Intended for healthcare professionals

Analysis Personal paper

Perils of criticising Israel

BMJ 2009; 338 doi: (Published 25 February 2009) Cite this as: BMJ 2009;338:a2066
  1. Karl Sabbagh

    The BMJ’s acting editor received 1000 emails after the journal published an article criticising Israel in 2004. Karl Sabbagh examined them and is reminded of what happened when the magazine World Medicine criticised Israel 27 years ago

    In October 2004, the BMJ published a personal view by Derek Summerfield in which he expressed his concern at what he saw as systematic violations of the fourth Geneva Convention by the Israeli army in Gaza.1 The article claimed that many of the actions deemed necessary to root out and prevent terrorism had had the foreseeable effect of killing or maiming large numbers of Palestinians, including children, who had played no part in attacks on Israelis. (This issue is, of course, at the heart of worldwide criticisms of Israel’s actions in Gaza last month.) Summerfield supported his arguments with figures published by reputable international organisations, such as the United Nations and Amnesty International.

    Summerfield’s article provoked hundreds of responses, about 550 of which the BMJ published as rapid responses.2 Of these, a small proportion were broadly supportive of Summerfield’s article, but most were hostile. Reading them might give the impression of a civilised debate in progress, but the published responses were a skewed sample of what had been received, as abusive and obscene contributions were not posted.

    Emails to editor

    In addition to responses sent to the website, almost 1000 emails were sent directly to Kamran Abbasi, the BMJ’s acting editor at the time. An analysis of all these emails provides a less benign view of what editors face when entering this thorny debate. A general flavour of the feedback can be gathered from a few verbatim quotes (box 1).

    Box 1 Extracts from emails sent to Kamran Abbasi

    • “The IDF, unlike the Arabs, has NEVER killed innocent civilians.”

    • “It is known that the Israeli army is one of the most moral armies of the world, and is not allowed to shoot to kill children—unless they are a direct threat to Israeli soldiers.”

    • “The great extent to which Israel goes to avoid unnecessary civilian enemy casualties is truly remarkable . . . a tribute to the Jewish people’s long history of serving as a beacon to the world on ethical behavior.”

    • “No non-combatant child who was clearly that has ever, ever been deliberately targeted and killed or maimed by any Israeli soldier. … As a Chartered Accountant I am by nature and training not given to making sweeping statements without caveat but on this there is no doubt whatsoever.”

    A far off country

    • “Remember, prior to 1967 there was no mention of a ‘Palestinian State.’ The Countries of Egypt and Jordan were where most of these Arabs lived.”

    • “I might also add that the land, including the parts which had to be bought from the Palestinians by the Jews, was nothing but barren and diseased land. It was the Jews who made it flourish, and developed it into a first-world country. It is by no means Israel’s fault that the Palestinians couldn’t be bothered to do the same.”

    • “If Israel did kill every one of the Arab Muslims there most Americans would not miss a beat. We hate Islam—we hate Arafat and you just don’t get it. America hates you evil bastards—you support evil—you live evil and you will die evil.”

    • “The problem is they procreate like rabbits and someday they will come to kill you.”

    Personal attack
    • “Your journal, having an editor with your clearly, mid-eastern name, the spewing of such published garbage seems inevitable.”

    • “You miserable animal . . . I’m glad HonestReporting is on to your filthy hate and lies. You can spew your lies and garbage until you breathe your last breath, and then it’s the fiery furnace for you, and that will be for all eternity.”

    • “I am a physician in the USA for 30 years. You are a moslem terrorist sympathizer who hates Israel and the Jewish nation. You have hijacked the BMJ to publish anti Israeli garbage propaganda. Please don’t show your filthy shit covered hands in this country. May you rot in hell you bastard son of a bitch.”

    • “You believe that killing chilren in self defence is moraly wrong? Give me your address, and I will pay a few kids to stone you to death. Believe me, 3-4 kids, 14-15 years old will kill you in a matter of minutes. Please give me your address. They can also kill your daughter for free. If you will not give me your address, then it means that you don’t really believe that when Israely soldiers kill a kid there is anything wrong with it. Waiting for your reply. By they way, if you really piss me off, I will hunt you down myself, and kill you with rock (10-15 times hit you over the head until your brain will show up). Hey, that is ok right? as long as I don’t have weapon in my arms.”

    It seems likely that most of the hostile emails resulted from a request from HonestReporting, a website operated from the United States and Israel (box 2). It claims to be “the largest Israel media advocacy group in the world,” and describes its mission thus: To ensure Israel is represented fairly and accurately HonestReporting monitors the media, exposes cases of bias, promotes balance, and effects change through education and action.”

    Box 2: HonestReporting’s call to action

    Inserting anti-Israel rhetoric into ostensibly neutral academic literature

    The British Medical Journal―hailed by the Financial Times as “one of the world’s top four general medical journals”—included in its Oct 16 issue an article entitled “Palestine: The assault on health and other war crimes.” The author, Dr Derrick Summerfield, compares the IDF’s acts to those of the 9/11 terrorist hijackers:

    The Israeli army, with utter impunity, has killed more unarmed Palestinian civilians since September 2000 than the number of people who died on September 11, 2001.

    The only actual similarity between the two is the death count—approximately 3000. Summerfield labels all Palestinian casualties “unarmed civilians”―denying the fact that (1) the clear majority of Palestinians who have died since September 2000 were terrorists and armed combatants (according to the Institute for Counter-Terrorism), and (2) no Palestinian civilian has been deliberately killed “with impunity”―in stark contrast to 9/11. Summerfield goes on to claim that since some Palestinian minors have died from wounds to the upper body and head:

    “Clearly, soldiers are routinely authorised to shoot to kill children in situations of minimal or no threat.”

    Beyond falsely branding Israel as guilty of “war crimes,” deliberate child-killing, illegal colonization and apartheid, the article makes absolutely no mention of how Palestinian terror and political corruption have contributed to the unfortunate state of the Palestinian health system. If you agree this article is inappropriate for a respected medical journal, send comments to British Medical Journal editor Kamran Abbasi: click here …

    The influence of HonestReporting and reliance on figures supplied by the Institute for Counter Terrorism are reflected repeatedly in the emails sent to the BMJ. Of the 971 emails, 210 (22%) showed direct evidence of being derived from the HonestReporting’s website. Nearly all quoted directly from the site, and in a third of them, the authors added few or none of their own words. Occasionally, there was evidence that authors had not paid attention to what HonestReporting had asked them to do. Several included criticisms of a Diabetes Voice article mentioned in the same HonestReporting web page, although the BMJ has nothing to do with Diabetes Voice. There was no evidence that any of the authors who used text from HonestReporting’s website in their emails had actually read the BMJ article they were criticising.

    In addition to the 210 emails quoting directly from HonestReporting’s website, a further 219 (23%) merely stated that such a biased or political article should not be in the BMJ. There was little evidence of writers’ familiarity with the BMJ and the fact that it regularly publishes articles on a wide range of non-scientific themes, including the effects of politics and warfare on health.

    The level of argument with the issues raised in Summerfield’s article was low. About a third of the emails issued blanket denials of all Summerfield’s claims, without offering any contrary evidence (box 1).

    Despite other emails suggesting that the BMJ should not publish political articles, several suggested that the article should have included other political elements which weren’t relevant to Summerfield’s claims—such as the high standard of care provided for Palestinian patients by Israeli doctors at Hadassah Hospital.

    Many of the emails betrayed ignorance about the Middle East in general, and about the Arab-Israeli dispute in particular. Several writers simply vented their anger against Arabs and other critics of Israel.

    Finally, many emails abused the BMJ or Abbasi personally. These were often sent anonymously from Hotmail addresses (which can be set up easily and then abandoned), allowing writers the freedom to use obscenities and personal (including racist) insults without worrying about the effect on their reputations. However, some abusive emails came from people apparently unconcerned about signing their names. One third of the emails were largely or solely abusive. Eighty seven of these made direct accusations of antisemitism against the BMJ, Summerfield, or Abbasi. Twenty nine made remarks about Abbasi based on the inference that his name and therefore his ethnic origins must have led him to encourage Summerfield to write the offending article and to publish it.

    Suppression the goal?

    In the 60 years since the establishment of the state of Israel, attempts to present in print an account of Palestinian history and Palestinian rights have usually been met by swift and highly organised protests. Protesters have written in their hundreds to journals and newspapers, often using arguments supplied by a central publicity machine and phrased in suspiciously similar terms. These campaigns, and similar campaigns launched against publications that print material critical of Israel, seem fundamentally different from the normal discourse between readers and the publications they read. The constant use of denial rather than argument; the demands for an apology or even the editor’s resignation; the enlisting of people who have never read, or even heard, of the publication in question; and the recourse to obscenity and accusations of antisemitism all go far beyond the average heated but civilised debate one expects to find in a scientific or medical journal.

    There is nothing intrinsically wrong with organising an effective lobby group, but lobbying for Israel seems to be in a different category from, say, lobbies against fluoridation and MMR vaccine. The ultimate goal of some of the groups that lobby for Israel or against Palestine is apparently the suppression of views they disagree with. (On its website, HonestReporting boasts of disrupting the normal running of a US television station that criticised Israel: “ readers sent up to 6000 e-mails a day to CNN executives, effectively paralyzing their internal e-mail system.”3)

    For that suppression to take place it has to be directed at people who are unfamiliar with the issues and who might be persuaded that they have somehow got it wrong. Reading through the emails sent to the BMJ, editors, and the people who manage and fund their publications, might well believe that a ghastly editorial mistake had been made. And creating that belief is, of course, the intention. If straying into the Israel-Palestinian conflict provokes such a large and hostile reaction, not to mention strident allegations that important details are wrong, then the temptation is quietly to avoid the topic in future.

    On the same day that HonestReporting asked its readers to write to the BMJ, it drew attention to an apology from the International Diabetes Federation and the resignation of the editor of Diabetes Voice, its quarterly publication. Diabetes Voice had previously reported on the difficulties faced by Palestinians with diabetes as a result of Israel’s occupation of Gaza.

    Flashback: World Medicine

    Although the ease with which people can email their comments has led to an increase in the volume of such lobbying, it is not new in medical journalism. Many editors have stories to tell of the pressure they faced when reporting on this issue. Attacks on the BMJ and Diabetes Voice bear a strong similarity to an experience I had 27 years ago, when the response came in the form of letters to the editor and was followed by the demise of one of Britain’s most popular medical magazines.

    At that time, I contributed a regular column to World Medicine, a popular fortnightly magazine for doctors. In 1981, the Israeli authorities announced a tourism promotion called medical Olympics, which aimed at encouraging British doctors who might never have visited Israel to find out more about the country. I wanted to tell doctors contemplating such a visit some facts about the country and its then prime minister, Menahem Begin, so I wrote about the massacre of innocent Palestinian villagers in 1948 at the village of Deir Yassin that had taken place under his command.4 Although Begin and other Israelis denied it at the time of my article, the facts about this and other examples of ethnic cleansing in 1948 have now been validated by several Israeli historians from military archives opened in the past decade or so.

    After the article was published, the British branch of the Israel Medical Association organised a protest campaign. The secretary of the association, Lionel Balfour-Lynn, wrote a letter to members which included the following call to arms:

    “In order to emphasise their [Jewish doctors] feeling of revulsion it is suggested that all future copies of World Medicine are returned unopened with a letter of protest attached, to the editor Michael O’Donnell, until categorical assurances are forthcoming that this magazine will never again publish blatant PLO [Palestine Liberation Organisation] propaganda. Moreover, all drug companies advertising in World Medicine will be requested to withdraw their support to this magazine until this undertaking has been given.”

    The letters received at World Medicine after my article displayed a similar tone to that of the emails sent to the editor of the BMJ a quarter of a century later. Several correspondents writing to protest “in the strongest terms” asked if they could be sent a copy of the article, admitting that they had not read it. Subsequently, a series of decisions by the publisher of World Medicine as a result of this article and the complaints of Jewish doctors led to the resignation of Michael O’Donnell as editor and the closure of the magazine.

    Standing firm

    I hope that the tide can be turned by editors refusing to respond to the kinds of pressure described here. Indeed, the abuse hurled at the BMJ and its staff, and the egregious misuse of “facts,” could well be a justification for a return to the subject matter of the original contribution and a fuller account of why it was justified. A recent article in the London Review of Books about the activities of the pro-Israel lobby in the United States5 was greeted with a similar deluge of denial and abuse to that unleashed on the BMJ. But in this case, far from suppressing discussion of the issue, these attacks led to a vigorous defence of the right of the authors to write their article and the veracity of the facts they cited.

    Such campaigns cannot be allowed to succeed—not so much because they are wrong about the issues, but because their ultimate aim is censorship and suppression by means of intimidation, something which conflicts with the values of the civilised world. After my tussles with the Israel lobby in 1981, Michael O’Donnell, then still editor of World Medicine, wrote the following in an editorial in the magazine, words which are as relevant today as they were then:

    “I can understand the anger stoked by Karl Sabbagh’s article and clearly we will never appease the anger of some of our more venomous correspondents. But I would remind the others, as their anger cools, of the now rather hackneyed, though nonetheless true, proposition that free speech is really only worth defending when you disagree with or disapprove of what is being said.”6


    Cite this as: BMJ 2009;338:a2066


    • Editorial, doi:10.1136/bmj.b500
    • doi:10.1136/bmj.a2094
    • doi:10. 10.1136/bmj.b524
    • Personal view, doi:10.1136/bmj.b722
    • I thank Iain Chalmers for drawing this topic to my attention and facilitating the process of analysis; Kamran Abbasi for supplying the emails and reading and commenting on a draft of the article; Harvey Marcovitch for advice and support; and Bella Sabbagh for processing the texts of the emails and identifying the large proportion of emails that were derived from the HonestReporting website.

    • Competing interests: KS is the British son of a Palestinian father and has been the target of pressure from supporters of Israel’s policies against the Palestinians.

    • Provenance and peer review: Not commissioned, not externally peer reviewed.