22 December '15..
The Israeli Medical Association has reversed a 2008 decision mandating that doctors at the scene of a terrorist attack treat victims before the terrorist, regardless of the severity of the attacker's wounds.
Only a week ago -- in the midst of an unprecedented terror wave of stabbings and car rammings -- a change was suddenly made to the medical ethics regulations, literally out of the blue. The IMA Ethics Board's guideline stipulated that "charity begins at home" -- that is, in a case where personnel or equipment are in short supply in a multi-casualty terrorist attack, the victims should be treated before the terrorists. It was decided to eliminate that instruction and the only rule that remains in place is the one that decrees that the wounded must be treated according to the severity of their condition and ability to survive, and no other criteria. In practice, this means that the terrorist would have to be treated before his victims, if it turns out that his wounds were more severe than theirs, which is entirely feasible, if he has been shot by the IDF or an armed citizen.
The IMA not only made its decision without any prior public debate, but it clearly sought to hide it from the public, which is even more troubling and sinister.
Israel Hayom reported that the announcement about the revocation of the previous rule simply appeared on the IMA's website and that "the IMA was apparently concerned about widespread political and ethical criticism of its decision."
The IMA has every reason to be concerned. Such a decision of life and death, taken behind the back of the Israeli public and sneaked into policy by a mere announcement on a website is odious in itself. But it gets worse.
One has to ask oneself why the IMA decided to reverse this crucial guideline? Here is the reason in all its tragic simplicity: In October, members of Physicians for Human Rights contacted IMA Chairman Dr. Leonid Edelman and IMA Ethics Board Chairwoman Dr. Tami Karni. Their demand: Cancel the "charity begins at home" clause in the regulations on treating terrorism victims. Physicians for Human Rights argued in a letter that the organization was convinced that the principle went against the ethical principles that have guided the medical community until now. Following the appeal by members of Physicians for Human Rights, the Ethics Board held a discussion on Dec. 1. At its conclusion, a decision was taken to accede to the organization's request and cancel the "care for your own" clause entirely. According to Ethics Board members, most members agreed with the decision.
It is interesting that one appeal from a nongovernmental organization can reverse the policy on such a crucial question for an entire nation just like that, isn't it? Since Physicians for Human Rights wield such tremendous influence, being able to sway the entire IMA Ethics Board, it is relevant to look in depth at who they are.
Physicians for Human Rights-Israel was founded in 1988 and claims to be "a nonprofit, nongovernmental organization that strives to promote a more fair and inclusive society in which the right to health is applied equally for all." According to its mission statement, PHR-Israel strives to "put an end" to "Israel's prolonged occupation over Palestinian territory," which it views as "the basis of human rights violations."
The organization has a budget of approximately 9.5 million shekels ($2.4 million) and it is funded by a number of pro-Palestinian international organizations that have nothing or little to do with medical issues (Bread for the World, Human Rights and International Law Secretariat, Diakonia and others which are funded by Sweden, Germany, Switzerland, Denmark and the Netherlands). PHR-Israel is also funded by the European Union, the U.N. High Commissioner for Refugees and others. In January 2015, PHR-Israel published "Gaza 2014: Finding of an independent medical fact-finding mission" which turned out to be yet another Israel-bashing report, which NGO Monitor described as having "no independence, no facts, no evidence."
What we have here is another clear-cut example of foreign and hostile governments and organizations taking a shot at Israel by political warfare. This is just the latest tool in the toolbox of political warfare: Medical warfare.
While the resourcefulness of Israel's enemies in searching for, aiming at and hitting our softest spots is impressive in its mendacity, it is tragic to watch the ease with which they are enabled to succeed in their most deceitful endeavors. This is warfare and those who wish to undermine Israeli society use all means possible -- including hitting our guidelines on saving our own citizens from terrorists.
What is astounding here is not that Israel's enemies try with all means, but that they succeed with such ease. How is it possible that the IMA did not question the origin of the request, coming as it did from Physicians for Human Rights, a deeply hostile, leftist NGO with a clear agenda of working for the undermining of Israel from within and with ample foreign funding?
Why did not a single member of the IMA question the deeply suspect timing of such a request -- in the midst of a devastating terror wave?
Why did no one in the IMA find it necessary to consult with the public or at least members of the public with deep knowledge of an issue that might have absolutely devastating consequences for terror victims if followed?
The irresponsibility of the whole thing is mind-boggling and brings one to question whether members of the IMA Ethics Board are fit for the positions of extreme responsibility that they fill. They simply served as a Trojan horse for the hostile intentions of the backers of Physicians for Human Rights.
Thankfully, the reversal has been met with harsh criticism and requests to reverse the decision. One such request came from Rabbi Yuval Cherlow, who heads the ethics division of the Tzohar rabbinical organization. Cherlow knows the issue of medical ethics first-hand; he is a member of the Supreme Helsinki Committee on Medical and Genetic Experiments Involving Human Subjects, and formerly served as the public's representative on the National Conference to Expand the Medical Basket.
"The dramatic new instructions are a serious mistake," Cherlow says. "The wounded at the scene of a terrorist attack should always be treated first, and only then the attacker. Only in special cases, in which it can't be determined who the terrorist is and who the victims are, should medical treatment be given to the most seriously wounded first."
According to Professor Asa Kasher, a renowned philosopher and ethicist who wrote the Israel Defense Forces' code of conduct, "The immediate example that comes to mind is the difference in battlefield triage, which has to account for things beyond pure medical considerations, like sending soldiers back to their units as quickly as possible.
"The same goes for the scene of a terrorist attack. You can't run it according to pure medical considerations -- that's just out of the question. Say you have two people seriously wounded, the terrorist and a victim. The terrorist's wounds are slightly more serious than the victim's. Would you treat the terrorist before the victim? That's unthinkable. There is more to the scene of a terrorist attack than pure medical considerations -- as there should be. What are we supposed to tell a victim's family if he dies because we treated the terrorist first? That we're sorry, but we had no choice but to treat the terrorist first? That's absurd."
ZAKA emergency response service Director Yehuda Meshi Zahav was outraged by the decision: "We will instruct our volunteers to first treat injured Jewish victim, without thinking twice," he said. "And only after [will they treat] the terrorist murderer who carried out the attack. Despite the ethical code which mandates the most injured victim be treated first, you must know morality has a limit. If we will not keep our distinction, we will lose our direction. Even in Halachah, it is written: All who are merciful to the cruel will end up being cruel to the merciful."
Not being merciful to the cruel is what our tradition teaches. Foreign-funded, hostile NGOs such as Physicians for Human Rights must not be allowed to dictate life-and-death issues for Israeli citizens through an unelected body such as the IMA. Everything possible should be done by responsible Israeli authorities, if need be with the intervention of Knesset members, to reverse this shameful decision.
Judith Bergman is a writer and political analyst living in Israel.
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