducted any investigation - it has repeatedly taken the word of the IMA regardless of the evidence presented 
Complicity in the use of torture was the subject of the Nuremberg war crimes Tribunal and Nazi SS doctors were executed because of their complicity and active participation in torture, 'euthenasia' and medical experiments.  The complicity of Marmot in Israel's use of torture is to be complicit in a war crime.  As Marmot is registered with the GMC it is also duty bound to investigate his behaviour and I have accordingly submitted a complaint to them although, in view of the GMC's previous record with respect to doctors' breach of human rights in Irish cases, I have no confidence that it will succeed.   
Israeli  Demonstrators Against the Practice of Force Feeding

An example of the naked racism of the Israeli Medical Association is its letter to Marmot in 2009 when it explicitly stated that it didn't regard the complaints of Palestinians who have been tortured as evidence of torture.  The victims of torture are not to be believed, as a matter of course.  In recent months Israel has also begun to  torture Jewish prisoners too, as if any confirmation were needed of its practices.  see Israel isn't denying that it uses torture, it's justifying it 

See British Doctors Demand Israel’s Expulsion From World Medical Association and See Professor Sir Michael Marmot made President-Elect of World Medical Association 

You might also want to send Marmot an email telling him what you think of him
The WMA's adherence to hypocrisy rather than the Hippocratic Oath - It rightly criticises Turkey and then approves Israel's use of torture
 Submission to World Medical Association Against IMA January 2016

NEW EVIDENCE-BASED SUBMISSION TO WMA PRESIDENT MARMOT REGARDING COMPLICITY OF ISRAELI MEDICAL ASSOCIATION/ INDIVIDUAL DOCTORS WITH TORTURE IN ISRAEL
Yoram Blachar - previous Israeli President of the WMA - Supporter of Israel's use of torture
Dear WMA President/Sir Michael Marmot

We the undersigned 71 UK doctors wish you well in the Presidency of the World Medical Association (WMA). This is not a personal appeal, but a formal evidence-based submission to the WMA (7 pages, the list of signatories, 3 attachments).  We ask you as President to take this submission to WMA headquarters/Council and to ensure that action appropriate to the gravity of the case and the weight of evidence is taken at institutional level. It is on account of previous experience with the WMA (see below) that we are sending this to your UK academic email address rather than direct to the WMA Secretariat.

We bring a matter that lies squarely within the remit of the WMA as the official international watchdog on medical ethics, one that could hardly be more extreme.  Its subject is the collusion of doctors (and their national medical association) with torture, and it concerns one of your member associations – the Israeli Medical Association (IMA).  The WMA is mandated to ensure that its own members adhere to the WMA Declaration of Tokyo, the definitive international anti-torture code for doctors.  The Declaration states that doctors are forbidden from direct participation in acts that satisfy international definitions of torture, and, further, they are obliged to protect the patient, protest and speak out in situations where they encounter or suspect they encounter torture.  In 2007 the then WMA President, Dr John Snaedel made the second part of this ethical commitment crystal clear, stating that the WMA was explicitly advising doctors to document cases of torture when they encountered them.  Dr Snaedel added that the absence of documenting and denouncing such acts “might be considered as a form of tolerance and of non-assistance to the victim”. 

This submission is fresh but is grounded in the evidence-based submission made to the WMA in May 2009 by 725 medical doctors (including 114 professors) from no less than 43 countries- a principled coalition of unprecedented breadth. 235 signatories were from the UK; some of these are signatories again today, some signatories are new. Emailed via the WMA Secretariat, we addressed the then WMA Council Chair, Dr Edward Hill and the whole Council.  We attached some of the documentary evidence published by organisations of high repute like Amnesty International which pointed unambiguously to the use of torture as an instrument of state policy in Israel, and to the ongoing active and passive collusion with torture by Israeli doctors attached to interrogation units, shielded and defended by the IMA.  We did not address the appeal to then WMA President Yoram Blachar because the probity of his presidency was what we were in part contesting. As longstanding IMA President, Dr Blachar had become known for his repeated refusal in medical journals like the Lancet or BMJ to admit the existence of torture in Israel, and in particular to admit what as long ago as 1996 Amnesty International had described as the everyday and institutionalised involvement of doctors with torture. Dr Blachar had consistently claimed that such claims were slanderous and malicious, vilified those who had made them, ignored the evidence base, and pointed to membership of the WMA as proof in itself of the ethical credentials of the IMA.  Indeed Dr Blachar once went as far as to justify the use of “modest physical pressure” (condemned as torture by the UN Committee Against Torture ) in the Lancet in 1997 (350:1247). On the BMJ website he dismissed a 2004 BMJ article on health and human rights in the Occupied Palestinian Territories –a paper which cited Amnesty, Johns Hopkins University, the International Court of Justice, a UN Rapporteur, and Physicians for Human Rights-Israel – as “the lies and filth he spews….reminiscent of some of the worst forms of anti-Semitism ever espoused”.  Dr Blachar’s ascension to the WMA Presidency seemed to us in 2009 to make a mockery of the idea that the WMA could represent an effective and even-handed regulator of medical ethics worldwide.  I am attaching our initial letter in 2009 to the WMA Council Chair, a summary of the evidence we appended, and a list of the 725 signatories. (attachment 1)

None of this documentary evidence has ever been acted on: to give the flavour we will revisit just two pieces of evidence we attached at that time.  A report in 2007 by the Public Committee against Torture in Israel (PCATI), based on the detailed testimony of nine Palestinian men tortured between 2004 and 2008, gave a graphic demonstration of extent to which Israeli doctors continued to form an integral and everyday part of the running of interrogation suites whose output was torture.  Doctors, some of whom were actually named, saw the prisoners at various points between episodes of torture (which in one case led to spinal cord damage), did not take a proper history, did not protest on these men’s behalf, and typically prescribed simple analgesia before returning to their interrogators.  They did not need to ask the prisoners what had happened to them because they knew perfectly well.  It was notable that doctors in positions of authority were involved in several of these cases, like the Chief Medical Officers of the Israeli Prison Service and of the Israeli Police. The PCATI report was sent to the IMA, whose Ethics Chair was then Professor Avinoam Reches, and the IMA later conceded to PCATI that they had indeed received this.  No action was taken, which in itself was a prima facie violation of the Declaration of Tokyo requirement that if doctors hear or suspect that torture has taken place, they must investigate and speak out.  This was straightforward collusion by the IMA. The IMA eventually told PCATI they would investigate and we attach a scan of their 2009 report back on their travesty of an ‘investigation’ (attachment 2). Professor Reches stated that they had attempted to contact the doctors in question, that all had denied any past or present connection with the Israeli Prison Service- a denial the IMA accepted at face value.  Their conclusion that there was no “shred of evidence other than the word of the prisoners” , so no further action could be taken. This says it all: what kind of investigation starts with a blanket dismissal of the testimonies of the victims? Here we see transparently how the IMA maintains its solidarity with the status quo in interrogation centres, and how it fails to provide ethical leadership to Israeli doctors posted to such centres.

Secondly, in the November 2008 annual report to the UN Committee Against Torture, the UAT Coalition, a coalition of 14 Israeli and Palestinian human rights organisations, concluded that “since the Committee last reviewed Israel, the practice of torture and ill-treatment has continued unabated.  The UAT Coalition wishes to inform the Committee that in its opinion the use of torture and ill-treatment by Israeli authorities against Palestinians is both widespread and systematic.  The UAT Coalition has recorded evidence of acts, omissions and complicities by agents of the State at all levels…..until this culture of impunity is addressed this situation is unlikely to improve”.

IMA membership of the WMA appears to have been a figleaf designed to deflect criticism.  The IMA pays lip service to medical ethics and to the Declaration of Tokyo but their actual behaviour over many years points the other way. Physicians for Human Rights-Israel (PHRI) describes the IMA as basically playing the role of loyal State actor, upholding a decision on political grounds to turn a blind eye to torture in Israel while it remains intrinsic to State policy- and thus to provide moral cover for the actions of Israeli doctors implicated in this, regardless of the Declaration of Tokyo.

To set the scene for this new appeal to the WMA it is necessary to describe briefly how the WMA responded to the 2009 appeal.  As noted above, we sent the appeal to the WMA Council. Council members are geographically scattered , so we sent the dossier to the Secretariat and asked them to forward to each member. Only later we established that this had been blocked, that Council members had been kept in the dark and had never seen the material!  Dr Blachar, as WMA President, vilified the signatories in the Israeli and London Jewish press, pointed contemptuously to those signatories with Arab sounding surnames, and most pointedly of all instructed London libel lawyers Finers, Innocent and Stephens to begin a libel writ against appeal convenor Dr Derek Summerfield.  It seemed grotesque that a principled appeal so securely grounded in evidence from multiple independent, reputable sources, highlighting an issue at the heart of why the WMA was founded after World War 2, should be answered by the WMA President with a libel suit!  Assisted by academics like Professor Noam Chomsky, who had supported the appeal from the outset, we resisted the suit.

At no time did we ever receive an acknowledgement from the WMA that we had written to them. Repeated reminders sent at intervals to the WMA and to permanent Secretary General Dr Otmar Kloiber, elicited nothing.   Finally lead signatory Professor Alan Meyers rang up Dr Edward Hill in his medical clinic in the US, and was told that the WMA would take no action to investigate the IMA and the probity of Dr Blachar’s Presidency, and requested us not to send any more material.

You may remember that at a point when you were on the WMA Council, Sir Iain Chalmers and Professor John Yudkin approached you about all this.

Faced with this naked refusal by the WMA to act as mandated, we felt we had to move on to the UN Special Rapporteur on Torture, first Manfred Nowak and latterly Juan Mendez.  We conveyed to him our experience of the WMA’s refusal to act.  A special rapporteur does sometimes investigate individual cases, including within Israel, but we were informed that the investigation of civil society bodies like a national medical association was outside the remit of the Rapporteur. It is however what the WMA is for.

At the heart of this fresh appeal is the most recent comprehensive report by PHRI and PCATI- “Doctoring the Evidence, Abandoning the Victim: the Involvement of Medical Professionals in Torture and Ill-treatment in Israel (2011). See online at stoptorture.org.il.  It is based on testimonies and other evidence from the files of over 100 victims of torture and ill-treatment handled by PCATI/PHRI since 2007.  Its summary affirms that “medical professionals abandon their duty by failing to document and report torture; by passing on medical information to interrogators; returning detainees to the custody of their interrogators when in danger of being exposed to further torture or ill-treatment; and in extreme cases, by taking an active part in the interrogation.  Because of their unique social status, the presence of medical professionals in facilities where torture or ill-treatment are carried out indicates the boundaries between the permissible and the impermissible: it grants Israeli Security Agency (ISA) interrogators a stamp of approval, whether explicit or tacit, that their conduct is acceptable”.

The report also notes that this conduct by doctors “furthermore precludes the victim from presenting evidence which can aid in pursuing justice through various legal and administrative proceedings”. The significance of this can be seen in the fact that “over 700 complaints alleging torture/ill-treatment by ISA interrogators have been filed since 2001 and not one single criminal investigation has been initiated”. Complicity by doctors is therefore a significant force in maintaining the impunity of ISA interrogators.

PCATI/PHRI record that “medical staff in prisons, detention centres and hospitals which treat prisoners are part of the broader administrative systems, primarily the medical apparatus of the Prison Service, the Israeli Medical Association and the Ministry of Health”. Torture continues to receive the full institutional backing of the state.

From long experience PCATI/PHRI conclude that “there are serious doubts that the IMA is willing to enforce these rules: persistently repeated requests by PCATI/PHRI calling the IMA’s attention to cases arousing suspicion of doctors’ involvement in torture and cruel or degrading treatment, have not been dealt with substantively.”   PCATI/PHRI note that the IMA’s ethical code contains clauses which do not accord with the fundamental principle of medical ethics, which is that the well-being of the patient should be the doctor’s sole concern.  IMA codes require the doctor to respect “the good of society as a whole and its right to protect itself”, authorising the doctor to assist the security authorities upon their request, even when this may harm the rights of the patient….  “With these clauses, the IMA enables the needs of the security apparatus to be seen as coming before the ethical duties of doctors”. 

We provide a selection of the specific cases detailed in the report, and with named doctors.

l. Failure to document, see Cases MA (incriminating Drs Laikh Victoria and Rodvan Yelena) and case AR.

In Case MA the injuries inflicted on the detainee included an eye injury which 1 month later was still preventing him from reading because of blurring. Dr Victoria recorded no injuries and merely wrote “overall condition satisfactory, heartbeat regular”. The subsequent examination by Dr Yelena also documented no injuries. 2 weeks after the first examination MA was referred to an eye doctor by a court. As the report puts it “if so long after the arrest a judge was convinced of the necessity of treatment, the same should certainly have been expected of a doctor whose job this is”.

AR was arrested on 17 June 2010, assaulted, and interrogated for 6 days while handcuffed in a painful position. On 12 October 2010, nearly 4 months later, AR told a visiting PCATI attorney about his treatment and attempted to show the marks still present. His medical file contained no documentation of these injuries.

Access to medical files is anyway often delayed for months following requests by PCATI or PHRI for copies, arrive only partially complete, illegible, or have apparently been lost.

II  Silence as Consent.  Case JM was of a man from Jenin whose shoulder was dislocated by a soldier during arrest. He was taken to Kishon Detention Centre where Dr Saliman Fares recorded that he had pain in his right shoulder, but nothing more specific nor the cause.

In Case TS the detainee was ill-treated both during arrest, including being bitten by a dog brought by the soldiers, and in a military base. He was transferred to the notorious Russian Compound (where interrogations take place). Here his condition prompted the prison doctor to refuse to accept him and he was transferred to hospital. His medical file from “Sha’arei Tzedek” hospital in Jerusalem signed by Dr Alexander Bergman records the bite, and a detention centre doctor Dr Emil Erkin informed the interrogators of the injury by means of a special form (an unethical practice in itself, as the report notes). “Neither in the medical file nor anywhere else is there any record suggesting that the case was reported to an external body of any kind by any of the doctors who encountered him, not those at the military facility, the Russian Compound, the hospital or Kishon.”

TC was arrested on 1 July 2006 and during the course of interrogation lasting several months was subjected to “hitting, isolation, sleep deprivation, prolonged cuffing to a chair in a position so painful it led to loss of consciousness, threats and curses….his body was so harmed that an attorney who met him several days after the interrogation had ended was able to easily make out the injury marks.” Of the doctors he saw over the course of his interrogation, one  told him to co-operate with his interrogators, another refused to check his injured eye when requested to do so by TC, and his medical file revealed only some details (with some doctors reporting nothing of his injuries). PCATI/PHRI subsequently discovered a memorandum dated 5 March 2007 which showed that a Detention Centre doctor had recorded TC’s complaint of an assault 4 days earlier and had noted injury marks. The doctor addressed this to the Commander of the Detention Centre but to no other authority, in clear violation of his ethical duty.

III. Refoulement ( returning the victim to the torturers despite evidence of torture). Such action serves to afford the interrogators medical permission to continue with their practices, drawing the doctor into the circle of active participation.

Case BA suffered from severe pain in arm, leg and back following ill-treatment but the doctor ignored this, took his blood pressure and said “all is well and there is no problem”. There is no documentation covering this clinic visit but in Shikma Prison Dr Shimon Kaslesi noted that “the patient had no complaints and that his overall condition was good.” He was returned to the Russian Compound for further interrogation.

Case SA was treated similarly to TC above. At one point he vomited blood. His medical file records several clinic visits after which he was returned to the interrogators. In a report dated 2 May 2010 Dr Vladimir Gudin describes “use of reasonable force”. PCATI/PHRI comments thus: ”On what basis did the doctor know that “reasonable force” had been used? SA’s medical file shows that, though a number of doctors were witness to his distress, which itself resulted in part from interrogation conditions, they nevertheless chose to return him to the control of his interrogators and to the very same despicable imprisonment conditions, over and over again”. 

KhZ, arrested 13 January 2011, was knocked unconscious during arrest, and at the Russian Compound was further abused as in the cases above.  According to his testimony he saw doctors on an almost daily basis, but was always returned to the interrogators. Documents dated 16 January 2011 and 10 February 2011 signed by Dr Ganady Lesitza lists complaints of headache and of lack of sleep but nothing more.

IV. Serving the Interrogation over Medical Confidentiality. In Case G.Tz the detainee was held in a series of painful positions, assaulted, handcuffed to the point of bleeding, and members of his family were arrested to apply pressure to him. At Kishon Detention Centre Clinic a form signed Dr Galina Veinar recording “pain in the hands due to an injury to a nerve in the hand” was addressed to the Officer in Charge of Special Interrogations Wing. As PCATI/PHRI comment, “plain and unadorned, medical information about the interrogee is passed to an outside body”, moreover a body whose interests are directly opposed to those of the detainee. The injury is likely to have resulted from prolonged tight handcuffing.

Case MJ is similar, incriminating Dr Vladimir Gudin.

V. Doctors or Interrogators?  Case SD asserts that he was “brought before a doctor many times” (doctor not named) and told he could “get out of…his military interrogation” (ie. torture) if he were to co-operate with his interrogators.

VI. Behind Bars or Hospital Walls. In Cases SB, the hospital release form read as follows: “Says that 2 days ago was struck in the head, left eye and upper back without losing consciousness. Fully conscious, calm during examination. Haematoma of left eye, abrasion on right upper back”. Thus the doctors had diagnosed SB as a victim of violence whilst in custody, but did not report this to any external body (as the WMA Declaration of Tokyo mandates) and after treatment returned him to custody.

In Case JM (2), a man from Tulkarem, the doctor, and ambulance crew, appear to have colluded with the interrogator who asked them to support an agreed version of events, which was that the detainee’s injuries had been caused by his falling down some stairs rather than through torture sustained during 20 days of intensive interrogation. JM was then taken by ambulance, hands and feet cuffed, to “Laniado” hospital in Netanya. When JM told the examining doctor that it was a lie that he had fallen down stairs, but that he had been beaten, the response was this was not her business, that the cause of injury was of no interest. Several other doctors who saw the detainee in Laniado hospital responded similarly when the detainee tried to tell them what had happened to him. After his head injury was sutured he was discharged, having heard his interrogator tell the doctor to try to avoid keeping him in hospital. The files show that Dr Alexander Afensayev examined him on 5 October 2008.

The doctors who saw JM consistently ignored his complains about violence, did not document his injuries in a way that would allow their origin to be identified, did not report them to an outside authority, and did not hesitate to return JM to the custody of his interrogators despite what had already been inflicted on him by them.

An appeal was subsequently made by PHRI or PCATI to the IMA, the Ministry of Health and the hospital. The IMA response was merely to ask if the police had been approached, and as in all other cases they did nothing, despite their ironclad obligation in terms of the WMA Declaration of Tokyo.

To conclude, PCATI/PHRI devastatingly report that “except for one case (JM, where even here the doctor reported in only a limited way, insufficient to satisfy the Declaration of Tokyo) our research did not discover a single case where torture and ill-treatment were reported.” This makes it transparent that the problem is not one of a few rotten apples in the barrel, but of institutionalised practice.  Individual doctors who transgress in these ways carry individual culpability, but major responsibility must lie with their professional bodies, notably the IMA. If challenged such doctors could realistically claim that the IMA had never meaningfully instructed them to behave differently, had never instigated proper investigations when challenged with specific cases (as in this report) and had in effect an implicit policy to endorse the status quo on torture on political grounds- as the evidence shows overwhelmingly. This is why the focus of our campaign has been the IMA, who could halt the practice of torture in 5 minutes by obliging doctors to act ethically whenever their findings suggest torture, or indeed by forbidding doctors to work in units where torture is routine.  PCATI/PHRI cites the case of South Africa and in particular the precedent set by Dr Wendy Orr in exposing comparable abuses by the Medical Association of South Africa (MASA) and individual doctors during the apartheid era. This led to the exclusion of the MASA from the WMA for a period.

In early 2013 a well- publicised case further highlighted the intimate involvement of Israeli doctors in these matters.  A healthy 30 year old man Arafat Jaradat, arrested on suspicion of throwing stones,  died after several days of interrogation by Israeli Shin Bet internal security service on February 23rd, 2013 at Israel’s Meggido prison.  An autopsy was held next day at Israel’s institute of Forensic Medicine in the presence of Dr Saber Aloul, the Palestinians Authority’s Chief Pathologist, who assessed that the bruising on the body was evidence of torture.  The Israeli authorities denied this, claiming in their defence that Jaradat had been seen by Israeli doctors two days before his death and they had found him in good health.   This disclosure begged the medical ethical question: what where these doctors examining him for, if not to assess whether he could withstand torture or further torture? (Analogously, the existence of a “fitness for interrogation” form came to light some years ago in Israel, to be signed by a doctor. Since interrogation routinely meant torture, the doctors were giving the green light to the interrogators and were part of the whole process.) 

It has been clear to us and to PHRI that IMA postholders have been for many years well embedded at the WMA. We note that amongst current WMA Council members is Leonid Eidelman, who as successor to Yoram Blachar as IMA President maintained entirely the same line. On the basis of our experience since 2009 it seems irrefutable that the WMA has committed itself to shielding Israel no matter what – though the WMA does speak out about possible involvement of health professionals with torture in other countries, like Iran or Bahrain. This lack of evenhandedness is ethically corrupt. Failing to act on the voluminous body of evidence to which we point is to implicitly support the IMA position, and to put the WMA in complicity with what passes in interrogation centres.  In relation to the regulation of something that goes to the heart of the public reputation of the medical profession, it appears that the WMA and some of its officers (not least the Sec Gen) are not fit for purpose. You are an academic with an international reputation and profile. In becoming President of the WMA you cannot but take responsibility for the integrity and probity of the organisation.  We UK doctors request that the appropriate arm of the WMA examine this report, note the continuity with the evidence we cited in 2009, and hold the IMA (and named doctors) formally to account for its contents.  If the mountain of evidence incriminating the IMA were to be judged insufficient to make the case at the WMA, then no evidence ever would.  As noted earlier, the WMA is mandated to ensure that its member associations abide by its statutes. If it will not act now, when would it? The Declaration of Tokyo cannot be a mere paper exercise. Taking the precedent of the exclusion of the Medical Association of South Africa from the WMA, we submit that similar action regarding the IMA is justified by the facts.

There are many people beyond the signatories who are concerned about the outcome of this appeal, and the BMJ have taken an interest from the outset in 2009, publishing several articles and letters over the years (the last in 2014) and highlighting “Doctoring the Evidence, Abandoning the Victim: the Involvement of Medical Professionals in Torture and Ill-treatment in Israel” when it was first published (see BMJ article, attachment C).

We look forward to hearing from you.  We note with confidence that in your WMA inaugural address in Moscow on 16 September you affirmed that  “The WMA upholds the highest ethical standards of the practice of medicine”, and that “I want the WMA to use the same moral clarity to be active against the causes of ill-health.” The cause of ill-health we are concerned about is of course torture, no less, and the complicity of medical leadership in Israel that with open eyes helps to keep it going.

As a matter of significant public interest, we are copying our appeal and evidence to the editors of the BMJ and The Lancet, and to the Guardian and Independent.

Yours sincerely

Dr Chris Burns-Cox              Physician                       Wotton-under-Edge (lead signatory)
Sir Iain Chalmers               James Lind Library              Oxford
Baroness Tonge                  House of Lords                  London
Dr Pauline Cutting OBE          Emergency Medicine Consultant    Bangor
Professor Sami Timimi           Child Psychiatry                        Lincoln
Dr Ben Alofs                    General Practice                Bangor
Dr Derek Summerfield            Psychiatry                      London (convenor)
Dr Swee Ang                     Orthopaedic  Surgery            London
Dr Zeyn Green-Thompson  Psychiatry                      Cambridge
Dr Mostafa Mohanna              Psychiatry                      Lincoln
Dr David Halpin                 Orthopaedics & Trauma    Newton Abbot
Dr Philip Thomas                Psychiatrist                    Hebden Bridge
Dr Tia MacGregor                General Practice                Oxford
Dr Sukaina Hirji                        General Practice                Watford
Dr Alex Scott-Samuel            Public Health                   Liverpool
Dr Daniel McQueen               Psychiatry                      London
Dr Tom Gilberthorpe             Psychiatrist                    London
Dr Maha Elias                   Anaesthetist                    Weston Super Mare
Prof. Marco Chiesa              Psychiatry                      London
Dr Chris Evans                  Psychiatry                      London
Dr Alison Payne                 General Practice                Coventry
Dr Numan Shah                   Trauma & Orthopaedics           Leeds
Dr Suman Fernando               Psychiatry                      London
Dr Kamilia El-Farra             Gynaecologist                   Bishops Stortford
Dr Nik Husain                   Anaesthetist                    Kingston-Upon-Thames
Dr Pam Wortley                  General Practice                Sunderland
Dr Catherine Houghton           Respiratory Medicine            Bury
Dr Sonia Allam                  Anaesthetist                    Larbert
Dr Nuri Gene-Cos                Psychiatry                      London
Dr Suheib Abukmeil              Psychiatry                      Northampton
Dr A Ravalia                    Anaesthetist                    Kingston-upon-Thames
Dr Ala Jebreel                  Ears, Nose, Throat              Sheffield
Dr Maged Agour          Psychiatry                      Doncaster
Dr Assaddullah Reha             Psychiatry                      London
Dr Coral Jones                  General Practice                London
Dr Brian Robinson               Psychiatry                      Milton Keynes
Dr Charles Essex                Paediatrics                     Leamington Spa
Dr Colin McKean         General Practice                Liverpool
Dr Tim Paine                    General Practice                Bristol
Dr Felicity de Zulueta          Psychiatry                      London
Dr Walid Abdul-Hamed            Psychiatry                      Chelmsford
Dr Sushrut Jadhav               Psychiatry                      London
Dr Katy Briffa                  Psychiatry                      Tavistock
Dr Rhodri Huws                  Psychiatry                      Sheffield
Dr Duaa Saeed-Chesterman        Histopathology                  London
Dr Khalil Hossenbux             Internal Medicine               London
Dr Sylia Chandler               General Practice                Evesham
Dr Jo Moncrieff                 Psychiatry                      London
Dr Mamdouh El-Adl               Psychiatry                      Northampton
Dr Tomasz Pierscionek           Psychiatry                      Newcastle
Dr Neil Wellappili              Psychiatry                      London
Dr Rukyya Hasssan               Psychiatry                      Manchester
Dr Aneesa Peer                  Psychiatry                      London
Dr Tessa Harris                 Population Health Research Institute    Reading                
Dr Musa Sami                    Psychiatry                      Kent
Dr Ghada Karmi                  Public Health                   London
Dr Eric Windgassen              Psychiatry                      Manchester
Dr Bob Johnson                  Psychiatry                      Isle of Wight
Dr Sandra Oelbaum               General Practice                Liverpool
Dr M Makhdum                    Psychiatry                      Colchester
Dr Jane Hamilton                Perinatal Psychiatry            Stirling
Dr Ian Kerr                     Psychiatry                      Stirling
Dr Roger Allen                  Dermatology                     Nottingham
Dr Stephen Ginn         Psychiatry                      London
Dr Norbert Andersch             Psychiatry/Neurology            London
Dr Carine Minne         Forensic Psychiatry             London
Dr Betty Gordon         Surgery                         London
Dr Hisham  Al-Qassab            Physician                       London
Dr Anna Livingstone             GP/medicolegal reporting        London
Dr Estela Welldon                Forensic Psychiatry             London
Dr Brian Martindale             Psychiatry                      Newcastle