Rapid Responses to:

ANALYSIS: Karl Sabbagh Perils of criticising Israel BMJ 2009; 338: a2066 [Full text]

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Rapid Responses published:

Shooting the messengers

Robert L. Tankel   (26 February 2009)

Perils of Inaccuracy

Sharon R Fine   (26 February 2009)

There is no peril in criticising Israel

Jacob Amir, M.D.,F.A.C.P.   (26 February 2009)

Are you really a medical journal?

marti eisenberg, 92024   (26 February 2009)

medical journal or propaganda sheet?

john t nemesh   (26 February 2009)

Support for statements highlighting the discrimination in Israel

J O'Hara   (26 February 2009)

Perils of criticizing Israel? Try criticizing Arab countries

Judy McLaine   (26 February 2009)

Science, bias and invective in the BMJ

Arnold G Zermansky   (26 February 2009)

To care about replies or not?

Hans Hoghet   (26 February 2009)

keep up the good work

Sheraz Haroon   (26 February 2009)

Topics and Authors

Dean J Noimark, Pond Street, London, NW3   (27 February 2009)

What a shame

David Gurwitz, Tel-Aviv 69978 ISRAEL   (27 February 2009)

A discussion we must have.

Michael Boltzmann   (27 February 2009)

Stay out of politics, that's your problem

Jonathon A Moseley   (27 February 2009)

Re: shameful bias in bmj

Tony Delamothe   (27 February 2009)

shameful bias in bmj

Mark Gardner   (27 February 2009)

Rich Debate

Babar Vaqas   (28 February 2009)

Shame on you BMJ

David P Inwald   (28 February 2009)

Un-green behaviour

Elliot Daniel   (1 March 2009)

Diabetes in Gaza: Getting the Facts Correct

Paul Z Zimmet   (1 March 2009)

Why defend Summerfield?

Steven M. Albert   (1 March 2009)

The elephant's foot on the mouse's tail

Mohammad Farhad Peerally, Nusra B. Khodabux   (1 March 2009)

Keep grasping the nettle...

Gene S Feder   (2 March 2009)

The only solution is to keep talking

Gwyn S Williams   (2 March 2009)

A brave and rare insight

Adrian Worrall   (2 March 2009)

Evidence does not support conclusions.

Michael A Apple   (2 March 2009)

The fallacy of some democracies

Bassem R Saab   (2 March 2009)

The perils of bias mascarading as fact

Ben Bradley   (3 March 2009)

Something is wrong

Doron Samuell   (3 March 2009)

Rapid Responses vindicate the article

Sellam Ismail   (3 March 2009)

Thank you to Karl Sabbagh

Linda Belanger   (3 March 2009)

providing evidence for Sabbagh-(live as we speak!)

Ahmed Sewehli   (3 March 2009)

Thank you for publishing this article

Paola Canarutto   (3 March 2009)

Disproportion in the Israel-Palestine Conflict

Jonathan Bernstein   (3 March 2009)

Health is sociopolitical

Stephen K Ginn   (3 March 2009)

Freedom of speech in Arab countries

Yair Yodfat M.D., Arie Carmon   (3 March 2009)

In praise of pachydermatous truth

Brian Robinson   (4 March 2009)

Support for the right of debate

Marco Chiesa   (4 March 2009)

Re: The fallacy of some democracies

Jonathan Bernstein   (4 March 2009)

Well done BMJ

Shahab A Siddiqi   (4 March 2009)

Simple reflections

Faisal M Mirza   (4 March 2009)

Finally, the oppressed have a voice!!!

N A Shah   (4 March 2009)

Re: Freedom of speech in Arab countries

Brian Robinson   (4 March 2009)

Re: Diabetes in Gaza: Getting the Facts Correct

Tony Delamothe   (4 March 2009)

predjudice on both sides

Laura R Hulbert   (5 March 2009)

Lost in admiration

Harold Bourne   (5 March 2009)

Politics, The BMJ and the Practice of Medicine

Raymond Pollak   (5 March 2009)

Immoral

Larry Weisbrod   (5 March 2009)

Congratulations on Your Bravery

Janet M. Desroches   (5 March 2009)

Providing a Balanced Picture

Usman Sadiq   (6 March 2009)

Freedom of Speech

Roger Black   (6 March 2009)

Jfjfp supports the BMJ

Sylvia R Cohen   (6 March 2009)

BMJ Qualified Expert on Middle Eastern Politics?

Noam Millo   (6 March 2009)

Viva freedom of press

K Garman   (7 March 2009)

Childish Games

Sylvia M Watkins   (7 March 2009)

Acknowledge the pain of antisemitism but don't demonise strong criticism of Israel

Brian Robinson   (8 March 2009)

Politics and the BMJ

David J. Grant   (8 March 2009)

To Tony Delamothe Re his rapid response

Elliot Daniel   (9 March 2009)

Wolf in Sheeps Clothing

Shawn Malachovsky   (10 March 2009)

Diabetes in Gaza: Getting the Facts Correct

Paul Z Zimmet   (10 March 2009)

The Editor responds to charges of anti-Israel bias in the BMJ

Fiona Godlee   (11 March 2009)

More on the fallacy of some democracies

Bassem R Saab Saab   (12 March 2009)

Re: The fallacy of some democracies

Sheila F Raviv   (12 March 2009)

Lies and facts about the conflict

A Sabra   (12 March 2009)

Re: Diabetes in Gaza: Getting the Facts Correct

Tony Delamothe   (12 March 2009)

Re: The Editor responds to charges of anti-Israel bias in the BMJ

Jonathan Hasleton   (13 March 2009)

Re: Re: The Editor responds to charges of anti-Israel bias in the BMJ

Fiona Godlee   (13 March 2009)

The facts do not support your assertions

Michael A Apple   (15 March 2009)

Of course Israel should be singled out

Asad Khan   (16 March 2009)

Setting the Record Straight

Wasim Maziak   (17 March 2009)

Time for reconciliation

Amin El Hihi, WN7 1HS   (18 March 2009)

Grasp the nettle harder

Rupert A Gude   (19 March 2009)

Criticism of Israel is not related to facts

Pinchas Halpern   (20 March 2009)

Re: Diabetes in Gaza: Getting the Facts Correct

Paul Z Zimmet   (21 March 2009)

Re: Re: Re: The Editor responds to charges of anti-Israel bias in the BMJ

Jonathan Hasleton   (31 March 2009)

Re: The Editor responds to charges of anti-Israel bias.... Now what about Sri Lanka?

Peter J Flegg   (15 April 2009)

Re: Perils of criticising Israel

Omar A. Khan   (13 May 2009)

Shooting the messengers 26 February 2009
Robert L. Tankel, attorney Dunedin, FL 34698 Send response to journal: Re: Shooting the messengers	I read of your work thanks to Honest Reporting. I saw your series of articles and it seems that you concentrate on the fact that you take umbrage at people exercising their right to their own opinions that differ from yours. I wholeheartedly agree that profane and abusive email have no place in civilized discourse. However you seen to forget the fact that the only reason such "watchdog" organizations exist is because Israel is regularly bashed in the press. If the Jews really controlled the media, rest assured the situation would be different. Britain occupies far more territory than Israel does and has never hesitated to use brutal force to protect its interests, even where such lands are thousands of miles away and pose no threat to it, i.e., the "Falkland" islands, Northern Ireland, several hundred square miles of Cyprus, the Chagos Archipelago, &tc., &tc. How much effort have you put into monitoring and reporting on the aggression carried out by Britain in those areas, rife with killings, denial of Human Rights and so forth? Thank you for your attention to this matter. Bob Tankel Dunedin FL USA Competing interests: None declared
Perils of Inaccuracy 26 February 2009
Sharon R Fine, physician Sharon Fine MD PC, 19066 Send response to journal: Re: Perils of Inaccuracy	The peril, as you put it, is not in criticising Israel or any other particular entity. The peril is in stating fiction as fact, or in distorting facts to prove a point. To slough off legitimate criticism and lump it in with abusive hate mail trivializes a pursuit of accuracy, particularly in a supposedly scientific journal. Competing interests: None declared
There is no peril in criticising Israel 26 February 2009
Jacob Amir, M.D.,F.A.C.P., Physician - Hematology-Oncology Jerusalem, Israel 93783 Send response to journal: Re: There is no peril in criticising Israel	There is no peril in criticising Israel. One can look at the British press and read almost daily very harsh criticism of Israel's policies. But, why will Sabbagh ignore the grave errors in Derek Summerfield’s article. He wrote that the Israeli army has killed more unarmed Palestinian civilians than the number of people who died on September 11, 2001. But, the number of Palestinians killed was 1508 while the number of those who died in New York was 3000. Does not such a mistake betray Summerfield's enormous anti-Israeli bias? And, why should not readers express their strong objections to such obvious distorting of the truth? After all, the BMJ is a scientific paper, where one expects to find accurate data. Competing interests: None declared
Are you really a medical journal? 26 February 2009
marti eisenberg, geologist self employed, 92024 Send response to journal: Re: Are you really a medical journal?	Why is a British medical journal giving an opinion on politics in the Middle East? I think you are way out of your jursidiction and expertise. I will surely note this obout your journal and from this day forward i will make sure not to use you as a source for legitimate information. Competing interests: None declared
medical journal or propaganda sheet? 26 February 2009
john t nemesh, intensive care and anaesthetics registrar the wollongong hospital 2500 australia Send response to journal: Re: medical journal or propaganda sheet?	As a medical practicioner and not a political animal , i am annoyed that that the bmj has crossed the line and entered into a territory that it should never have traversed. if i want to read about the political situation in the middle east then i will do so in the relevant outlets. if however i want to learn/keep up with general medical literature then in our profession, this journal should keep to what it does properly. this is not, i repeat not, the place to have the never ending debate on the middle east-regardless of the writers having a dr before their names. yours sincerely, john nemesh bsc(syd uni), mbbs (unsw) nsw, australia Competing interests: None declared
Support for statements highlighting the discrimination in Israel 26 February 2009
J O'Hara, administrator SW1 Send response to journal: Re: Support for statements highlighting the discrimination in Israel	I have just returned from the West Bank and seen at first hand the land grab (the Israelis have taken over 50% of the land of the West Bank), the restrictions on movement of Palestinians, indefinite detention without charges or trial, checkpoints that limit entry and exit even with all the proper papers, water limited to two days per week, house demolitions, restricting access to education.. In short blatant discrimination. How I wish we could get the true story out into the media. Thank you Karl Sabbagh and the BMJ for supporting free speech. Competing interests: None declared
Perils of criticizing Israel? Try criticizing Arab countries 26 February 2009
Judy McLaine, medical research ABC Medical Send response to journal: Re: Perils of criticizing Israel? Try criticizing Arab countries	Sorry, but BMJ is most definitely biased against Israel. I, too, scoff at mass orchestrations of emails from watchdog groups of any persuasion, but the "perils of critizing Israel?" Oh please . . . when you criticize Israel you elicit emails; try criticizing Arab and/or Muslim governments. You'll elicit fatwas calling for your murder (now THAT's peril) and other such expressions of thoughtfulness and tolerance. I have subscribed to BMJ for 15 years and do not give BMJ a pass for its record of anti-Israel bias. Pointing out the idiocy of mass "up in arms" emails is fine, but don't use it as a smokescreen for the clear bias of your journal. J. McLaine Competing interests: None declared
Science, bias and invective in the BMJ 26 February 2009
Arnold G Zermansky, General practitioner Park Edge Practice, Asket Drive, Leeds LS14 1HX Send response to journal: Re: Science, bias and invective in the BMJ	I would not have expected you to allow me to analyse and pass comment on the pro-Israel responses you received to Dr Summerfield's article condemning Israel in 2004, because my credentials as a Zionist undermine my credibility as a dispassionate commentator, however even-handed I might promise (or indeed try) to be. What amazes me is that you allowed another self-confessed biased commentator to do so. That Mr Sabbagh's article is far from even-handed is no surprise, and no more than I (or you) should have expected. I do not condemn him for this. He is not a scientist and is not trained to collect, collate and analyse evidence statistically and and present it in a non-biased way. He also has his prejudices and they figure prominently in the way he presents his highly selected evidence and the inferences he draws from it. It is you who allowed him access to your personal emails as well as the Rapid Responses that are in the public domain, and gave him space to give vent to his invective against the pro-Israel lobby without even mentioning the anti-Israel lobby (from which you certainly received some outrageous Rapid Responses, and (I guess, though I can't vouch, not having had the privelege that Mr Sabbagh has had to read them) some even more outrageous emails. The publication Of Mr Sabbagh's article lends it scientific credibility that it does not merit. I am not sure that I understand your objectives in accepting it, but it is difficult to imagine one that has anything to do with unbiased reporting of medical science or news. If you do think such an analysis might have merit five years on, may I respectfully suggest that you seek the help of an unbiased medical scientist to analyse and report on your correspondence, and then put it out to peer review before publication. That's what BMJ editors are supposed to do. Competing interests: I am a Jew and a Zionist. I am also a democrat and an advocate of free speech and a peaceful two-state solution to the Israel/Palestine conflict (as is the Government of Israel).
To care about replies or not? 26 February 2009
Hans Hoghet, Senior officer EA1 2TY Send response to journal: Re: To care about replies or not?	Is there much point to use rapid response to anything controversial then? If I were to have an opinion that differ to that of the author, will my reply merely get lumped together with others and seen as "can be ignored". I guess not. Feel free to enjoy your undisputed and anti-free speech soap box. PS. British Medical Journal is a part of the BMJ group. Is that enough "evidence of familiarity with the BMJ", or do I need to include a minor essay in the future? Just curious, and a tad bit cynical. Competing interests: None
keep up the good work 26 February 2009
Sheraz Haroon, engineer netherlands Send response to journal: Re: keep up the good work	its a pity how people take things deliberately out of context just in order to be able to critisize! people accusing the writer of anti-semitism are no different than "Mullas" declaring people "Kafir" when they dare to question their wierd interpretations of Islam! i hope that the authors will continue to be professional in their treatment of subjects and will not give in to (most probably overwhelming) unjust criticism. Competing interests: None declared
Topics and Authors 27 February 2009
Dean J Noimark, SpR General & Geriatric Medicine Royal Free Hospital, Pond Street, London, NW3 Send response to journal: Re: Topics and Authors	Dear Sir, I have for many years enjoyed the content of the BMJ. It provides useful succinct updates written by authorities in their fields and often thoughtful commentaries. I am therefore slightly bemused by the BMJ's editorial team to publish another article on the controversial Israeli-Palistinian conflict. The BMJ's mission statement published on its website guides authors as follows: 'The BMJ's mission is to lead the debate on health, and to engage, inform, and stimulate doctors, researchers and other health professionals in ways that will improve outcomes for patients. We aim to help doctors to make better decisions' (1). I am not certain how the article by Sabbagh (2) adds to the BMJ's declared mission. As the BMJ have already realised, there is no truly neutral opinion in this conflict. One cannot condone the hostile e-mails sent in response to Summerfield's article (3), but is the personal review by Sabbagh worthy of publication or helpful in a medical journal. Sabbagh in his book Palestine: A Personal History (4)describes himself as follows "I am the son of a Palestinian father, but... I am not poor, unshaven or a speaker of broken English. I do not know how to use a gun or manufacture a bomb. I have little to do with camels, sand or palm trees. But I both sympathise and identify with the Palestinian people." There is no doubt that Sabbagh is an experienced author but nevertheless he will always have a biased slant which negates his 'personal view' as having true substance. When i open the BMJ i choose to read about subjects on medicine and healthcare. For political topics, i choose other sources. Whilst this series of articles is sure to increase the hit rate on the BMJ website and the level of correspondence, it fails to meet the high standards of a serious medical journal. This series of aticles, however balanced and well-written the editorial board think they are, hints at an all powerful jewish lobby. These are dangerous grounds, especially in times when the far right is gaining presence in British society. I urge the editors to continue to publish the excellent journal the BMJ has become but to avoid topics which are so clearly inflammatory. 1. BMJ Website 2. Sabbagh K. Personal paper: Perils of criticising Israel. doi:10.1136/bmj.b500doi:10.1136/bmj.a2094Personal view, doi:10.1136/bmj.b722 3. Summerfield D. Palestine: the assault on health and other war crimes BMJ Oct 2004; 329: 924 4. Sabbagh K. Palestine: A Personal History. 2006. Atlantic Books Competing interests: None declared
What a shame 27 February 2009
David Gurwitz, Faculty of Medicine Tel-Aviv University, Tel-Aviv 69978 ISRAEL Send response to journal: Re: What a shame	What a shame that BMJ was not so pro-active on world politics during WW2, when the British Government immigration policy, prohibiting entry of Jewish refugees from mainland Europe to Britain or to British-controlled Palestine played into the hands of the Nazi's "final solution to the Jewish problem". Further reading: http://www.jewishvirtuallibrary.org/jsource/Holocaust/grobim.html PS I checked on the BMJ archive, going back to the 19th century – nothing about this topic there. Competing interests: I am Jewish, an advocate to the two-state solution to the Israeli-Palestine conflict, and a second-generation holocaust survivor
A discussion we must have. 27 February 2009
Michael Boltzmann, Physician (retired). Balgowlah, Sydney, NSW 2093, Australia. Send response to journal: Re: A discussion we must have.	Most of the responses so far have again criticised the BMJ for raising this issue, with some going so far to repeat the allegations that the journal has an anti-Israel bias. The author analysed the trends in responses to previous coverage of Israel in the BMJ. Few of the responses so far have addressed the author's assertion that responses could be generalised into categories such as denial and abuse. Nor has anyone addressed the concern that many of the responses to the BMJ article were made by individuals who had not read it, but had been enlisted as part of a campaign by a lobbyist website. I have seen the same tactic employed by anti-vaccination lobby websites. I support the BMJ's efforts to promote discussion about academic free speech. Editors should be encouraged to publish diverse views on topics such as Israel without the fear of smear campaigns. Competing interests: None declared
Stay out of politics, that's your problem 27 February 2009
Jonathon A Moseley, Attorney 1307 West Broad Street #266, Richmond, Virginia 23060 Send response to journal: Re: Stay out of politics, that's your problem	No, the problem is when the British Medical Journal departs from its mission of writing about medicine and becomes an advocacy lobby for Hamas murderers in Gaza. I don't have to read an article on politics to know that it should not appear in a medical journal. And don't give me that we were writing about medicine in Gaza line. How dumb do you think we are? Even when done through such sly -- but incredibly obvious -- gimmmicks as talking about the medical system of Gaza, a medical journal becoming an advocate for one side in a war is not acceptable. And people have every right to call you on the carpet, and ask your advertisers to pull your funding, because you are taking sides in a political issue and a war. Try writing about medicine for a change. If you want to criticize Israel, start a new publication named "We love Hamas." All you have done is expose your own hypocrisy for writing about politics instead of medicine. Competing interests: None declared
Re: shameful bias in bmj 27 February 2009
Tony Delamothe, Deputy editor, BMJ BMA House, London WC1H 9JR Send response to journal: Re: Re: shameful bias in bmj	I haven't checked, but I suspect that these disgusting comments appeared among the 20203 free text comments submitted by voters in our poll on an academic boycott of Israel (2007). We've removed all links to these comments, which were hosted for us by a third party. Competing interests: Co-author of editorial, " What to do about orchestrated email campaigns"
shameful bias in bmj 27 February 2009
Mark Gardner, director of communications CST, London NW4 Send response to journal: Re: shameful bias in bmj	Not content with damaging BMJ's professional reputation by taking such an obsessive one eyed approach to an overseas conflict, the editors cannot even muster the honesty to accurately represent Jonathan Freedland's excellent article on BMJ's own website. The article is summarised as: "Jonathan Freedland suggests growing a thicker skin." Really? I read his article and it doesn't emphasise that - rather it empathises that there is nothing exceptional about the pro Israel lobby, and arguing otherwise risks straying into the territory of antisemitism. In addition to that misrepresentation, we also have the unsurprising evasion of what the anti Israel lobby says in emails to BMJ. For your short memories, here's some exmaples of the readers responses you ran in July 07 after your poll on the academic boycott of Israel: 'anyone voting no is either a jew or ignorant' 'israel occupation forces are as bad as nazis' 'zionism is the new nazism' 'jews are trouble maker and they are not used to listen to arguments. they should be boycotted as south africa was boycotted and their special privilege and treatment and immunity to criticism should be put to an end' 'because they are all liars and killers and demons' 'its time the zionists stopped milking the holocaust industry. Jews havent been victims in decades. they are now the victimsers, the persecutors, the opporessors. too bad the only lesson they learnt from hitler was how to treat palestinians the way they were treated. shameful!' I appreciate that giving more than one part of the narrative is not your primary concern, but nevertheless please accept that some people do actually give a damn about it. (For the avoidance of doubt - I have never spoken to Honest Reporting, and I am not a card carrying member of any conspiracy, Jewish, Zionist, pro-Israeli, or otherwise.) Competing interests: director of communications, CST. (dealing with antisemitism on behalf of UK Jewish community)
Rich Debate 28 February 2009
Babar Vaqas, Surgical Registrar London Send response to journal: Re: Rich Debate	Let us not forget that this article is personal analysis, not a scientific research paper. The hallmark of what makes Britain so great, and this Journal the heartbeat of our profession, is rich debate. Provided whatever is said is backed up with sound evidence, it should be welcomed, criticised, digested and should become part of our consciousness that keeps our diverse society, and medical community, alive. Competing interests: None declared
Shame on you BMJ 28 February 2009
David P Inwald, Consultant in PICU W2 1NY Send response to journal: Re: Shame on you BMJ	So a bunch of nutters shoot off some abusive emails and this is evidence of a worldwide Jewish conspiracy to suppress free speech? Shame on you, BMJ, for printing such twaddle. Competing interests: None declared
Un-green behaviour 1 March 2009
Elliot Daniel, Consultant Orthopaedic Surgeon University College London Hospital NW1 2BU Send response to journal: Re: Un-green behaviour	For a long time now I have adopted the routine of opening the plastic envelope of the package that I receive every week. I flick through the BMJ, then I bin it. The BMA News is placed above the toilet for more indepth perusal at my convenience. I have asked my consultant colleagues and juniors if they do the same and it appears that my weekly ritual is in fact quite common practice amongst doctors. This article is further proof that the BMJ has long stopped being a medical journal and is simply junk mail that doesn't even cut it as toilet reading! Due to my guilt about this un-green behaviour I have requested to stop receiving the BMJ (I do still have a use for the BMA news) I suggest the same to those who do the same weekly ritual as me me. Think of the Amazon rain forests! Competing interests: I support peace and reconciliation in the Middle East and not divisive nefarious nonsense
Diabetes in Gaza: Getting the Facts Correct 1 March 2009
Paul Z Zimmet, Director Emeritus Baker IDI Heart and Diabetes Institute 3181 Send response to journal: Re: Diabetes in Gaza: Getting the Facts Correct	Not even the BMJ and its correspondents are immune to publishing information that is factually incorrect and misleading in lack of detail. Karl Sabbagh's article "Perils of criticising Israel" stated: "For instance, the International Diabetes Foundation recently apologised for an article on the difficulties faced by diabetic Palestinians in Gaza, and the editor of Diabetes Voice (the foundation's quarterly publication) resigned." Sabbagh is a victim of the same type propaganda that he claims others have perpetrated. He has not checked his facts. Diabetes Voice is the quarterly magazine of the International Diabetes Federation. It covers the latest developments in diabetes care, education, prevention, research, health policy and economics, as well as themes related to living with diabetes. The article cited by Sabbagh contained a significant amount of material taken by its author lifted almost word for word from an official PLO website. It was historically incorrect and was not relevant to the rest of the article which was a true statement of the diabetes situation. The article slipped past the editor concerned. The International Diabetes Federation quite rightly removed the article from its website and issued an apology. Competing interests: None declared Competing interests: None declared
Why defend Summerfield? 1 March 2009
Steven M. Albert, Professor University of Pittsburgh, USA 15232 Send response to journal: Re: Why defend Summerfield?	Unfortunately, Karl Sabbagh does not deny the false claims made in the original Summerfield article. Sabbagh simply asserts that Summerfield "supported his arguments with figures published by reputable international organisations." To BMJ's credit, readers can find examples of Summerfield's bias in Jonathan Freedland's accompanying commentary. For example, Summerfield wildly exaggerated Palestinian casualties (insisting nearly all were unarmed civilians) and omitted Israeli casualties entirely. In the same vein, Sabbagh lets stand his original comments on Deir Yassin, continuing to speak of it as "a massacre of innocent Palestinian villagers" despite archival data showing it was a battle between Israeli and Arab regulars, in which Israeli soldiers warned villagers to leave. This is the real problem with a medical journal's foray into politics, not email blasts or pressure from interest groups. If "suffering humanity is our remit" and the justification for a medical journal entering the political realm (as BMJ editors have argued; BMJ, 2002; 325: 1431-32), then let us insist that every effort be made to get the facts of this suffering right. Otherwise BMJ is lending support to partisanship and a political agenda. Calling these accounts "personal papers" does not absolve the Journal of its responsibility. Competing interests: I serve on the medical/public health task force of Scholars for Peace in the Middle East
The elephant's foot on the mouse's tail 1 March 2009
Mohammad Farhad Peerally, Medical Student University of Sheffield, S10 2RX, Nusra B. Khodabux Send response to journal: Re: The elephant's foot on the mouse's tail	As far as we can tell, all that this analysis is about is a recount of the bombardment of hate mails editors received 5 years ago following the publishing of an article on the palestine health crisis1 and a reminder of how powerful and effective Israeli lobby can be. It is very hard to speak about the Israeli-Palestinian conflict without being accused (or praised) of taking sides. But can we always be impartial? Desmond Tutu famously said, "If you are neutral in situations of injustice, you have chosen the side of the oppressor." The BMJ is more than just a medical journal. What makes it stand out is the diverse mosaic of factual articles, all with the common aim of educating, as opposed to misinforming and brainwashing readers - a theme which has been recurrent in propaganda websites from both sides. 1. Summerfield D. Palestine: the assault on health and other war crimes. BMJ 2004;329:924. Competing interests: None declared
Keep grasping the nettle... 2 March 2009
Gene S Feder, Professor of primary health care University of Bristol BS8 2AA Send response to journal: Re: Keep grasping the nettle...	Unlike most of your correspondents to date, I welcome Karl Sabbagh's analysis of responses to Derek Summerfield's 2004 BMJ article about IDF human rights violations in Gaza. Not because I think there is anything intrinsically wrong with orchestrated email campaigns nor because I think that this is unique to articles about Israel-Palestine (I am with Jonathan Freedland on the latter point). My concern is that editors are not intimidated by these campaigns nor by other pressure that can be exerted on journals. Sabbagh cites evidence that this has happened in the past and we need to ensure that it does not induce self-censorship in the present. Should the BMJ and other medical journals avoid all contested political issues and military conflict? This would be ignoring the profound effect that political, economic and military decisions have on the health and survival of individuals and whole populations. If they are not debated in medical journals, giving space to opposing views, including evidence and opinion, then I believe they are failing in their duty to help us understand the forces that drive global health and health care. This is as true of Gaza, as of Burma...or Bristol. Even if other correspondents don't agree with Virchow that "all Medicine is a social science and politics is nothing else but medicine on a large scale," I think they are kidding themselves that medicine can be completely separated from politics. I wish the BMJ resilience (and a thick skin)in continuing to grasp this nettle! Competing interests: I am the son of a Holocaust survivor and believe in a genuine 2-state solution to the Israel-Palestine conflict
The only solution is to keep talking 2 March 2009
Gwyn S Williams, ST1 Ophthalmology Carmarthen - SA31 2AF Send response to journal: Re: The only solution is to keep talking	I must congratulate the BMJ on having the courage to publish Karl Sabbagh's analysis of the response to the publication of an article which was perceived to have an anti-Israeli bias (1). A common point raised by those authors that repeatedly criticise the BMJ for concentrating on Israel is that there are so many other conflicts currently underway in the world that writing about Israel is unfair. It is however no less true that the Arab-Israeli conflict is arguably the most contentious issue in the world, with a workable solution seemingly as far away today as at any time before. Shades of this conflict colour our everyday lives in many different ways and the hackles raised by any statement whatsoever to do with the middle east is always a degree of magnitude greater. I agree with Jonathan Freedland that great sensitivity, impartiality and accuracy must be used when discussing this conflict, but avoiding this discussion is tantamount to giving up on any meaningful effort to find a resoultion. The problems, including healthcare issues, of Israelis and Palestinians are not simply part of a far greater collection of world disasters. It is the elephant in the room and turning a blind eye is not fairness and worsens the long term prospect of peace. Even if the barrage of hostility continues in response to your article any discussion however negative, is better than no discussion at all and I applaud your decision to publish. (1) Sabbagh K. Perils of criticising Israel. BMJ 2009; 338:509-511 Competing interests: None declared
A brave and rare insight 2 March 2009
Adrian Worrall, Researcher London E1 8AA Send response to journal: Re: A brave and rare insight	Thank you, BMJ for this brave and rare insight into pro-Israel lobbying. I have recently returned from the West Bank and have seen how Palestinian society is being systematically and comprehensively destroyed by Israel. I was shocked by the progress of this since my visit a year earlier. But this BMJ paper and responses show a glimpse of a more global and less visible war of lobbying and media manipulation. Now you have stepped into one of the front lines. Thank you for supporting free speech and for being steadfast against the bullies. I expect the BBC faces similar barrages on the rare occasions it provides a Palestinian perspective. Senior managers would do well to read your papers and then analyse the forces that lobby the BBC. I doubt the BBC would publish any such analysis for fear of precipitating more extreme lobbying. You have shown that the BMJ is made of stronger stuff. Competing interests: None declared
Evidence does not support conclusions. 2 March 2009
Michael A Apple, GP Garston Medical Centre Watford WD25 9GP Send response to journal: Re: Evidence does not support conclusions.	Dear Madam I have subscribed to the BMJ for some 35 years and yet still learn from the journal of uncertainties in how to treat otitis media. But I need read the BMJ for only a month or so to find out the absolute truth about the Middle East and that the true villain is Israel. Report after report presents “evidence” for this and now an article, years after the events, also tells me of the “perils” of criticizing Israel. Perils? Has someone been shot or attacked? Have homes or offices been vandalized? Has there been a fatwa? Has someone been stabbed for making a critical film? No; someone has had a lot of emails 4 years ago. Is Karl Sabbagh’s article a personal view? Not many personal views get editorial endorsement. Is this a scientific paper? Clearly not or it would perhaps show an analysis of responses to a statistically valid number of other articles critical of Israel. And possibly compare with the responses to control articles or to articles critical of the Palestinian administration or of Hamas. Is such research in process? So is this maybe relevant to some on-going “peril” that has arisen after criticizing Israel or some on-going bullying, as the editorial team implies? The BMJ published a recent report (BMJ 2009: 338: b170) about conditions in Gaza. This was written during the war and based largely on quotes from someone who is on record as saying that 9/11 was just what certain people deserved (where, incidentally, was that declaration of interest?). That report generated 7 rapid responses. These are your “sinister forces” ? This is “peril” ? This is “bullying”? You’d get more reaction to a wrong recipe for chicken soup. As for these present articles, after 3 days these have generated about 30 responses. What irony, or maybe disappointment, that articles referring to “sinister forces” and “orchestrated campaigns” and “bullying” induce such a feeble torrent. And talking of sinister forces, may I query why you publish this now? It surely cannot be because 4 years were needed for complex number crunching and peer reviews. And certainly not because of the intellectual sophistication of the analysis of the emails. It strains credulity that it has taken 4 years to get a legal opinion. So why now? Is it offered as a contribution to the current bien-pensant, chic and nonchalant climate of opinion that vilifies Israel and her advocates, before reaching for another croissant? I only ask. Jonathan Freedland has suggested you develop a thicker skin. I think I know of what he speaks. If Karl Sabbagh, Kamran Abbassi , and the editorial team want to learn about real peril and sinister forces, look at the Guardian’s “ Comment is Free” section for the hundreds of overwhelmingly hostile responses that follow with hours any article even vaguely supportive of Israel. Read, say, Mr Freedland’s article on 4th Feb 09 about left wing bias against Israel. Within a few days that generated in excess of 800 responses most of which were full of loathing for Jews (spare me also the sophistry of the distinction between Israelis and Jews) and which condoned, excused or encouraged violence against Jews. And that omits the comments deleted by the moderators which did not, one assumes, suggest hug a Jew today. That is a concerted response and that is peril. Not the sort of “peril” or indeed “bullying” that may have given your writers pause between sips of coffee but peril and bullying that finds real physical expression now in attacks on Israeli shops in Kensington, attacks on Jews old and young in London and Manchester, the vandalizing of a synagogue in Venezuela and the need for a heightened level of security in synagogues across the UK. The BMJ could stick to being an academic journal and argue about p- values . It is much the better for not doing so. But when the journal does go into areas outside its acknowledged expertise, it is putting views to a wider audience that will include people better informed on many issues than you are. People, who quite legitimately may get irritated when publication in the BMJ gives a spurious veracity to what may be no more than opinion and who, horror, express their views. Your editorial has drawn in evidence 4 year old data which is unremarkable as compared to responses to controversial issues in other media right now. The few responses to far more recent articles criticizing Israel give the lie to your assertions of peril and bullying. And on such a feeble basis you proclaim your fears of "sinister forces" to the world and congratulate yourselves on your principled stance. This demeans the BMJ from whom I'd welcome rather more certainty about treating otitis media and rather less certainty about the rights and wrongs of the situation in the Middle East. Dr Michael Apple Competing interests: None declared
The fallacy of some democracies 2 March 2009
Bassem R Saab, Professor of Family Medicine American University of Beirut, P.O.Box 11-0236 Send response to journal: Re: The fallacy of some democracies	I have read with interest "Perils of criticizing Israel" by Karl Sabbagh. Democracy when practiced right is a great thing. One dictionary defines democracy as "government by the people or their elected representatives". Intimidating people isn't democratic. If Israel established a real democracy where Jews, Christians, and Moslems have equal rights it would not have reached to a stage where its existence is in real danger. Competing interests: None declared
The perils of bias mascarading as fact 3 March 2009
Ben Bradley, GP London E5 9BQ Send response to journal: Re: The perils of bias mascarading as fact	The BMJs latest foray into anti-Israel bias is so far out of step with its alleged purpose as a journal that you really have to wonder what's behind these editorial decissions. Mr Sabbah clearly hates Israel, with relevant personal background, and is writing from this viewpoint. Even given that political issues can't be ignored in a medical journal, what does that have to do with this latest, purely personal tripe? As for the the 'perils' of criticising Israel, if Mr Sabbah thinks that emails represent peril he'd better look up the dictionary definition. Competing interests: I am Jew and a fair person with a sense of justice.
Something is wrong 3 March 2009
Doron Samuell, Consultant Psychiatrist Sydney, 2000 Send response to journal: Re: Something is wrong	I was one of those who responded to an earlier contribution by Summerfield. I would ask that this response be printed in full to illustrate my current response: "Dear Dr Summerfield, Your concerns about the IMA would indeed be commendable if there was contextual balance to your views. It would have been helpful for instance for you to have detailed how in fact Red Crescent Ambulances have been used on many occasions to convey terrorists and bombs. You might have also mentioned how Palestinian hospitals have been used by terrorists for bases and snipers. It may also have helped the debate to elaborate how Palestinian doctors have systematically engaged in misinformation campaigns, using patients and false information for political purposes eg Jenin. Even had you taken into consideration many of the above comments, it would still not absolve the IMA. Indeed had you been practicing in Israel you would probably come across many survivors and victims of terrorism, particularly if you worked in rehabilitation or psychiatry. You may not have to look over your shoulder when you go to a shopping center or supermarket. You may not have to plan trips so that you and your wife are in different locations just in case. You may not even have a bomb shelter. Not having had these experiences, I am not sure that you understand what it must be like to have escaped one Holocaust and to face the prospect of another. Whilst I understand the British affinity for regulations and guidelines and do not seek to denigrate these, your own security forces will pull no punches in apprehending potential terrorists on British soil. In short, had you balanced your comments with concern about the various medical associations in the Arab world and in the many totalitarian countries and had you acknowledged the various breaches of the Geneva convention that occur when terrorist mingle with (and therefore endanger) their own and had you acknowledged the enormity of the trauma confronting Israel on a daily basis, then I would give your views some more consideration." I maintain my earlier views and express considerable concern about what is happening in this journal. My feedback above was not cited by the authors, instead, they chose to provide a skewed selection of material that in itself was designed to denigrate those who are critical of their position. The essence of the problem is that individuals who contribute articles are experts in their medical field. This expertise is then leveraged to give opinions in areas where there is no demonstrable expertise. The opinions are therefore given status that lacks merit. This undermines the credibility of the journal. Almost all of the claims made by the various recent contributors can be factually disputed. But this is not the point. Had they had a genuine concern for human rights, for the freedom of speech, affiliation and movement, why would they chose to focus this on the one democracy that lies in a sea of despotic regimes where there are little to no human rights? If the authors have authentic grievances, please let us hear about the persecution of gays in Iran or the Coptics in Egypt, the Christians in Gaza and so on. And what about the treatment of dissent in Syria and the fact that no Arab country has freedom of press. Further, to quote organisations such as the UN as bolstering credibility for the claims made against Israel is at best naive and precarious. The UNRWA employs members of Hamas. The UN claimed a "massacre" in Jenin and subsequently retracted this. But more worrying for the authors should be the fact that their views are completely synchronized with the majority of member states that are non-democratic and who systematically abuse human rights without fear of criticism by BMJ contributors. Whilst the BMJ contributors may feel bullied, as a Jewish physician, I will not be censored in my feedback or subject to caricatures that grotesquely distort those who support Israel. I will not tolerate what are thematic distortions that are the very essence of bias and prejudice. Competing interests: None declared
Rapid Responses vindicate the article 3 March 2009
Sellam Ismail, Consultant 94550 Send response to journal: Re: Rapid Responses vindicate the article	Just as the response to Walt & Mearsheimer's work on the Israel lobby proved their point, so too do the reponses to this analysis prove its point. In what other conflict in history has the right of the oppressor and occupier (in this case Israel) been elevated above that of the oppressed and occupied (in this case the Palestinians)? This is a sick proposition, and speaks volumes about the injustice of the matter. Please remember that the Palestinians are the victims. And please remember what Occam counseled: the simplest answer is usually the correct one. In this case, Israel occupies Palestinian land. That's all you need to know to render a proper and correct judgement here. Competing interests: None declared
Thank you to Karl Sabbagh 3 March 2009
Linda Belanger, retired -- Send response to journal: Re: Thank you to Karl Sabbagh	I hope this will be just one of many letters of congratulation that you will receive for your expose of the Israeli propaganda machine. (Perils of Criticising Israel) This is a bold manifesto against the Israel lobby which threatens our freedom of speech. The movement to free Palestine must now refocus its sights to the home front; we must free ourselves from the lobby before we can do hope to advance the cause of Palestinian rights. The lobby is operating at full throtle but hopefully this is because it senses that the end is near. We have made progress over the past few years and it has come to the point where each new attempt to suppress the truth becomes and opportunity for the rest of us to speak out. The Israel lobby is in a pit of quicksand - the harder it struggles the faster it sinks. L. Belanger Ottawa, Canada Competing interests: None declared
providing evidence for Sabbagh-(live as we speak!) 3 March 2009
Ahmed Sewehli, ST3 Psychiatry Manchester Send response to journal: Re: providing evidence for Sabbagh-(live as we speak!)	Having read Sabbagh's analysis 'perils of criticising Israel' it was in a way humorous (although the whole issue is no laughing matter) to find that many rapid responders criticising him were in fact agreeing with his analysis as they proved his point: even more accusations of anti-semitism, claims that Arabs would stifle debate by issuing fatwas, claims that BMJ is biased, etc. BMJ: please continue to show your independence. Competing interests: None declared
Thank you for publishing this article 3 March 2009
Paola Canarutto, hospital physician (Internal Medicine Department) Ospedale S. Giovanni Bosco - p. Donatori di Sangue 3 - 10100 Torino - Italia Send response to journal: Re: Thank you for publishing this article	Besides being an hospital physician, I co-ordinate the Italian Network of Jews against the occupation, and I am a member of the EJJP's (European Jews for a Just Peace) Executive Committee. As such, I have visited the West Bank quite a few times (the Israelis never allowed me into the Gaza Strip). What I saw was the strangulation of Palestinian society: by settlements, roads on which only cars with Israeli plates (that is, not Palestinian ones) are allowed, now the Wall. Even the quantity of water which Palestinians are allowed to use is less than one sixth of the quantity granted to Israelis (even of the settler variety). Do not give in the the pressure by the lobby. In Italy, we have the same problem, and most media just give up. We desperately need voices that manage to say the truth. Best regards Competing interests: None declared
Disproportion in the Israel-Palestine Conflict 3 March 2009
Jonathan Bernstein, GP Principal The Beechcroft Medical Centre, Wembley, HA9 8EP Send response to journal: Re: Disproportion in the Israel-Palestine Conflict	Proportionate to the size of the conflict, the Israel-Palestine problem generates a hugely disproportionate media coverage as evidenced from a simple Google search of media reports. Compare for example the coverage given to the fighting in Fallujah, Iraq, in 2004. Following American warnings 2/3 of the 300,000 civilian population fled yet an estimated 6000 civilians were killed, 66 mosques (out of 200) used to store weapons were destroyed and 30,000 buildings demolished or significantly damaged: All this to root out 5000 insurgents. In Gaza 20,000 armed militants attacked by Israel resulted in 20 destroyed mosques, 25,000 destroyed or damaged buildings and 894 civilian deaths (according to Palestinian figures) out of a population of 1.5 million unable to flee the conflict zone (1). As another example compare the current rarely-reported fighting in Sri Lanka with that of Gaza. In Sri Lanka human rights abuses on both sides (2,3) including attacks on hospitals (3,4) and the deaths of 70000 since 2005 (5) do not exercise Western journalists or commentators in the way Gaza has done. Israel, in echoes of the medieval blood libel, is accused of a blood lust that generates head lines such as “Israel faces Rage over Massacre” (6) even when more sober subsequent analysis and independent investigation disproves such accusations (7). Similarly in the recent Gaza conflict before the facts were truly known Israel was condemned in headline news items for hitting a school and killing 43 civilians who had sought refuge there (8) . The truth when it came out after sober investigation was barely reported albeit that the casualties were ultimately the same in number though not in place (9). Israel too is criticised for closing its borders with Gaza even though it is de facto and de jure at war with Hamas. Egypt which is not is rarely mentioned for its closure of its border (10) and the confiscation of humanitarian aid by Hamas (11) largely ignored. In a democracy governments take decisions that may be supported by only part of the electorate and which, when relevant, may generate international opprobrium eg: Britain’s intervention in Iraq. The actions are usually judged on the facts of the situation and the world does not ascribe collective responsibility on the citizens of that nation, eg British citizens, when it disagrees with the decision. In contrast when the democratically elected Israeli Government chooses to act in a particular way, judgement is often made without all the facts and without account to the fact that no other democracy faces the same real threats as Israel. Furthermore, Israelis and Jews the world over are judged and tarred with the same critical brush for any action taken by Israel’s Government irrespective of any individual Jew’s or Israeli’s opinion of that decision. The consequences are ill-tempered media campaigns with ill-judged sweeping statements that consciously or otherwise drag up well-rehearsed anti-Semitic stereotypes that imply Jewish control of the media (12) or Jews/Israelis have policies to kill children (13). On the street anti-Semitic attacks increase (14) and the sense of isolation and vulnerability in the Jewish community feeds media campaigns such as those led by HonestReporting and the hate mail that Kenneth Sabbagh rightly condemns. It is the combination of this disproportionate media interest in Israel and perceived and actual anti-Israel bias, together with the ramifications for Jews worldwide when violence breaks out in Israel and the Palestinian territories, together too with deep-rooted scarring in the worldwide Jewish psyche left over from world inaction in the face of the Nazi Holocaust and previous anti-Semitic outrages that results in the over -reaction of Jewish and pro-Israel groups. But the perception, if not the reality, is that anti-Israel commentators such as Kenneth Sabbagh assume Palestinians always to be in the right and Israel always to be in the wrong. The truth of the matter lies between these extremes and the majority of ordinary men, women and children on both sides of the conflict suffer hugely as the result of the failure of their respective leaders to put down their weapons and talk. 1. Susser L, The Post-Gaza Clean-Up, The Jerusalem Report February 16th 2009 2. http://www.amnesty.org.uk/news_details.asp?NewsID=18045 3. http://news.bbc.co.uk/1/hi/world/south_asia/7901321.stm 4. http://www.amnesty.org.uk/news_details.asp?NewsID=18057 5. http://news.bbc.co.uk/1/hi/world/south_asia/2405347.stm 6. http://www.guardian.co.uk/world/2002/apr/17/israel2 7. http://www.guardian.co.uk/world/2002/aug/02/israel2 8. http://www.timesonline.co.uk/tol/news/world/middle_east/article5459394.ece 9. http://www.rte.ie/news/2009/0204/gaza.html 10. http://weekly.ahram.org.eg/2009/929/eg12.htm 11. http://www.un.org/News/Press/docs/2009/sgsm12089.doc.htm 12. Sabbagh K, Perils of criticising Israel, BMJ 2009; 338:a2066 13. Summerfield D, Palestine: the assault on health and other war crimes, BMJ 2004;329:924 14. Symons L et al, Worst wave of hate for quarter of a century, The Jewish Chronicle, January 15th 2009 Competing interests: I am Jewish, Zionist, son of a Holocaust survivor and believe in a negotiated two state solution to the Israel-Palestine conflict
Health is sociopolitical 3 March 2009
Stephen K Ginn, Psychiatry trainee Maudsley Hospital SE5 8AZ Send response to journal: Re: Health is sociopolitical	A theme of some reponses to this article and to the previous one by Summerfield are that the BMJ should keep its nose out of politics and international affairs and stick to what it does best, being a medical journal. For example in the reponse titled 'Medical Journal or Propaganda Sheet': "if i want to read about the political situation in the middle east then i will do so in the relevant outlets. if however i want to learn/keep up with general medical literature then in our profession, this journal should keep to what it does properly." I disagree; to consider the health of people both nationally and internationally without addressing wider sociopolitical concerns would be to ignore a major driving force for morbidity and mortality worldwide. It is a valid critism of the medical establishment that we are most confident in providing individual ex post facto interventions when the most pressing change is at the level of governments. Although we as doctors cannot directly action this ourselves, it behoves us to speak out as our continuing pivotal societal role rewards us influence at least. Competing interests: None declared
Freedom of speech in Arab countries 3 March 2009
Yair Yodfat M.D., Professor emeritus in Family Medicine Sheba Medical Center, Tel Hashomer, Israel, Arie Carmon Send response to journal: Re: Freedom of speech in Arab countries	I have one comment about Freedom of Speech. Why are there no protests by BMJ about the Arab attitude to Freedom of Speech, e.g. the Fatwa against Rushdi but also many life threats by Hamas and other Arab organisations against anyone who criticises them. Israel does much self criticism and does not have to be lectured about FOS. Competing interests: None declared
In praise of pachydermatous truth 4 March 2009
Brian Robinson, Retired NHS psychiatrist Retired MK5 6WB Send response to journal: Re: In praise of pachydermatous truth	In another article in the BMJ around this topic, the journalist Jonathan Freedland urged the BMJ to 'grow a thicker skin'. I think it must always have had one, although its journalists have never lost their sensitivity to the sufferings of humanity around the globe as a result of conflicts. Ordinary people get caught up in the grand schemes others. There are medical consequences arising from political decisions. It has always been so, and how can any medical journalism worthy of the name avoid reporting and discussing them? To paraphrase someone else whose valiance for truth landed him in trouble, if we are serious about trying to resolve this conflict, we'd best not get sidetracked by obfuscations, but focus on the real issues, as the BMJ (and indeed for that matter, the Lancet, also in the past subject to similar pressures) have done. The question should not be about whether the BMJ should or should not write about the Israel-Palestine conflict. The questions, and I'm quoting now, but there are many others had I the time, should be: “Do you support the demolition of homes and torture?” “Do you support Jewish-only roads and Jewish-only settlements?” “Do you support a political settlement embraced by the entire world apart from the U.S., Israel and some South Sea atolls?” (1) I hope that other questions relating to the effects on health of the Israeli occupation will continue to be reported on and discussed by the BMJ and other medical journals. And indeed not only the effects for the health and wellbeing of Palestinians. On a recent tour of the West Bank with several medical colleagues and other health professionals, I heard from a senior psychiatric colleague how greatly Jewish Israeli society is itself suffering in various sociopsychological ways as a direct result of the brutalising effects of the conflict. It would take me too far afield to itemise these here, but see for example, the website of Physicians for Human Rights - Israel (2) There is a vast amount more one could write - and should write - about the problems of trying to run basic hospitals under the occupation, about shortages of supplies, staff problems simply getting to work, and so on. And this is not even to mention all the horrors of the recent onslaught on Gaza. My recent tour was my second in 5 years, and served to highlight just how much things have got worse in terms of health care, education, the economy and more. This makes the BMJ's initiative all the more timely - and praiseworthy. To discuss this in the ways that the BMJ does, and the Lancet has in the past, is not 'antisemitism', or 'singling out Israel', nor has it anything to do with that much abused word 'demonisation' and it is simply wrong to attempt to reframe honest work done writing about it in these terms. And that in turn is not to deny that, yes, indeed there are and have been antisemitic ways of writing and speaking about Israel, but to conflate these tendentiously, as is sometimes done, in the long run does no-one any favours. The BMJ has proved that it is possible to be thick-skinned without losing sensitivity or humanity and I salute it. I don't usually like phrases that begin, "I'm proud to be ..." but I can't resist its coming to mind: yes, I'm proud to be a subscriber. Dr Brian Robinson Footnotes 1 http://tinyurl.com/45xvd4 2 http://tinyurl.com/c8uc5v Competing interests: Signatory, Statement of Jews for Justice for Palestinians; founder member, British chapter of Israeli Committee Against House Demolitions.
Support for the right of debate 4 March 2009
Marco Chiesa, Consultant Psychiatrist Cassel Hospital TW10 7JF Send response to journal: Re: Support for the right of debate	The article by Karl Sabbah predictably, but sadly, shows once again that the right of debate is stifled when even robust and well-evidenced criticism of Israeli policies in the Occupied Territories is voiced. Those who stand by the right of finding facts and truths should be encouraged by the rock bottom level of response by most of those writers who purport to support Israel. A Journal like the BMJ should not be intimidated into submission by insult and hypocrisy. Competing interests: None declared
Re: The fallacy of some democracies 4 March 2009
Jonathan Bernstein, GP Principal The Beechcroft Medical Centre, Wembley, HA9 8EP Send response to journal: Re: Re: The fallacy of some democracies	Professor Bassem Saab writes "If Israel established a real democracy where Jews, Christians, and Moslems have equal rights it would not have reached to a stage where its existence is in real danger." While Israel has its imperfections all its citizens, Jewish, Christian, Muslim, Druze, Bahai and others, have equal access to the ballot box and equal rights in law. (This does not apply in the Palestinian territories as that would require annexation.) This is not true in any neighbouring country including his own Lebanon where Palestinians born and bred in Lebanon are disenfranchised and the number seats in Parliament pre-allocated to each religious community and where the President and Prime Minister can only be from specific communities. Competing interests: I am Jewish, Zionist, son of a Holocaust survivor and supporter of a negotiated 2 state solution to the Israel-Palestine conflict
Well done BMJ 4 March 2009
Shahab A Siddiqi, colorectal fellow Waikato Hospital, Hamilton, NZ 3204 Send response to journal: Re: Well done BMJ	I was impressed by the BMJ's bravery in publishing Derek Summerfield article. Very few institutions manage to maintain neutrality in this topic and fail to succumb to outside pressure. Please carry on being brave and write the truth. You were correct to publish Karl Sabbagh's article, but it had no academic value and failed to respond to the original article in any way. Well done! Competing interests: None declared
Simple reflections 4 March 2009
Faisal M Mirza, Surgeon Palo Alto, CA 94304 Send response to journal: Re: Simple reflections	I applaud the BMJ for encouraging and not stifling such a debate. Fear of antagonism is what breeds further hatred and yet the power of one voice can reach so many that the stimulation of interest only fosters further comprehension of the issues. The plight of the Palestinians was most strongly felt by a recent Palestinian doctor's loss televised on local Israeli news. This made the impact real to many of the human suffering in this crisis. We are physicians and our Hippocratic oath demands that we first do no harm. We are the guardians of health and the healers of the injured and suffering both physically and mentally. Regardless of which side you stand politically, the suffering is real and the hatred is unmistakeably frightening. Yes, this is a topic for a medical journal to discuss. It's not about Palestine or Israel or religion. It's about power and the absolute corruption of the mind's eye in it's perception of events as simply inevitable rather than unacceptable and leading to a modern-day holocaust with the dignity of humanity at stake. I ask all physicians to realize this critical moment and recognize why we chose our professions; to live and breathe so that others may do the same, help all the world's children survive, regardless of political or religious bias or beliefs. Thank you BMJ for bringing my own existence into question and temper my doubts and quench my thirst to heal. Competing interests: None declared
Finally, the oppressed have a voice!!! 4 March 2009
N A Shah, Medical doctor Manchester Send response to journal: Re: Finally, the oppressed have a voice!!!	I must applaud, congratulate and support the BMJ in publishing this balanced analysis article. For far too long the apartheid regime of Israel has maltreated, oppressed, punished, ghettoised, terrorised, suffocated, malnourished, tormented the beautiful people of Palestine. Let them now be heard for the first time. Israel should respect human life and sanctity of property, preserving the Geneva convention and adhere to United nations resolutions. Well done, absolutely fabulous BMJ!!! Competing interests: None declared
Re: Freedom of speech in Arab countries 4 March 2009
Brian Robinson, Retired NHS psychiatrist MK5 6WB Send response to journal: Re: Re: Freedom of speech in Arab countries	Professor Yodfat asks "Why are there no protests by BMJ about the Arab attitude to Freedom of Speech". Unfortunately he doesn't tell us whether he has done a full search of the archive (and I'm not entirely sure if he didn't mean to write, for example, 'fundamentalist Islamic', rather than 'Arab') and I don't have time to do the search, but in any case the question is irrelevant. As a critic of much Israeli policy, I experience no cognitive dissonance when I write letters protesting human rights abuses in those countries under theocratic rule where many Muslims suffer grievously at the hands of fellow Muslims, or when I wrote recently in support of Peter Tatchell's recent article (1) concerning Hamas's own crimes, none of which "excuse Israel's disproportionate, reckless and indiscriminate attacks on Gaza". It is true that there is more freedom of speech and of the press in Israel than in many other countries, and perhaps the example most often quoted is that of the leftist daily paper Ha'aretz, but on that recent study tour I mentioned in an earlier post here, I was told authoritatively that only some 5% of Israelis actually read Ha'aretz. And to my astonishment, on the same trip, I was made aware that relatively few Israelis actually realise what is going on in the occupied territories - for example the delays at the checkpoints which mean that patients cannot get to hospital for diagnosis or treatment, frequently with fatal consequences but always to their detriment. So what good is freedom of speech if so many people either do not know what they ought to be discussing, or perhaps suspect too well, and uneasily, what they prefer not to acknowledge? From what I have observed in Israel and the occupied Palestinian West Bank, yes, I can agree with my colleague Dr Yodfat that "Israel does much self criticism", but I must add that its self-justifications too often sound unconscionably apologist. So I come back to why I believe questions about what, allegedly, the BMJ does or does not 'protest', about what 'Arabs' (or Muslims?) do or do not do, essential to talk about in many fora, are irrelevant when we are discussing, as we must, the statistics (2) of what Israelis are doing to Palestinians. By all means let us talk about jihad, Sharia, dhimmi status when we want to (and we should want to) but that must never prevent us from talking about what Israel is doing, over and above its legitimate security needs. If human rights and justice are indivisible, and they are, then highlighting the shortcomings of one party to any conflict must never mean keeping the spotlight away from those of the other, even where disparity of power is as evident as in the Israeli-Palestine dispute. 1 Peter Tatchell, Comment is Free, Guardian website, 18 Feb 2009 http://tinyurl.com/b9u94d 2 http://www.btselem.org/English/Statistics/Index.asp Competing interests: Signatory, Statement of Jews for Justice for Palestinians; founder member, British chapter of Israeli Committee Against House Demolitions.
Re: Diabetes in Gaza: Getting the Facts Correct 4 March 2009
Tony Delamothe, Deputy editor BMA House, London WC1H 9JR Send response to journal: Re: Re: Diabetes in Gaza: Getting the Facts Correct	I don't understand what Professor Zimmet finds "factually incorrect" and misleadingly lacking in detail in the BMJ's account of the events at Diabetes Voice. The details come from Diabetes Voice's website: http://www.diabetesvoice.org/files/attachments/issue_29_en.pdf (The apology appears on page 17.) Similarly, I can't spot any factual inaccuracies (given its date) in the introduction to the disputed article, which has been removed from Diabetes Voice's website but is available from Honest Reporting: "The year 2003 marked the 55th anniversary of the Nakba (cataclysm) of the Palestinian people. In 1948, according to the United Nations Conciliation Commission, 760,000 Palestinians were evicted from their cities and villages, hundreds of which were razed to the ground. What remains of the Palestinian people's land is now split between the West Bank of the river Jordan and Qita Ghazzah (Gaza Strip), and remains occupied by Israeli military forces and settlers. In 2003, the second uprising, or Al-Aqsa Intifada against this occupation entered its third year. Panagiotis Tsapogas, Medical Co-ordinator of the Greek section of Medecins Sans Frontires (Doctors Without Borders) in Gaza, 2002-2003, reports on the difficulties faced by Palestinian people with diabetes in Gaza, and makes a call for the provision of improved diabetes care in the region." Competing interests: Co-author of the editorial, "What to do about orchestrated email campaigns
predjudice on both sides 5 March 2009
Laura R Hulbert, ob-gyn , MD, FACOG 2900 Lemay Ferry Road, St. Louis, MO 63125 Send response to journal: Re: predjudice on both sides	I would ask that readers look at the Hamas charter to understand what Israel is fighting against. While legitimate criticism of Israel has a role, the media jump to conclusions too rapidly. In the Gaza war, they accepted the Hamas statistic of 900 civilians dead immediately, while an Italian journalist estimated casualties at 500-600, mainly Hamas-age young men. Furthermore, Col. Richard Kemp of the British army stated that the Israeli army incursion into Gaza was the most protective of civilians of any operation he had seen. No one has mentioned that the Israelis have endured daily rocket attacks for years, with most of the population of southern Israel from posttraumatic stress disorder. Besides accuracy, the amount of coverage of the Gaza war was more plentiful than any other military operation. In an analysis by Dr. Simon Fishman, the BMJ had one citation per 2000 deaths in Bosnia, 1 citation per 4000 deaths in Rwanda, 1 citation per 7000 deaths in Darfur, and 1 citation per 13 deaths in Gaza. For Kurds killed by government operations, there were no citations. Given that Israel is a democracy and has fully investigated any wrong doing by its troops, attention needs to be turned to other parts of the world and other issues. Besides the war statistics, governments have misused psychiatric hospitalizations for their opponents. Women living under Taliban law have no access to medical care. It is important to speak about medical issues throughout the world. Competing interests: American Republican
Lost in admiration 5 March 2009
Harold Bourne, Psychiatrist 00136 Rome Italy Send response to journal: Re: Lost in admiration	Karl Sabbagh's courage in face of"The perils of criticising Israel",and in the British press too - such a lone voice! He might escape to Israel where, to judge from quotes in my Rome newspaper,he would not be so perilously isolated. Competing interests: Atheist Jew
Politics, The BMJ and the Practice of Medicine 5 March 2009
Raymond Pollak, Consultant Skokie, Illinois, USA 60076 Send response to journal: Re: Politics, The BMJ and the Practice of Medicine	Karl Sabbagh's editorial does little to quell the controversy over the alleged bias of the BMJ when the Journal appears to abandon its core mission to enter the world of politics. Indeed, Mr. Sabbagh's description of the Deir Yassin atrocity in the 'Flashback' section of the editorial has only a political goal. He omitted, however, to remind the readership of documented atrocities committed by Arabs against Palestinian Jews in 1920/21, 1929, 1936-39 and in 1948. He also omitted to mention the role of the Mufti of Jerusalem, Haj Amin Al-husseini in formenting these riots and his later support for Nazi Germany. At the Nuremberg Trials, Eichmann's deputy Dieter Wisliceny (subsequently executed as a war criminal) testified: "The Mufti was one of the initiators of the systematic extermination of European Jewry and had been a collaborator and adviser of Eichmann and Himmler in the execution of this plan. ... He was one of Eichmann's best friends and had constantly incited him to accelerate the extermination measures. I heard him say, accompanied by Eichmann, he had visited incognito the gas chamber of Auschwitz". After his exile from Palestine in 1937, the Mufti never returned to Jerusalem. He was replaced by his nephew Mohammed Abdel-Raouf Arafat As Qudwa al-Hussaeini, better known as Yasser Arafat.(abstracted from www.palestinefacts.org). For a more balanced view of the current realities in Gaza, especially with regards to the health and living conditions of its residents, the reader is referred to a recent eye-witness account by Yvonne Green (see http://www.jpost.com /servlet/Satellite?cid=1235898327903&pagename=JPArticle%2FShowFull) "From what I saw and was told in Gaza, Operation Cast Lead pinpointed a totalitarian regime's power bases and largely neutralized Hamas's plans to make Israel its tool for the sacrifice of civilian life," she writes. Against this background and Sabbagh's concern with Honestreporting.com, is the latter's recent PubMed citation analysis of the BMJ. If accurate, the analysis suggests that when there is ethnic strife in the world, the BMJ publication record is selectively focused on the Arab-Israeli conflict. Why should this be the case? Is it because of the cynical view that media opprobium occurs only where there is access and freedom of the press? Or does the alleged bias of the BMJ reflect inherent racism by the BMA and Editors of the BMJ? If the latter is true, Hippocrates would hang his head in shame. Competing interests: None declared
Immoral 5 March 2009
Larry Weisbrod, MD, FRCP(C) Toronto M6M 3Z4 Send response to journal: Re: Immoral	You are antisemites! What should people do when attacked as you have attacked the Jews? We will fight, and we will fight for our beleaguered country Israel. And we shouldn't have an organized response? You must be stopped at all costs. We've seen what the effects of not acting against antisemites are. Competing interests: I have morals
Congratulations on Your Bravery 5 March 2009
Janet M. Desroches, Administrator in Doctor's office Doctor's Office, K1P5Z9 Send response to journal: Re: Congratulations on Your Bravery	Dear Karl Sabbagh and Michael O'Donnell, Thank you for your courage in standing up to the Israeli Lobby, and printing your very excellent article about the perils of doing so. You have helped all of us all over the world who have tried to do so and have been unable to be heard. Our letters go unanswered and unpublished, our complaints about biased reporting and the difficulty of getting more than half of the news go unheard, and we are left feeling alone and confused. I'd just like to add, however, that I feel your inclusion of the article by Jonathan Freedland was unfortunate. Mr. Freedland has shown repeatedly by his articles in the Guardian that he is very heavily biased toward Israel, and his comments make it look like criticising Israel is similar to criticizing Obama. It isn't. As your two articles point out very well, criticizing Israel is the one thing no one dares to do because of the sometimes brutal and certainly well orchestrated harrassment of anyone who dares to do so. They are trying to silence us and we must not let that happen. Sincerely, Janet Desroches Competing interests: None declared
Providing a Balanced Picture 6 March 2009
Usman Sadiq, Management Consultant 140 Old Lodge Lane, CR8 4DH Send response to journal: Re: Providing a Balanced Picture	I was impressed at how organised the HonestReporting has been at mobilsing such huge numbers of people to respond to articles it deems "biased". Maybe if this level of organisation was put to resolving some of the issues raised by the Sabbagh article we would all be moving towards a safer future. Competing interests: None declared
Freedom of Speech 6 March 2009
Roger Black, general practice Whitevale Medical Group, Glasgow G311QS Send response to journal: Re: Freedom of Speech	Dear Sir, Mr Sabbagh's lack of objectivity in his approach to criticism of the Summerfield story is soundly demonstrated by his inability to countenance any viewpoint other than his own as independent or of having any worth. He collectively repudiates contrary opinion as 'lobby action' and asserts, without proffering any evidence,that these respondants had failed to read the original article.The basis for this view seems to be that any opinion differing from his own can only be based on ignorance. Even if his own figures are to be accepted,77% of the letters received had no connection with HonestReporting.com. Why is so little of his article given to addressing these views? Perhaps it is because he stereotypes those who support Israel and who disavow Palestinian extremism as necessarily all'Jewish doctors'. There are many who wish to add their support to Israel and who abhor the effects of militant Palestinian tactics both on those living in Israel as well as on its own subjects in Gaza. Mr Sabbagh's rank dismissal of alternative opinion appears completely at odds with the principles of free speech he purports to defend. Yours faithfully, R.Black Competing interests: None declared
Jfjfp supports the BMJ 6 March 2009
Sylvia R Cohen, Executive, Jews for Justice for Palestininas n/a Send response to journal: Re: Jfjfp supports the BMJ	Thank you for publishing this article. We support this and the continued publication of articles which point to the effect of the Occupation on Palestinian health and lives, despite the kinds of hostile responses which have been analysed here. Debate must not be closed down. Competing interests: None declared
BMJ Qualified Expert on Middle Eastern Politics? 6 March 2009
Noam Millo, MD University of Alberta Send response to journal: Re: BMJ Qualified Expert on Middle Eastern Politics?	At what point did the BMJ become an authority to comment on the situation in the middle east? Is there a medical aspect to this story that I am missing or is this just another shameless slander on Israel. With all due respect to Karl Sabbagh his artible does not even pretend to present a balanced view. Mr Sabbagh has chosen to publish a few poorly written or innacurate comments on behalf of the pro-Israel lobby of the thousand or so that were sent in. Were there no inflammatory, hateful, or innacurate comments sent in by the pro-Palestinian lobby? The BMJ and its editorial group should limit themselves to publishing unbiased articles that are relevant to medicine. There is nothing even remotely academic about this particular publication. Competing interests: None declared
Viva freedom of press 7 March 2009
K Garman, Foundation Programme Doctor GP - Birmingham Send response to journal: Re: Viva freedom of press	Health has many political determinants that we as health professionals need to understand. Thank you for bringing these to our attention with your series of articles on a range of political issues affecting health throughout the world, not least in the Middle East. I will continue to read the BMJ and encourage you to continue your vital work. Competing interests: None declared
Childish Games 7 March 2009
Sylvia M Watkins, retired physician Hitchin SG4 9BJ Send response to journal: Re: Childish Games	My congratulations to Karl Sabbagh and the BMJ for having the courage to publish this informative article. He gives an illuminating analysis of the reaction to Derek Summerfield's 2004 article about the actions of the Israeli army in Gaza at that time. Some of the responses were so extreme as to be almost funny; much of the abusive language, the hectoring denials of any misdemeanour, and the expressions of venomous hatred, are all reminiscent of childish temper tantrums; however, children react in this way because they are self- centred, and do not comprehend the issues, and this is totally understandable. That supposedly educated and rational adults can react (with or without "orchestration") with such venom and bias is very sad. Even sadder is the fact that five years on the vitriolic attacks are much the same. The writers deserve our pity (not contempt), because they are just self-centred children who do not understand. Anyone who has seen the realities of life in the Occupied Palestinian Territories has some understanding of the problems relating to physical and mental illness, health care, education, the economy and housing (evictions, demolitions and settlements), mostly due to the illegal occupation by Israelis. My most recent visit, just before the invasion of Gaza, proved to me that the situation has deteriorated greatly, in comparison with my seven previous visits. Those who react to accounts of real life with vitriolic hyperbole should take another look. Competing interests: None declared
Acknowledge the pain of antisemitism but don't demonise strong criticism of Israel 8 March 2009
Brian Robinson, Retired MK5 6WB Send response to journal: Re: Acknowledge the pain of antisemitism but don't demonise strong criticism of Israel	I should like to cite, in reply to some of the responses above, an article by Antony Lerman in the Independent of Saturday, 7th March 2009, entitled "Must Jews always see themselves as victims?" I have long admired Lerman's scholarship especially on questions relating to antisemitism. He is lucid and compelling. The article follows upon what the Independent's sub-heading refers to as a "fierce debate [that] has been raging in 'The Independent' about Israel's conduct in Gaza". He writes: "It's perfectly possible to acknowledge the pain caused by increased anti-Semitism but reject wild scenarios and counterproductive ways of dealing with the problem – such as demonising strong criticism of Israel". The link to the article is: http://tinyurl.com/7amn9r Or the full link: http://www.independent.co.uk/news/world/middle-east/must-jews-always-see- themselves-as-victims-1639277.html Competing interests: Signatory, Statement of Jews for Justice for Palestinians; founder member, British chapter of Israeli Committee Against House Demolitions.
Politics and the BMJ 8 March 2009
David J. Grant, Consultant Physician Edinburgh EH16 6UB Send response to journal: Re: Politics and the BMJ	In publishing the peer-reviewed article “Perils of criticising Israel” and accompanying editorial at this time, the BMJ is acting politically. I am unconvinced by the reasons given in the editorial for the four-year delay in publication, namely the sophistication of the analysis in the paper and the complexity of the review process. Indeed I am surprised that any paper containing sentences such as “a general flavour of the feedback can be gathered from a few verbatim quotes” has survived peer review by a scientific journal. It is indeed not possible to remove medicine from politics or politics from medicine. In choosing to engage itself in the politics of the Middle East, I ask the editorship of the BMJ to reflect on whether its actions will in any way promote a just and lasting solution to a seemingly intractable conflict, or contribute to the health and wellbeing of the people in the region, or both. As a Jew I question my own objectivity in this debate. However, in this case I am doubtful. Competing interests: None declared
To Tony Delamothe Re his rapid response 9 March 2009
Elliot Daniel, Consultant Orthopaedic Surgeon University College London Hospital NW1 2BU Send response to journal: Re: To Tony Delamothe Re his rapid response	You have expressed a profound lack of understanding concerning the misinformation of Diabetes voice's article. You quote their article mentioning Arabs leaving Israel as a ‘Naqba’. You have conveniently not mentioned the one million Jews expelled from Arab countries Aden, Iraq, Libya etc. These Jews were expelled under threat of death. The majority of the Arabs that did not run from their homes in 1948 still live in them as Israeli citizens. Have you ever been to the cities of Acre, Haifa, Jaffa, Ramle, Lod, Jaljulia, Kfar Kassem etc? The Arabs who chose to stay and not flee as instructed by their leaders are still living in their homes today as Israeli citizens. The Jews of Arab lands had no such choice. Not to mention that this was a war of aggression by the Arab countries who rejected the UN's two state solution in 1948. I suggest you research this a little deeper. You do not have to go far London has a community of 5000 Adeni Jews expelled from Aden during the anti-Jewish pogroms there. Israel is a multi-cultural society. One quarter of Israeli citizens are not Jewish, they are Arab Moslems, Christians and Druze amongst others this includes Army officers, members of parliament, Judges, doctors, nurses all walks of life. How many Jews are living and working in Jordan, Libya and Aden? The life expectancy of Israeli Arabs is 80 years of age. That of Palestinians is 73. These figures are a great deal higher than many European countries. Have a guess what the life expectancy is of Jews in Arab countries? Think about all of this a little and maybe you’ll begin to understand that Middle Eastern politics is not for novices. Indeed your comments and those expressed in this article are impertinent in the true sense of the word. Competing interests: I support peace and reconciliation in the Middle East and not divisive nonsense and incitement
Wolf in Sheeps Clothing 10 March 2009
Shawn Malachovsky, Attorney 10005 Send response to journal: Re: Wolf in Sheeps Clothing	The BMJ published a political one-sided article demonizing Israel. Those that care to defend Israel's good name respond to the article with emails. Some use HonestReporting.com as their source. And this author (Karl Sabbagh) attacks the responders by demonizing them as campaigners to stifle debate. In fact this author goes further and conjures up a subtle conspiracy that since the establishment of Israel 60 years ago these campaigns have had a goal to suppress debate. May I remind this author and other readers that in Israel itself criticism of the Israeli Government its Military and Palestinian issues are open and free in the press and in all other forms of expression, that the debate is rich and open and vast. Perhaps the author should rethink his definition of debate, as it is not one sided . . . responding to an article demonizing Israel is not a conspiracy to stifle debate. Instead it is the very expression of debate. Who is suppressing debate? Perhaps the author should look in the mirror. Competing interests: None declared
Diabetes in Gaza: Getting the Facts Correct 10 March 2009
Paul Z Zimmet, Director Emeritus Baker IDI Institute Send response to journal: Re: Diabetes in Gaza: Getting the Facts Correct	Tony Delamonthe has challenged my claim that the BMJ has published information that is not factual. In the interim, he has posted the material in question in a Rapid Response above. Firstly, the use of the Diabetes Voice as an example was inappropriate as the actual facts surrounding the incident belie the way this has been used. You are welcome to check with the International Diabetes Federation as to the actual truth of what happened, and the circumstances of the editor’s ‘resignation’. In fact, I was either the first or one of the first, to draw this matter to their attention. Secondly, in relation to the abstract and the four accusations that I have been asked to defend 1. The year 2003 marked the 55th anniversary of Nakba (cataclysm) of the Palestinian people Most Palestinians refer to the establishment of Israel in 1948 and the concurrent creation of the Palestinian refugees as a-Naqba, which means The Catastrophe, as opposed to The Cataclysm. As such, the article was strictly correct in making the claim of 2003 being 55 years since "Nakba." However, to not add that one of the reasons for the refugees was the invasion of the new state of Israel by five Arab armies shows gross bias. 2. In 1948, according to the UN Conciliation Commission, 760000 Palestinians were evicted from their cities and villages, hundreds of which were razed to the ground. There are two main factual errors in this statement. The UN Conciliation Commission estimated that there were 711,000 Palestinian refugees (not 760,000), and did not mention whether they were "evicted" or fled the fighting of their own accord or, indeed, as some thousands of Palestinians did, left well in advance of the fighting (at the urging of Palestinian and Arab leaders), expecting to return to a country free of Jews in a few weeks. There has been much controversy over how many Palestinian refugees were forced to flee by Israeli troops, and how many fled of their own accord. The most widely accepted figure is that just less than half were evicted, and these only after Arab states made clear they were going to invade Israel, and Israel felt it would be destroyed unless it had viable land within which to operate. (Benny Morris, widely credited as being the authority on Palestinian refugee figures writes, "Most of Palestine's 700,000 'refugees' fled their homes because of the flail of war... But it is also true that there were several dozen sites, including Lydda and Ramla, from which Arab communities were expelled by Jewish troops." While this context need not have been in the original article, the statement that all Palestinian refugees were evicted is patently false, and gives the wrong impression about the goals of each side in the war. Let us remember, Israel was fighting a war of survival; Palestinians and their Arab state allies were fighting a war of liquidation (the statements issued the leaders of all parties prove this beyond doubt). The relevant article in the UN Conciliation Commission report is from Appendix 4 (Report of the Technical Committee on Refugees), Article 15: "The estimate of the statistical expert, which the Committee believes to be as accurate as circumstances permit, indicates that the refugees from Israel-controlled territory amount to approximately 711,000. The fact that there is a higher number of relief recipients appears to be due among other things to duplication of ration cards, addition of persons who have been displaced from area other than Israel-held areas and of persons who, although not displaced, are destitute." 3. What remains of the Palestinian people's land is now split between the West Bank of the River Jordan and Qita Ghazzah (Gaza Strip) and remains occupied by Israeli armed forces and settlers. The statement that all the land belongs or belonged to the Palestinians, of which only the West Bank and Gaza Strip remain is both incorrect and evidence of gross bias. The Palestinians didn't and never have 'owned' the land in the sense of the British owning Britain or Australians owning Australia, since the Palestinians have never had, throughout history, an independent state. Israel replaced the British mandate (essentially a colony mandated by the League of Nations to establish a Jewish state), which replaced the Ottoman Empire's control of the area, which replaced (in 1517) the Mamluk's control of the area, and so on. 4. In 2003, the second uprising, or al-Aqsa Intifada against this occupation entered its third year. This staement is correct. So, in the context of the above, my statement that the BMJ published information that is factually incorrect and misleading in lack of detail stands. I am quite happy for you to publish this letter. I also think it would be appropriate for the BMJ to issue a statement to the effect that they were provided with incorrect information. Yours sincerely, Paul Zimmet Competing interests: None declared Competing interests: None declared
The Editor responds to charges of anti-Israel bias in the BMJ 11 March 2009
Fiona Godlee, editor BMJ Send response to journal: Re: The Editor responds to charges of anti-Israel bias in the BMJ	Several responses to the recent article by Karl Sabbagh [1] and other articles in the BMJ,[2,3,4] have charged the BMJ with two counts of bias against Israel . First, that the journal’s editors discriminate against Israeli researchers in decisions about which research papers to accept for publication.[5] Second, that the BMJ’s coverage of conflict zones is dominated by the conflict in Gaza and the West Bank to the exclusion of other conflicts in which larger numbers of civilians have been killed (http://www.honestreporting.com/articles/45884734/critiques/new/BMJs_Bad_Medicine.asp). Prompted by these concerns, we have looked for evidence of such bias over the past five years. We compared the acceptance rates of research papers submitted from Israel and four other countries of comparable size and development between 2004 and 2008 (table 1). We have not looked back at the papers themselves and have no gold standard measure of quality, which make these data hard to interpret. However, they do not suggest a systematic bias against Israeli research. We then searched PubMed for the past five years looking for articles that referred to eight major conflict zones identified by Amnesty and Medicins Sans Frontieres (table 2). We searched using key words for the conflict zones and for terms that would bring up articles relating to conflict (war, casualty, disaster, civilian, violence, humanitarian, human rights, crisis, refugee). We then did the same search limited to articles published in the BMJ. For Sri Lanka, Iraq, and Myanmar, 1-2% of relevant articles in PubMed had been published in the BMJ. For Palestine, Congo, and Somalia, the figure was 4-6%. For Darfur and Zimbabwe, the rates were 15.8% and 17.4%. Both sets of data are crude. We make no claim that they address the extreme complexities of the political or humanitarian situation in each region, nor do they reflect the number of civilian casualties in each case. However, we believe they show no evidence of bias against Israel either in our selection of research articles or in our coverage of conflict zones over the past five years. The BMJ welcomes research from all parts of the world and aims to publish the very best that we receive, looking especially for research that will help doctors make better decisions. We also aim to highlight threats to health and human rights wherever they occur. Fiona Godlee, editor, BMJ 1. Sabbagh, K. The perils of criticising Israel. BMJ 2009;338:a2066 2. Delamothe T, Godlee, F. What to do about orchestrated email campaigns. BMJ 2009 338: b500 3. O’Donnell M. Commentary: Standing up for free speech. BMJ 2009 338: a2094 4. Freedland J. Commentary: Toughen up. BMJ 2009 338: b524 5. Siegel-Itzkovich J. British Medical Journal complains of 'obscene' attacks by pro-Israel lobby. Jerusalem Post, February 24, 2009. http://www.jpost.com/servlet/Satellite?apage=2&cid=1235410704498&pagename=JPost%2FJPArticle%2FShowFull Table 1: Rates of acceptance and rejection of research papers submitted to the BMJ from Israel, Italy, Spain, France, and the Netherlands between 2004 and 2008   Decision n (%) Israel n (%) Italy n (%) Spain n (%) France n (%) Netherlands All research papers submitted in 2004 Accept 2 (3.8) 4 (4.1) 1 (1.9) 4 (3.9) 6 (3.4) Immediate reject 46 (88.5) 84 (86.6) 44 (83) 82 (80.4) 146 (83) Reject after review 4 (7.7) 9 (9.3) 8 (15.1) 16 (15.7) 24 (13.6) All research papers submitted in 2005 Accept 2 (4.8) 1 (1.1) 0 (0) 2 (1.8) 7 (3.1) Immediate reject 34 (80.9) 86 (91.5) 46 (86.8) 91 (82.7) 189 (83.2) Reject after review 6 (14.3) 7 (7.4) 7 (13.2) 17 (15.5) 31 (13.7) All research papers submitted in 2006 Accept 0 (0) 2 ( 3.3) 0 (0) 0 (0) 3 (1.3) Immediate reject 43 ( 97.7) 57 (93.4) 34 (97.1) 69 (90.8) 192 (87.7) Reject after review 1 (2.3) 2 (3.3) 1 (2.9) 7 (9.2) 24 (11) All research papers submitted in 2007 Accept 1 (3.8) 0 (0) 0 (0) 2 (2.9) 7 (3.3) Immediate reject 25 (96.2) 69 (92) 54 (96.4) 63 (92.6) 185 (86.8) Reject after review 0 (0) 6 (8) 2 (3.6) 3 (4.4) 21 (9.9) All research papers submitted in 2008 Decision not yet made 0 (0) 2 (2.2) 1 (1.6) 2 (2.2) 2 (0.9) Accept 0 (0) 4 (4.4) 2 (3.3) 6 (6.5) 17 (7.4) Immediate reject 24 (88.9) 74 (82.2) 51 (83.6) 74 (80.4) 168 (73) Reject after review 3 (11.1) 10 (11.1) 7 (11.5) 10 (10.9) 43 (18.7) Table 2: Results of a search of PubMed and BMJ for citations relating to major conflict zones for the years January 2004 to present   Conflict zones* Key words PubMed search PubMed search restricted to BMJ (%) Palestine palestin* gaza “west bank” 139 8 (5.7) Sri Lanka ”sri lanka*” 176 3 (1.7) Congo congo* 92 4 (4.3) Darfur darfur sudan* 63 10 (15.8) Iraq iraq* 1154 17 (1.5) Somalia somali* 99 5 (5.0) Myanmar myanmar burma burmese 58 1 (1.7) Zimbabwe zimbabw* 46 8 (17.4)   *identified by Amnesty International and Medicins Sans Frontieres   Details of search Date of search: 6/3/09. The search was limited by date of publication from 01/01/2004 to the present. The keywords above were used to search “all fields” within items stored on Pubmed i.e. title, abstract, author, journal etc. They were also mapped to MeSH terms. Where more than one key word was used for a single conflict zone, the Boolean operator “OR was used within brackets eg. (palestin* OR gaza OR “west bank”). The same qualifier key words were added to all searches, as follows: AND (war OR casualt* OR disaster OR civilian OR violen* OR humanitarian OR "human right*" OR crisis OR refugee). So for the search on Palestine, the full search entry was (palestin* OR gaza OR “west bank”) AND (war OR casualt* OR disaster OR civilian OR violen* OR humanitarian OR "human right*" OR crisis OR refugee). Competing interests: I am editor of the BMJ and have overall responsibility for the balance of coverage in the journal.
More on the fallacy of some democracies 12 March 2009
Bassem R Saab Saab, Professor of Family Medicine American University of Beirut, P.O.Box 11-0236 Send response to journal: Re: More on the fallacy of some democracies	I am pleased to see that Sabbagh’s article is creating strong emotions and diverse discussions. Yesterday I noted the response of my colleague Dr. Bernstein to what I have written. Dr. Bernstein introduces himself as a “Jewish, Zionist, son of a Holocaust survivor and supporter of 2 state solution to the Israel-Palestine conflict”. I agree with him that Lebanon is not a perfect democracy (even far from democracy). In fact perfect democracy, in my opinion, can be found only in dictionaries and may be in few countries. Dr. Bernstein believes that Palestinians have the right to vote in Lebanon. The Palestinians in Lebanon are registered under the United Nations Relief and Works Agency (UNRWA). This means that they are refugees who were expelled by force from their towns and villages in Dair Yasin, Haifa, Jerusalem, and many others. I agree with Dr. Bernstein that the Palestinians should have the right to vote, but we disagree on where they should vote. The UN gives the Palestinians the right to return to their homes where they should have access to the ballot box. In my life time I have witnessed several massacres perpetuated in the name of religions and Zionism in Lebanon. The end to suffering may be achieved by separating religion from state affairs in Lebanon and everywhere. I support a one secular state solution where Jews, Moslems, Christians, atheists, and others enjoy equal rights and duties. Competing interests: None
Re: The fallacy of some democracies 12 March 2009
Sheila F Raviv, Retired home 96956 Send response to journal: Re: Re: The fallacy of some democracies	Israel is a democracy and in her Capital City Jerusalem 52 Christian denominations and 6 Moslem denominations live side by side with the great variety of Jewish opinion and belief. Israel has a specific clause in her constitution declaring freedom of prayer to all faiths. I would ask the writer which other country in the entire region has a record of religious freedom which compares. Why is it considered undemocratic for Israel to declare herself a Jewish State when every other country in the region declares itself a Moslem State? Competing interests: None declared
Lies and facts about the conflict 12 March 2009
A Sabra, EM UHBristol NHS Trust Send response to journal: Re: Lies and facts about the conflict	Follow the link for more facts about the conflict: http://mitworld.mit.edu/video/645 Yet,if you continue to doubt, you should go and see the facts with your bare eyes just like O'Hara1 did. 1.http://www.bmj.com/cgi/eletters/338/feb24_2/a2066#210323 Competing interests: None declared
Re: Diabetes in Gaza: Getting the Facts Correct 12 March 2009
Tony Delamothe, deputy editor, BMJ BMA House, London WC1H 9JR Send response to journal: Re: Re: Diabetes in Gaza: Getting the Facts Correct	Professor Zimmet writes that the use of "Diabetes Voice" as an example was inappropriate "as the actual facts surrounding the incident belie the way this has been used." Most of the details of this incident are in the public domain.[1] What the International Diabetes Federation's apology doesn't say is that it was subject to an orchestrated email campaign against the offending paragraph. A spokesperson confirmed that it received hundreds of similarly worded emails, many including text drafted by NGO Monitor (still available on its website.[2]) When it comes to the offending paragraph that cost Philip Home his editorship of Diabetes Voice, I accept that there may have been one substantial error. Instead of reading "In 1948, according to the UN Conciliation Commission, 760000 Palestinians were evicted from their cities and villages, hundreds of which were razed to the ground," the correct wording would have been, "In 1948, according to the UN Conciliation Commission, 711 000 Palestinians were either evicted from or fled their homes." Regarding the third accusation: try as I might I can't see what's problematical about the use of the term "Palestinian people's land" to refer to land that Palestinian people have been living on for hundreds of years. [1] Lèfebvre P, Silink M, Home P. Editor’s note—an apology. Diabetes Voice 2004;49(3):17. [2] http://www.imra.org.il/story.php3?id=21620 Competing interests: I co-authored the editorial, "What to do about orchestrated email campaigns"
Re: The Editor responds to charges of anti-Israel bias in the BMJ 13 March 2009
Jonathan Hasleton, Cardiology Research Fellow University College London, WC1E 6HX Send response to journal: Re: Re: The Editor responds to charges of anti-Israel bias in the BMJ	Godlee's response to her critics is disingenuous. In her attempt to try and prove any lack of 'anti-Israel bias' at the bmj she fails to use 'Israel' as a search term. Godlee calls this 'crude' data, I would call it unsound data. Although Godlee claims to champion publication ethics, she has failed to respond adequately to concerns raised about the integrity of data in a number of papers/editorials in the bmj written by Rytter, Summerfield, Sabbagh and Delamothe. However undesirable the publication of unsound data is, the consequences of such publication are made far worse by the subsequent failure of the people involved to react appropriately to valid concerns and correct the scientific record where necessary. (1) Godlee and Delamothe fail in a number of their responsibilities as laid down by the Committee on Publication Ethics.(2) The integrity of the academic record of the bmj remains in question as does the bias shown by Godlee and Delamothe. It may be that anti-Israel bias is the least of their worries when a simple search for the term 'Israel' on their website brings up a comment that 'Israel is a pariah nation, and its representatives have no place in 21st century society.'(3) This is not anti-Israeli, rather antiSemitic. This is a far more serious charge and one that ought to be dealt with independent of the Editors of the bmj. Yours sincerely, Dr Jonathan Hasleton (1)Godlee F. Dealing with editorial misconduct. BMJ 2004 Dec 4;329(7478):1301-2. (2)Committe on Publication Ethics Code of Conduct. http://publicationethics.org/code-conduct. Accessed 12/3/2009. (3)http://bmj.com/cgi/eletters/327/7414/561#36333, 6 Sep 2003 Competing interests: Jew, Zionist and Fully paid member of BMA
Re: Re: The Editor responds to charges of anti-Israel bias in the BMJ 13 March 2009
Fiona Godlee, Editor in chief, BMJ BMA House,Tavistock Square, London WC1H 9JR Send response to journal: Re: Re: Re: The Editor responds to charges of anti-Israel bias in the BMJ	The rapid response posted in 2003 containing the comment "Israel is a pariah nation" has today been removed from bmj.com.[1] I agree that this was a purely political statement that did not add substance to the topic under discussion, which was the disputed appointment of Dr Yoram Blacher as president of the World Medical Association. Dr Hasleton suggests that the data presented in my 11 March rapid response above are unsound because we did not include Israel as a search term. While reiterating my view expressed earlier that these data are crude and are intended only to answer the criticism of bias levelled against the journal, we have repeated the search presented in table 2 with "Israel" as a search term. This reduces the proportion of PubMed articles referring to the conflict in Israel and Palestine that were published in the BMJ. Since January 2004 there were 804 articles published in PubMed for the search (israel OR palestin* OR gaza OR “west bank”) AND (war OR casualt* OR disaster OR civilian OR violen* OR humanitarian OR "human right*" OR crisis OR refugee), of which 19 appeared in the BMJ: 2.3% compared with the 5.7% reported in my rapid response. 1. http://www.bmj.com/cgi/eletters/327/7414/561#36333 Competing interests: I am the editor of the BMJ and am responsible for its content
The facts do not support your assertions 15 March 2009
Michael A Apple, GP Garston Medical Centre Watford WD25 9GP Send response to journal: Re: The facts do not support your assertions	Dear Madam To date (15th March) Karl Sabbagh's article and the related articles in the BMJ have generated 75 rapid responses. Of these 36 are broadly critical of the articles, 26 are broadly supportive and 13 make more general points about freedom of expression. Many of those broadly supportive of your views refer to the critical responses as being evidence of an Israeli lobby. This is presumably on the basis that responses that support their own views are "comments" while those supporting an alternative view are "a campaign". So some people may be beyond genuine debate. But hopefully not the BMJ who, let us repeat, says it took some 4 years to analyze and agonize before publishing articles and an editorial showing that it has been perilous to criticize Israel and may be perilous in future. I wonder how they now justify those assertions in the light of a crop of 75 genuinely felt but by no means overwhelmingly one sided or threatening responses? If there have been new personal threats to the editorial team, which I would deplore, or threats to remove advertising please share it with us. Otherwise rarely in a scientific journal could a thesis, 4 years in the gestation, have been proposed, tested and debunked as quickly as this one. Your readership deserves some comment. Competing interests: None declared
Of course Israel should be singled out 16 March 2009
Asad Khan, Specialist Registrar in Respiratory Medicine Royal Blackburn Hospital, Blackburn, BB2 3HH Send response to journal: Re: Of course Israel should be singled out	I extend my congratulations to the BMJ for publishing this series of articles. It was heartening to see the considerable number of appreciative rapid responses. However, I was not at all surprised to see the usual accusations of anti-Semitism hurled at Karl Sabbagh and the BMJ. Criticizing Israeli government policy is no more anti-Semitic than criticizing South Africa was anti-white South African or criticizing Zimbabwe was anti-Black. As I have said in these columns before, if one criticizes the demolition of civilian homes, the erection of a Wall whose route steals occupied land, the harassment and humiliation of an entire civilian population through a system of 700 checkpoints/roadblocks, a 700 km network of settler roads built on Palestinian land (and there is no apartheid!) and the bombing of ambulances and hospitals- and one is accused of being anti-Semitic- then is one to assume that these atrocities and human rights violations are an integral part of Judaism? If so, the accuser is bizarre indeed! For those unconvinced, I invite you to spend two weeks in the West Bank or Gaza. I did, and it changed my life: http://www.bmj.com/cgi/eletters/335/7611/124#177732 And of course Israel should be singled out for extra criticism. When the governments of Sudan, China or Zimbabwe violate human rights, the world calls a spade a spade, and rightly so. But the difference between these states and Israel is, as we are continuously reminded, that Israel is 'a thriving democracy' and 'an oasis of civilization in the Middle East'. Therefore, it should follow that it be held to higher standards than non-democratic nations. However, the world fails to hold Israel to even the most basic standards one would expect of a member of the international community. One wonders what the 'civilized' world's response would have been if the 1300:14 Palestinian:Israeli death ratio in Gaza was the other way round. Yet the West continues to arm Israel to the teeth, when any other country would have had sanctions imposed upon it. Competing interests: None declared
Setting the Record Straight 17 March 2009
Wasim Maziak, Associate Professor University of Memphis Send response to journal: Re: Setting the Record Straight	Some of the responses accusing the BMJ for unbalanced presentation of regional issues have indicated lack of BMJ coverage of civil freedoms situation in the Arab world. I don’t know the whole history of BMJ coverage of these issues, but would like to provide excerpts of an editorial about health in the Arab World I published in the BMJ in 2006 (Health in the Middle East, Maziak, 2006): “Authoritarian regimes, economic incentives, and conflicts have resulted in the migration of health professionals”; “Greater exploration of power relationships, political representation, gender roles, and normative values of traditional societies is needed to understand and respond to the health needs of local communities”; “For many people in the region, health improvement must start somewhere else—with education, equality, and security”. “In authoritarian regimes health ministries have little incentive to present "bad" or politically loaded data or work on such data obtained from other sources, especially as they are not held accountable for failing to do so by independent bodies or a free press”; “requires broad but locally oriented research agendas backed by a vibrant civil society that promotes evidence based health and shields scientific inquiry from dominant social and political doctrines”; “More research is also needed in "taboo" areas associated with major health problems—for example, domestic violence, mental health, and the health of special groups (such as Palestinian refugees and Kurdish minorities)”; “These conflicts are used by national governments and outside powers alike to divert public attention from developmental failures”. Regards Wasim Maziak Reference - Maziak W. Health in the Middle East. BMJ. 2006 Oct 21;333(7573):815-6. Competing interests: None declared
Time for reconciliation 18 March 2009
Amin El Hihi, Consultant Psychiatrist Leigh Infirmary - Mental health unit, WN7 1HS Send response to journal: Re: Time for reconciliation	I would like to congratulate BMJ for the commitment to support the debate that honest people like, Dr Summerfield, Karl Sabbagh, and Karman Abbasi who expressed their opinion and concerns over the recent destruction of Gaza by Israel. For how long will the state of israel continue living in fear and insecurity? My father told me when I was little, These people are thieves, they have taken everything and left us with nothing, they have taken the sea, the farms, the homes , but they know, that we will remain for ever carrying this right to our homes and land. Have you seen the handwritten script by the Israeli soldiers on the walls in Gaza,'' death to Arabs'''' Mohammed is Pig'' Why, What for?? You are still living in the mentality of the Holocoust Revenge. Why the Palestinians are responsible for your deadly history? The Palestinians are fully aware that it's the right time for reconciliation, for living equally in harmony. For creating prospirity and love. The Isaelians need to realise the time is changing rapidly including the climate. Countries are working hard to have nuclear armament, the poor people in Gaza have managed to produce their own missiles to send masseges to Israel on daily basis- They deserve to live- Israel needs to withdraw from all occupied territories to give a first step of understanding and making a formal apology to the palestinian people. When Rabin made his speech to both people inviting them for peace, some Palestinians called their newborn babies Rabin. I believe It's the right time, for professionals especially academics and doctors to make an initiative to address facts through history,to be able to identify a new starategy to share the suffering of the 2 people . This needs to be done in our generation, because I don't want to leave for ever and my children still unable to return to my home land -Palestine. Competing interests: I am Palestinian of origin, British Citizen
Grasp the nettle harder 19 March 2009
Rupert A Gude, VSO doctor Kagondo Hospital, Kagera, Tanzania Send response to journal: Re: Grasp the nettle harder	I have just struggled through the aggressive responses towards the BMJ for publishing an article about the freedom of the press. It is extraordinary how well educated caring doctors can miss the point of the article so comprehensively. I would like to draw attention to the sanest response so far.. that from Prof Gene Feder of 2 March. What a breath of fresh air. I do hope that the BMJ keeps up its work of reporting on worldwide issues and does not succumb to unreasonable pressure from whatever quarter. Competing interests: I read about the Palestinian problem with great sadness
Criticism of Israel is not related to facts 20 March 2009
Pinchas Halpern, Chair, Emergency Department Tel Aviv Medical Center, Tel Aviv 64239, Israel Send response to journal: Re: Criticism of Israel is not related to facts	Everybody has a right to criticize anyone. I and many Israelis level criticism at our Armed Forces and government. However,the licence that the BMJ has taken to single out Israel as the only country on earth (pretty much, at least) to inflict pain, sometimes excessive, on its enemies, is astounding. It is as if Britain has never subjugated half the known world, tortured Irish terrorists and fought cruel wars against independence movements. It is as if Sudan, Pakistan, Uganda, Congo, Algeria, Myanmar, China, India, Sri-Lanka, Colombia, Morocco, Syria, Russia etc., are not fighting extremely cruel wars against insurgents, in which civilians by the hundreds of thousands are killed, their medical and other basic rights taken away, mass deportations are carried out, border fences are erected (vis. India and Bangladesh, Morocco, Spain, USA etc.). But I guess that these nations are immune from the BMJ's wrath because they are gentiles, because anybody criticizing Islam has a fatwa enacted against them, because - because of what actually? We Israelis are more open than most societies to criticism, internally and externally, we have a democratic process that most of the above mentioned nations can only dream of. But when there exists such clear singling-out of us for sophisticated attacks (including today's lengthy paper denying us the right for self-defense against such attacks), any chance that we might actually listen is destroyed. Try some perspective, some even-handedness sometimes, and you'll be taken seriously. Otherwise, you'll be lumped with the other hate mongers, cheered by themselves and by their supporters but not having any moral impact. Competing interests: None declared
Re: Diabetes in Gaza: Getting the Facts Correct 21 March 2009
Paul Z Zimmet, Director Emeritus Baker IDI heart and Diabetes Institute 3181 Send response to journal: Re: Re: Diabetes in Gaza: Getting the Facts Correct	Tony Delamonthe continues to challenge my claim that the BMJ's use of the "Diabetes Voice incident" as an example of Pro-Israeli email attacks is not according to the facts. My original claim was firstly that the use of the Diabetes Voice incident was inappropriate and secondly that the information in the article was incorrect in detail. He has agreed to the latter point but says that most of the details in relation to the former are in the public domain. He then goes on to say......." What the International Diabetes Federation's apology doesn't say is that it was subject to an orchestrated email campaign against the offending paragraph. A spokesperson confirmed that it received hundreds of similarly worded emails.....". I suggested that the BMJ obtain the correct details from the International Diabetes Federation rather than rely on a "spokesman" and obtain an official and reliable view of the incident including the circumstances of the "resignation" of the editor. When it comes to the offending abstract, not paragraph, which he published in full in his Rapid Response (BMJ, March 4, whereas an abstract should be a summary of the article, this was a straight piece of Pro-Palestinian propaganda that bore no relationship to the content of the article. No one disputes that social factors are relevant to public health issues but the placing of this abstract to lead in an article on diabetes in Gaza was inappropriate in the context of the article concerned. Again, I suggest Tony Delamonthe get the full facts before claiming that my accusation lacks legs. Competing interests: None declared
Re: Re: Re: The Editor responds to charges of anti-Israel bias in the BMJ 31 March 2009
Jonathan Hasleton, Research Fellow UCL WC1E 6HX Send response to journal: Re: Re: Re: Re: The Editor responds to charges of anti-Israel bias in the BMJ	Whilst I thank Fiona Godlee for removing one of the offensive rapid responses that has resided on the bmj website for six years, her reply (1) leaves me slightly bewildered. I do not remember asking her to remove the posting by Riordan because it was a 'purely political statement that did not add substance to the topic under discussion'. Rather I suggested that it was an antisemitic statement, and by not exposing it as such Godlee grants Riordan's statement with some legitimacy that it does not deserve. I would ask Fiona Godlee and Dr Asad Khan after her, where exactly would they like the representatives of Israeli society to be if 'they have no place in 21st century society' (2) ? This attitude must be condemned in the same unqualified terms as other forms of discrimination. (3) 1. http://bmj.com/cgi/eletters/338/feb24_2/a2066#210527, 13 Mar 2009 2. http://bmj.com/cgi/eletters/327/7414/561#36333, 6 Sep 2003 3. All Party Parliamentary Inquiry into Antisemitism, 2006. http://thepcaa.org/Report.pdf. Accessed 24.03.2009. Competing interests: None declared
Re: The Editor responds to charges of anti-Israel bias.... Now what about Sri Lanka? 15 April 2009
Peter J Flegg, Consultant Physician Blackpool FY3 8NR Send response to journal: Re: Re: The Editor responds to charges of anti-Israel bias.... Now what about Sri Lanka?	We hear from Fiona Godlee that BMJ coverage of conflict zones is "not dominated by the conflict in Gaza".(1) Yet in vain over the last few weeks I have been searching for the BMJ's coverage of the unfolding crisis in Sri Lanka. If what Fiona Godlee says is true, the BMJ has to feature this story in its pages, and if not it stands guilty as charged re: Israel/Gaza. Will this week's BMJ have an extensive report about the shelling of health centres within the Tamil enclaves, killing 20 people including a red cross worker? Will we read how the Sri Lankan forces have in the last 2 months have killed 2,800 non-combatants from the 150,000 Tamils trapped in the "no fire zone", and how two thirds of the children are reported to be suffering from malnutrition? (2) Will we expect your letters section to be inundated with calls for a scientific boycott of Sri Lanka? Somehow I very much doubt it. (1)http://bmj.com/cgi/eletters/338/feb24_2/a2066#210527 (2)http://www.timesonline.co.uk/tol/comment/leading_article/article6069666.ece Competing interests: None declared
Re: Perils of criticising Israel 13 May 2009
Omar A. Khan, Physician 19810 Send response to journal: Re: Re: Perils of criticising Israel	It does seem, doesn't it, that the perils Sabbagh warns against continue to the present day. The main defense mustered by those who object to his piece is that 'other [Arab] nations are worse'. The slurs against BMJ and its integrity have been answered effectively by Dr Godlee, although her responses are unlikely to placate the offended. Many moderate Muslims agree with greater attention being paid to, and appropriate criticism being leveled at, the extremist Muslim regimes around the world. In the US, however, there is such an intolerance of a balanced discussion on Israel, that it makes some commentators seem anti- Israeli when in fact they ask for justice and even-handedness. Were such balance to come about, I suspect we would all focus on the many injustices around the world and not appear to single out the Middle East/Israel conflict- in the pages of the BMJ or in the real world. Competing interests: I am on the list of reviewers for BMJ.