Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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The Interests of the Iraqi People Should Come Before the Rights of a Dictator
- Riadh T Abed (9 January 2004)
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unethical exam preceded by media dehumanisation
- Douglas J Carnall (9 January 2004)
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Monster(ou)s
- David Carvel (10 January 2004)
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What a pity
- Ali H Rasheed, Baghdad (10 January 2004)
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Showing Saddam was not a breach of Iraqi society's values
- Layth Delaimy (11 January 2004)
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Saddam examination evokes double standards
- peter j mahaffey (12 January 2004)
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Jabbour is a disgrace to Arab medical ethics
- Riadh T. Abed (12 January 2004)
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Iraqis are not offended
- Rihab F Tawfik (12 January 2004)
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Who is responsible?
- Diwa Nath das (14 January 2004)
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Crocodile tears on a fallen dictator
- Nazad Khasraw Ghafoor (14 January 2004)
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Medical Ethics and Politics
- Thalia A. Arawi (14 January 2004)
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AMAZING LOGIC!
- Dr. Akeel Alsadi (14 January 2004)
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Ethics of consent should be universally applied
- Douglas J Carnall (14 January 2004)
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Good Dictator or Bad Dictator?
- Gyan Fernando (14 January 2004)
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Shame on Dr Carnall
- Richard Watson (15 January 2004)
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Iraqi's delight at the capture of Saddam
- Rizgar Amin (15 January 2004)
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Saddam
- Mark Benjamins (15 January 2004)
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Fall of a dictator
- Michael O'Donnell (15 January 2004)
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The Civilized v The Barbarians
- Mark Struthers (16 January 2004)
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Fall of Tyrant but no fall of ethics.
- Farid Munim (18 January 2004)
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Re: Ethics of consent should be universally applied
- David Carvel (18 January 2004)
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Wait for the dictator to complain
- Layth Delaimy (18 January 2004)
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Re: Fall of a dictator, failure of ethics
- Samer Jabbour (19 January 2004)
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Why that physical exam ?!
- Sany Abdel-Aziz Hleis (19 January 2004)
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It is certainly a case of double standards
- Wasim Maziak (20 January 2004)
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Please, no thanks, but please, no abuse
- Calvin S. Ennis, Box 1358 Escatawpa Ms USA (29 March 2004)
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Re: Jabbour is a disgrace to Arab medical ethics
- jay taylor (25 June 2004)
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Riadh T Abed, Consultant Psychiatrist Rotherham District General Hospital, Moorgate Road, Rotherham S60 2UD
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I'm afraid that Dr Jabbour is wasting his ink using the case of Saddam Hussein to question the ethics of the American doctors who allowed the films to be taken of the dishevelled Saddam being examined after his capture. His article seems to betray a hidden and bitter disappointment at the dictator's disgrace despite the somewhat forced use of adjectives like 'criminal' and 'ruthless' to describe him. It should be remembered that Saddam would not have survived summary execution if he had been removed by a popular uprising rather than by coalition forces and therefore owes his survival so far and the humane conditions of his custody to the Americans. Furthermore speaking as an Iraqi citizen if the showing of the dishevelled Saddam would convince a proportion of his criminal followers to desist from killing and maiming Iraqis and the coalition forces in the name of resistance then the right to life of Iraqi citizens would take precedence over the rights of the dictator to enjoy the dignity he denied us during his rule. As it is Saddam has had more rights in captivity than any Iraqi has enjoyed under his rule. I would counsel my non-Iraqi Arab colleagues to stop feeling shocked about the treatment of Saddam and start feeling shocked about the crimes he has committed. Sadly most of these crimes went unrecognised and uncondemned by any Arab Medical or Professional organisation. The true ethical question for Arab doctors is to issue an apology to the Iraqi people for their years of silent while he was murdering them and forcing Iraqi doctors to violate their medical ethics by mass participation in the abuse of medicine. Competing interests: None declared |
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Douglas J Carnall, General practitioner London
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I agree with Jabbour's conclusion that the broadcast of Saddam Hussein's medical examination was a gross breach of medical ethics, and hope the World Medical Association will invite the practitioners involved to explain themselves. Such dehumanising treatment of a prisoner is, I suppose, unsurprising from the regime that runs Guantamano Bay. Perhaps it is appropriate to note here that the western media seemed happy to co-operate with Mr Hussein's elevation to world-hate-effigy, its correspondents routinely using the disrespectful "Saddam" to address the former president of Iraq rather than "Saddam Hussein," "Mr Hussein" or "former president." Even Orwell's Emmanuel Goldstein had the dignity of being addressed by his surname. Roll on Hate Week, eh? [2] Let's hope for doctors the world over who have enough guts and independence to refuse to join in. References 1 Jabbour S. Fall of a dictator, failure of ethics BMJ 2004; 328: 115 2 Orwell G. Nineteen Eighty-Four. London: Martin Secker and Warburg, 1949 Competing interests: None declared |
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David Carvel, GP UK ML12 6BE
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"The display of Saddam, looking as he did like a monster, will almost certainly contribute to forming an image in the public's eye that is not in Saddam's favour" My dictionary (Collins Millennium Edition) defines "monster" as "a cruel, wicked, or inhuman person". This would seem to be a fairly fitting description of Saddam (no apology to Dr Carnall either!), regardless of his physical appearance on the day of his capture. I searched Medline seeking Samer Jabbour's condemnation of the million people murdered under Saddam's regime (and Iraqi doctors' roles therein). I could find no single reference let alone a million. I thought there may have been considering Professor Jabbour feels he is in a position to be concerned about Saddam's "image". Competing interests: None declared |
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Ali H Rasheed, Psychiatrist MOh-PTSD team, Baghdad
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I think that the end of the dictator should be a lesson to many dictators on this Globe. But, a point to be mentioned, the frustrations Iraqi people feel from the unseen and foggy future. Iraqis thought the the light at the end of the dark tunnel will shape their new era, but that was just a big lie. The occupiers render the country a disrupted and outlaw country, and we like to believe that a new era has just started.And hope the occupier should respect the human rights of the Iraqis and prisoners, who mention bad situation at prison, torture and humiliation Competing interests: None declared |
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Layth Delaimy, Principal GP Ashley Medical Practice, Surrey, KT12 1LF
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If we look at the ethical point of view. It seems that the broadcasting of the clip showing Saddam on TV is unethical for the patient Saddam Hussein's persona and supporters only. Yet it seems that it was very widely accepted by the community of Iraq. My understanding of ethics is that we have to see them through that society's filter, according to their values and standards and not any other society's standards. It looks that the showing of that clip had indeed reduced the number of the terrorist operations targeting Iraqi civilians and police (refer to recent CPA and GC press conferences), thus, it has in effect reduced blood shed and saved some lives. As an Iraqi I felt disgusted by the scene. Not because of the showing of the clip, but because of the fact that Saddam had proved to me and many others something that we knew, his psychopathic and Narcissistic personality. A reminder to Dr Jabbour: think what would happen if we try Saddam according to his own laws. I think he will then face the execution charge as a defector from the army during war! Showing Saddam was not a breach of Iraqi society's values in Iraq. Therefore our Lebanese friend should take it to court in Lebanon, where he should say what he thinks, starting from his own country. Competing interests: None declared |
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peter j mahaffey, cons plast surgeon lister hospital, stevenage sg1 4ab
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Articles from both Professor Jabbour (BMJ 10 Jan 2004 p115) and the Editor (same edition, Editors Choice)contain well intentioned, if sanctimonious, critical comments about the manner in which Saddam Hussein was recently subjected to a televised medical examination. How unfortunate, therefore that in the same edition the BMJ sees fit to publish an obituary recording the rather puerile comments of an eminent gastroenterologist who having been asked to see the Iraqi leader nearly thirty years earlier for a stomach complaint jokes "I rather regretted I didnt do a rectal examination". What must the American military doctor castigated by Professor Jabbour a few pages later in the journal make of that? Peter Mahaffey Competing interests: None declared |
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Riadh T. Abed, Consultant Psychiatrist Rotherham District General Hospital, Moorgate Road, Rotherham
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Since writing my original reply to Dr Jabbour's article that lamented Saddam's treatment at the hand of the Americans I had a quick search of the medical journals for his past contributions on the subject of Iraq. I discovered that Dr Jabbour has a track record of spreading misinformation about the Iraqi situation through his support of the Arab Nationalist propaganda position that the problems facing Iraqis are all down to the occupation and the loss of sovereignty. In a letter to the Lancet on 6 December Wim De Ceukelaire, Samer Jabbour, Carolyn Stephens falsely claimed that the occupation of Iraq by coalition forces was the root cause of all the health problems of the Iraqi population. Forgetting that the Ba'thist state had run down the Iraqi health system for the past 20 years in the interests of its criminal wars and spending on the security services. Also this Lebanese doctor who teaches at the American University of Beirut(!!!) and no doubt commands a handsome salary (in US dollars?!)called on the poor miserable Iraqis not to accept any aid from the US or the West as this will only increase their debt and in any case the priority was (in his view) to end the occupation (presumably through armed action) !? Are you advocating more war in Iraq, Dr Jabbour? Is this a proper position for a public health specialist writing in a medical journal? All I can say is that with Arab friends like these Iraqis definitely do not need enemies. Competing interests: None declared |
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Rihab F Tawfik, Consultant Paediatrician Pinderfields Hospital, W Yorkshire WF1 4DG
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Dr Jabbour continues to be disturbed because of showing of Saddam's clip, examined by an American army doctor and wonders why not many people have protested against that. The same author, in a letter to the Lancet on 6 December 03 (1), asked Iraqis not to accept loans from others to rebuild their country because they would have to pay them back and their priority should not be reconstruction of their ruined country after 35 years of brutal rule but to attack foreign troops who are there to protect this process of reconstruction! What a nonsense! He asks us not to promote double ethical standards. Good enough, but where was he when Saddam was slaughtering his people, and others, through non-stop wars, chemicals, torture and intentional destruction?! It may be true that the clip aimed to show a struggle between barbarianism and civilsation but it is the barbarianism of a fallen regime versus civilisation of liberating forces towards their captive. It is no good trying again and again to portray the war of liberation in Iraq as a conflict of culture, civilsation or religion between East and West. When it comes to terrorism, torture and killing of innocents, we all are in the same boat. Iraqis loved watching that video clip and would continue to do so for a long time to come. We, Iraqis, know what is good for us, so please leave us alone. One more thing. There is nothing wrong in showing the doctor looking for lice in Saddam's hair. Wouldn't we all do the same when someone on the run, living in spider holes for 9 months, surrender to authorities?! Ceukelaire WD, Jabbour S, Stehens C. Securing Iraq's health. The Lancet 2003,362,p1938 Competing interests: None declared |
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Diwa Nath das, Surgical Staffgrade L&I DGH,OBAN PA34 4HH
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In the same context of Iraq and WMD and UN Sanctions, Who is after all reponsible for all those 500,000 children dead due to UN Sanctions? Why there was no realistic assesment done about WMD and Why sanctions were carried on and on when in fact Saddam was only posturing. Why no one protested? Is it UN or Members of Security Council or US and her allies who harboured pathological hatred for Saddam after nurturing him? Who will pay for all those dead? What was WHO doing all those years? Competing interests: None declared |
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Nazad Khasraw Ghafoor, Urologist Spinal injury centre , 4025 Switzerland
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The article of Dr. Jabbour deliberately ignores the atrocities commited by Saddam Hussein by trying to hide his true Anti-Iraqi and anti- American sentiment beneath medical ethics. I think that that the video clip shown was a sort of therapy for the millions of Iraqi victims who suffer from post-traumatic stress disorders having lived under this barbaric regime for 35 years, Iraqis had to see the monster who ruined the life of many Iraqi generations in this dishevelled form, to wake up from their nightmare and Saddamphobia. Dr.Jabbour like many disillusioned other Arab intellectuals is showing disregard for the sufferings of Iraqi peoples under Saddam Hussein. He should deplore the regime which used Iraqi doctors recruited in Iraqi Mukhaberat to maim, torture and even kill innocent Iraqi citizens instead of shedding crocodile tears on the current conditions of Iraqi people after liberation. Dr.Nazad Khasraw Ghafoor Competing interests: An Iraqi who suffered under Saddam`s rule |
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Thalia A. Arawi, Philosophy instructor and Chairperson International College, P.O.Box 11-0236
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The article of Dr. Jabbour "Fall of a dictator, failure of ethics" is touching on an important issue that is plaguing the medical profession these days. We hear of plenty of unethical medical behavior in war times and armed conflict and often say that these are special cases. Well, I think this is a sorry excuse. A person with principles stands firm to his/her principles no matter what. As such, physicians who have sworn the Hippocratic Oath, who have learned to live in a pluralistic society and who know very well the principles of medical ethics are held accountable for them. If in the ER we encounter a patient who is suffering from wounds following an attempt of kidnapping or theft or whatever crime, this should in no way affect the way we treat the patient. Physicians should be as impartial as judges. This is a special bond that ties patient to physician. Principles of privacy and autonomy are the cornerstone of American Medical Ethics. One cannot honor them in one case and not in the other. A physician is committed as long as he/she wears the noble white coat. Be it Saddam Hussein, people in the Guantanamo Camps, mother Theresa or Gandhi, respect or disgust is a personal feeling that physicians should dismiss. They have to wear a veil of ignorance, to use the words of the late Rawls, when fulfilling their role as physicians. A veil that will blind them to their tastes, judgments and whatever might affect their role as healers. Competing interests: None declared |
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Dr. Akeel Alsadi, Retired Int'l Civil Servant Santa Maria, CA 93454
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BMJ Editors - Greetings and best wishes for the New Year! I started writing this to Mr. Douglas J. Carnal but decided to send it to you for publication. Mr. Carnal bemoans the failure to respect one of the most notorious criminals in the annals of history, once captured as the low cowardly thug he realy is, in Iraq, in December 2003. I am hoping that our concepts of 'humane treatment' in the West, in the World, is reserved to HUMANS, not to mass murderers, inhumane evil doers, and destroyers of culture and civility shaming the human race forever. To be sure, there are still quite a few of them in business, politics, even in science, contributing to the destruction of life on this Earth. Mr. Carnal seems to be upset that this dictator is not being called Mr., or by his full name, or designated by 'former president;' he murdered top leaders of his Ba'ath Party and millions of Iraqis, with a gang of murderous barbarians, lacking rudimentary humanity, decency, ethics, or knowledge, and certainly LAW in the land where it was born. What a pity! Horrendous, shameful crimes were committed in Iraq over the past 40 years, by the Ba'athists and their ilk, firstly, in the aftermath of the 1963 coup (Nazi style killings, murdering the leader of Iraq in front of TV cameras, the infamous Trains of Death, imprisonment and torture of hundreds of thousands, the list goes on and on), and, secondly, when they returned to power by another coup in 1968, exceeded all tyrants in history (Hitler, Stalin, Pol Pot, Franco, Pinochet, et al): 3 futile, destructive wars, with 2 million innocent humans dead, half a million decimated in torture, summary executions, branding people as traitors on their foreheads, cutting ears and tongues, chemichal attacks, biological experiments on prisoners, mass graves, dislocation of hundreds of thousands--Stalinist style, thousands dissolved in acid baths, women raped, or even thrown alive to be devoured by starving wild dogs, environmental destruction. Four million Iraqis were forced into exile or could not return home, to avoid certain torture and death. The list is endless. Iraq is now the poorest oil producing and exporting country. Its people are impoverished, sick, half hungry, and as it looks--hopeless! They now live under occupation. Was there Western compassion to the people of the Cradle of Civilization over the long decades of slavery-like conditions, perpetrated by unworthy rulers, who score 100% in ELECTIONS? Was there much compassion to the Palestinian People who are being SLOWLY EXTERMINATED by Nazi methods, under which no Western citizen can even imagine to live, and would certainly revolt? We should vehmently protest Nazi and fascist extermination methods, regardless of the nationality, creed, political affiliation, ethnicity, religion, etc., of their perpetrators, and make sure to bring them to face justice for crimes against humanity. It is not revenge that is sought, but justice, even to those who flagrantly and filthily denied it to others. But let us not respect those who failed to respect themselves or any one else! Dr. Akeel Alsadi Competing interests: None declared |
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Douglas J Carnall, General practitioner London
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In their hurry to condemn Saddam Hussein Al-Tikriti, Abed, Carvel, Rasheed, Delaimy, Tawfik, Das, and Ghafoor neglect the central point of Jabbour's article: that it is unethical to videotape a patient examination without the express consent of the patient for such videotaping. [1] Whatever cultural resonances the images may have had, the point is the doctors conducting the examination should have ensured privacy and therefore confidentiality for their new patient, whatever crimes he is alleged to have committed. I do not know if the doctors concerned obtained such consent. If they did not, and the patient complained, that would, in my view, be an appropriate matter for the doctors' licensing body to investigate. Doctors who neglect ethics in their treatment of any patient should be censured, and review their practice to avoid future repetition. I do not deny, by the way, the right of the American military authorities to parade their prisoner in a humane manner: Saddam Hussein Al-Tikriti was a public figure whose whereabouts the world had a right to know, and television was an effective medium for publishing the fact of his capture. But just because he was one of the most palpably obnoxious rulers in history does not mean we should deny him his basic human rights: which almost certainly means he should have been medically examined in private. I will be surprised if the former president does complain (who were the doctors involved anyway?), but if he does so, it would seem there is a case to be answered. 1 Kurtz S, Silverman J, Draper J. Teaching and learning communication skills in medicine. Oxford: Radcliffe Medical Press, 1998, p61. Competing interests: None declared |
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Gyan Fernando, Home Office Pathologist Devon & Cornwall Constabulary, Middlemoor, Exeter, EX2 7HQ
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In October 1998 General Auguste Pinochet was arrested in London. Many accuse Pinochet of atrocities against Spanish citizens, human rights violations and attribute 3,000 deaths to him. He underwent many medical examinations, admitedly to assess his fitness to stand trial, but these were not conducted in a public manner as with Saddam Hussein. Was he a "Good" dictator? Competing interests: None declared |
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Richard Watson, General Practitioner Glasgow
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Shame on Dr Carnall. Shame on Dr Jabbour. Shame on the BMJ for publishing Dr Jabbour's propaganda. Previous rapid responses have revealed Dr Jabbour's long standing position as an apologist for Saddam. I wonder if Dr Carnall has published any letters complaining about the mass murder and torture committed by Saddam's regime? If so I invite him to draw them to our attention. All concerned should commit Dr Abed's response to memory and devote their efforts to protecting those more worthy of our compassion than Saddam (and yes I do mean disrespect by using that mode of address). Competing interests: An interest in the human rights of the Iraqi people. |
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Rizgar Amin, Consultant psychiatrist Central Middlesex hosp. London NW10 7NS
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I am wondering if Dr Jabbour is really ignorant about what Saddam has done to Iraq & Iraqi people or he is missing favours Saddam used to give to his agents, many in the Arab world to mislead the Arabs in the name of Arab nationalism or Islam. Do Iraqi's need to constantly remind people like Dr Jabbour about the countless atrocities committed by Sadam and his family (the 35 years of war with Kurds, resulting in hundreds of thousands of casualties, 182000 disappearance in the infamous Anfal campaign, destruction of 4000 villages and 10s of small and midium sized towns, Widespread use of chemical weapons culminating in the well publicised Halabja attack and killing of more than 5000 civilians, arabisation of oil rich kurdish areas, deportation of thousands of kurds and confiscation of their land..deportation of around 100000 Faili Kurds to Iran..etc, The drainage of historical and few remainig Marshes of the world in the Shia'a populated south, the size of some European countries, and the destruction of centries of history and tradition on top of dispalcement of hundrds of thousands of people....The shelling & destruction of the holly cities of Najaf & Kerballa including the shrines of the Prophrt's cousin and his grandson....invasion of Iran and Kuait with disastrous consequences for them and Iraq.... silencing all voices of dissent and reason ...banning all political parties and executing their members and supporters in thousand some in acid baths....raping hundreds of thousands of women and chilren.. stealing Iraq's wealth and leaving the country in massive debts....forcing nearly 4 million Iraqis to flee the country to avoid the fate of nearly another 2 millions in mass graves. Where was Dr Jabbour's ethics when all these were happening to his fellow arabs, kurds, muslims, christians ..etc Can't people like Dr Jabbour shut up and let Iraqi people come into terms with what had happened to them and rebuild what is left in their country and society. Competing interests: None |
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Mark Benjamins, SHO UK NW4
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Dr Carnall should cut out the pomposity. It is entirely reasonable to refer to the deposed murderer as Saddam. To call him Mr Hussein is ridiculous, as Hussein is simply not his surname. It is, rather, a clan name which is used just as much for any number of associates. When brainwashed, cowed populations were forced to parade for the deposed crinimal, they shouted that they would give their blood for "Saddam", not Mr Hussein, SH al-Tikriti or any other pompous title that Carnall, I'm sorry, "Douglas Carnall the Londoner" has invented for him. As for this being "an appropriate matter for the doctors' licensing body to investigate": all I can say is, get real. Competing interests: None declared |
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Michael O'Donnell, FRCGP. Former GP turned journeyman writer Loxhill GU8 4BD
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There is no evidence that the person exploring Saddam's mouth with torch and spatula was medically qualified. Indeed, there are some who believe the "doctor" was a spin doctor from Number Ten Downing Street desperately seaching for weapons of mass destruction. Competing interests: I suffer from a chronic allergy to cant |
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Mark Struthers, GP HMP Bedford, UK
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Saddam Hussein was a brutal despicable tyrant; that much seems certain. It's all the rest that is confusing and unclear. Who are the goodies and who are the baddies? Is might really right? Is not the white, clean civilised-appearing man really the new barbarian, a captive image in an ancient civilisation? It's a funny old world, a confusing topsy turvy world. Competing interests: a chronic allergy to hypocrisy and double standards perpetuated by the neo-Barbarians and Crusaders. |
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Farid Munim, Consultant Physician Frimley Park Hospital GU16 7UJ
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Editor-I found the article of Sameer Jabboor on the 10 January issue of BMJ quite appalling and I was surprised that it was published in the BMJ rather than being broadcasted in Al-Jazeera satellite Channel. Clearly Mr. Or Dr. Jabboor is trying to defend the Tyrant who was responsible for the killing, torturing, raping, gassing millions of innocent Iraqi men, women and children in addition to citizens of neighbouring countries and burying them in mass graves. I lived in Iraq for 30 years and witnessed his crimes and violations of human right. He, his sons, brothers and cousins used to witness the torture of political opponents and he used to film them and show the films to other people to deter them from opposing the regime. He ordered his intelligence and secret agents who were responsible for interrogation of political opponents to torture them physically and psychologically by raping their wives, sisters, or daughters in front of their eyes for two reasons first is to get confessions from them and second to humiliate them before being executed. Dr. Jabboor was talking about Geneva Convention, as if Saddam was a war hero who was captured while fighting the Americans. Unfortunately Geneva Convention only applies to POW’s and Saddam is not one of them and will never be. He was a mass murderer, responsible for the mass Genocide of millions of people and should be treated as any criminal. Dr. Jabboor mentioned that Saddam was examined by a Doctor looking for lice in his hair. If we believe this story then we should be very naive. The last thing the Americans want to do at the time of capturing a mass murderer is to look for evidence of lice or dental caries. Who gave us the impression that the person examining him was a Doctor? Why could he not have been an intelligence or military officer looking if Saddam had any Cyanide pill hidden in a denture or for any poisonous pills in his long hair or beard to prevent him from committing suicide? Filming Saddam was the best thing the Americans did to prove to the Iraqis that Saddam's regime is finished. After the sudden unexpected fall of the Tyrant on 9th of April, many Iraqis were fearful and suspicious. I talked to many of them some were inside Iraq others were in Exile. Many of them thought that Saddam struck a deal with the Americans and was taken with his family to a safe haven outside Iraq, where they could live prosperously and may even return to power one day. We as Iraqis needed evidence that this was not the case and the only way to prove it is by filming him. When his sons were killed no single Iraqi believed the story, till their bodies were shown on TV and this faded the fears of Iraqis but not completely. We still needed evidence of Saddam being captured or killed. That was the only way to make the fears of Iraqis disappear and start a new life to build their country not fearing of the return of Saddam or his thugs because they know now that Saddam is gone for good and will receive the justice which he denied millions of Iraqis and that he will never make a come back. Competing interests: None declared |
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David Carvel, GP Biggar ML12 6BE, UK
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In his first rapid reponse to this article Dr Carnall took issue with the use of the name "Saddam", calling it disrespectful. He referred to the tyrant as "Saddam Hussein". In his second response Dr Carnall curiously extended this title to "Saddam Hussein Al-Tikriti" but refers to myself and other critics simply by our surnames. If Dr Carnall continues to respond will our names become increasingly shortened, informal or "disrespectful" and reference to Saddam's ever more grovelling? Of course this line of argument is entirely missing the point! Competing interests: A GP, like Dr Carnall and similarly have never suffered under an oppressive regime. |
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Layth Delaimy, Principal GP Ashley Medical Practice, Surrey
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I think this debate highlights the importance of dialogue between people from different cultures. Here is a cultural fact from the middle east: People do not use surnames for identification. I would be called Dr Layth (my first name) in Baghdad and not Dr Delaimy. In fact sometimes using the surname is quite an insult. Surnames are used for verification to avoid confusion like Dr Layth Delaimy and not Dr Layth Fullani. Telephone books in the middle East are listed according to first names and not surnames. Using Saddam as a name is not an insult for his person. Saddams clip does not suggest that he had his medical without consent, nor Saddam objected on the presence of the Camera. He seemed very happy in letting the doctor examine his mouth. Also it seemed to me that he was complaining of some Temporomandibular joint problems. We need to wait and see whether Saddam will complain about the clip. I agree with the ethical point of consent but if we prioritise the crimes committed perhaps it will come in the page number 100001. I think that making an issue in these days is more like a deviation from focusing on the crimes committed by the dictator. Anyway if the "victim" does not complain then there is no crime -universal common law, Saddam is seeing the red cross as a prisoner of war. At least wait for the dictator to complain before crying on his "human rights violations" or is there another agenda? Competing interests: a British Iraqi GP |
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Samer Jabbour, Assistant Professor American University of Beirut, Beirut, Lebanon
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Dear Colleagues, I am deeply saddened at some of the responses to my article. I respect the disagreements over my interpretation of the televised event. However, I wonder about the purpose of making serious accusations about my motivation and integrity to the degree of accusing me of being on Saddam’s payroll. The article was intended to describe a double standard and expose the complex motivation behind it. Whether this is reasonable to do or not can be debated as was done by several colleagues. However, how can one lightly conclude that such a perspective amounts to support of the despicable Saddam and his atrocities and regime or that it represents disregard for the suffering of Iraqis? It is equally puzzling that our Lancet piece, which reminded the editor not to forget the goal of ending the occupation and called for compensating (not giving loans to) Iraqis for the grave damage they suffered, is interpreted to mean support for the ongoing nonsensical killing and destruction in Iraq. What purpose does it serve to try to discredit those with whom we disagree? Occupation and its consequences are the root causes of the current chaos. The root causes of the whole Iraqi situation are more complex: Saddam and his aids were the chief architects with a joint responsibility of the international community (including other Arab dictatorships and the American "liberators") through supporting him during the 1980s and then turning against him to impose merciless sanctions that affected mostly Iraqi civilians and infrastructure during the 1990s. Exposing hypocrisies and violations of ethics by those in power and those who claim to represent civilization remains legitimate today. The article did not mean to offend the sensitivities of some of my Iraqi colleagues. The long suffering and exile to which they have been subjected would only make me express respect and disappointment over our inability to replace accusations with dialogue. I understand that sensitivities are still very high during this period which may preclude such dialogue. Although we may disagree about the video and the article I wrote, we are not at odds when it comes to the aspirations of Iraqi people for peace and rebuilding of their society or, for that matter, the hopes of citizens of other Arab countries under dictatorships and occupation for liberty and liberation. Sincerely, Samer Jabbour Competing interests: None declared |
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Sany Abdel-Aziz Hleis, Resident of Family Medicine Saint Joseph University , Beirut, Lebanon
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Dear collegues, I'm wondering what was the purpose of the on-the-spot, broadcasted exam of the Iraqi president. Was it a periodical physical exam or was it centered on a complaint by the prisoner ? Was it completed by a digital rectal exam? If so, thank god it wasn't broadcasted. I would like to add that I appreciated the article by Dr Jabbour and the response of Dr Carnall . I think it's time for some of our Iraqi collegues to enjoy their ability to express themselves freely in the new chaotic Iraq without forgetting basic medical ethics ! Competing interests: None declared |
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Wasim Maziak, Director SCTS, PO Box 16542
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I think it is important to understand the regional context in which opinions and ideas evolve when considering the issue of Saddam Hussein, since this discussion involves more than abstract human rights and medical ethics. It is all about the selectiveness of this case. Certainly, the recent awakening of medico-ethical sensitivities of some in the region is understood by many Iraqis and Arabs, who are disgusted with Saddam’s atrocities during his long brutal reign, as an indirect way of expressing their disappointment of the turn of events in Iraq. To be convinced otherwise, the author should have a track record of supporting other cases of human rights violations or medical misconduct. Since the author is a Syrian currently living in Lebanon, I as well as others have a legitimate right to wonder whether he does not have examples of human rights violations or medico-ethical misconduct close to home. The author speaks about double standards, how about his approach to human rights! Competing interests: None declared |
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Calvin S. Ennis, none Escatawpa Family Clinic, Box 1358 Escatawpa Ms USA, Box 1358 Escatawpa Ms USA
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Physicians are under great seige today even with our sacrifices. When I am unduly attacked, I tell my critics dont thank me for my sacrifices but please do not abuse either. Dr. S. Jabbour of Lebanon tells us that the army doctor who examined Saddam after his capture was unethical . He had the gall to examine Saddam for lice and malnutrition in a video beamed to the world. This was done he says to portray Saddam as a "monster", a "villain" and to illustrate the difference between "barbarianism and civilisation" What in the world is Saddam other than a savage and a bloody barbarian? Does Dr. Jabbour not believe that Saddam is a mass murderer? Should he have been whisked off to the Beirut Hilton, showered, shaved and televised to the world as the new Saracen? In fact, Saddam was not killed by his captors,received medical care and is now being treated better than the millions he tortured. And the International Red Cross observes all. Yet Dr. Jabbour says the video represents a "double standard between army and civilian medicine". Dr. Jabbour seeks to occupy a higher moral ground but he is more guilty of a double standard than the "unethical American occupiers": 1) where was his outrage and letter when 5 US airmen captured alive,were executed and televised like a pile of trash 1 year ago? 2)where was his indignation and letter when 3 captured soldiers were televised with faces beaten to a pulp by their Iraqi captors? 3) where was his outrage and letter when Iraqi physicians under Saddam falsified death certificates to conceal torture and amputated ears of dissident Iraqis without anaesthesia in violation of the Human Rights Declarations of Geneva and Tokyo?(JAMA March 24,2004) 4)where is his outrage at the terrible medical neglect of Iraqis because of oil money diverted from medical care? 5)Where is his plan to join doctors from 20 other countries to treat diseased Iraqis from the Saddam regime? 6) and where is his outrage at the true occupation of his own country by 20000 Syrian troops in violation of UN Resolution 520 since 1982? No, the BMJ has been hijacked. His lecture is a cover. Al- Jabbour sounds more like al-Jazeera and much less like al-Hippocrates.It is not about ethics-its about ethnics. Its about the flip side of the white orentalism he complains of. It is about steretypical occidentalism in which Europeans and their American cousins can never do good-only evil. Oh, I know I speak as an insensitive boorish, brutal, petulant American(naturalized). But even Americans have feeling. It was our citizens who died on 9/11. It is our sons and daughters who die to rid the world ofa maniacal despot in Dr. Jabbour's backyard because so many in the Middle East tolerate and venerate evil dictators It is our doctors who now risk their lives to treat sick Iraqis. Dr. Jabbour's outrage is a clear example of the double standard he accuses others of. It appears his ethical concerns exclude Americans. He appears to adore Saddam and abhor Americans who were not only generous enough to serve as host for his specialty training but also removed a tyrrant from his part of the world so he can practice safer in his own country. Dangerous levels of hubris and hypocrisy do not produce medical harmony in the world. So doctor do not thank us for liberating Iraq. But, please, enough is enough, the abuse is obscene. Calvin S.Ennis M.D. Fellow AAFP ,br>Escatawpa Family Clinic, Escatawpa, Ms USA 39552 Competing interests: None declared |
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jay taylor, retired consultant 3809 Woodmoor Ct.; Chesapeake 23321
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Quite the contrary. Prof. Jabbour took a principled stand. The treatment meted out to the former President violated the law (Geneva Convention(s) forbidding humiliation). If the President were, at the time of capture, a war tribunal defendant, such treatment would be summary punishment, also prohibited. Two strikes against the US led coalition, as we Yanks say. The question of medical ethics is much more problematic. If we reject totally the hygenic pretext for the examination, as we must for similiar procedures to which prisoners, military conscripts and others are subjected - then the laws against humiliation apply. Otherwise, we must cite the US medical officers for failure to protect this patient's dignity by ordering the cameras stopped. The High Command failed to offer any explanation when this "trophy" footage was aired on CNN. Since the capture of Saddam, real scandal has broken over Abu Ghraib humiliation episodes many times worse! Like all hman societies, Arabs are dignity conscious and anyone professing solidarity with those disgraced now has carte blanche. Just look at the events of 24 June 2004. Competing interests: None declared |
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