Sir Michael Marmot, the World Medical Association, and medical complicity with torture in Israel
It is 20 years since Amnesty International concluded that Israeli doctors working with the security services “form part of a system in which detainees are tortured, ill-treated and humiliated in ways that place prison medical practice in conflict with medical ethics”. (1) In 2009 725 physicians from 43 countries appealed to the World Medical Association (WMA), the official international watchdog for medical ethics, attaching a raft of more recent evidence from reputable human rights organisations which supported Amnesty’s conclusions, and pointed to the studied refusal of the Israeli Medical Association (IMA) to take action. The IMA is a WMA member and at the time the WMA President was the IMA President Yoram Blachar. The WMA refused even to acknowledge the submission and it became clear that the WMA would not act against the IMA under any circumstances.(2)
We write as lead signatory (CB-C) and convenor (DS) of a fresh submission made in January this year by 71 UK doctors to the WMA, attaching a comprehensive report from the Israeli organisation Physicians for Human Rights (PHRI), with detailed case studies showing the complicity of Israeli doctors working in security units in which torture of Palestinian detainees was routine.(3) The BMJ has previously reported on this.(4) We also submitted a study published last November which showed that sexual torture too was endemic.(5) Why are the doctors posted to these units not protecting the detainees and protesting, and why has the IMA never acted on such reports, as required to do by the WMA Declaration of Tokyo? The new WMA President is the UK medical academic Sir Michael Marmot, and we looked to him to bring his international reputation to bear on a case that has been a standing reproach to the idea that global regulation of the ethical behaviour of doctors is even-handed and effective.
Marmot sent us an acknowledgement of receipt on 18 January. Within days, alerted by various reports of an IMA victory, we were staggered to see on the website of the Simon Wiesenthal Centre (wiesenthal.com) a letter from the WMA President on WMA notepaper, dated 25 January.(6) Written to Dr Shimon Samuels, Director for International Relations at the Centre, Marmot said that our allegations had been sent to the IMA for comment but at the same time exonerated them in respect of our earlier unanswered complaints. He wrote that "investigations have revealed no wrong doing . . . by the Israeli Medical Association”. We are not aware that any proper investigations have been carried out either by the WMA or, for that matter, the IMA. On the contrary, for many years the PHRI have tried to get the IMA to conduct such an investigation but found the IMA consistently unwilling. As they concluded in ‘Doctoring the Evidence, Abandoning the Victim: the Involvement of Medical Professionals in Torture and Ill-treatment in Israel’, “persistently repeated requests calling the IMA’s attention to cases arousing suspicion of doctors’ involvement in torture and cruel or degrading treatment, have not been dealt with substantively.” PHRI noted that IMA ethical codes privileged a duty to assist the security services ahead of duty to the patient.(3)
Marmot added that the IMA “have repeatedly affirmed their commitment to the policies and positions taken by the WMA”. This is to take verbal assurances at face value and the evidential record appears to say otherwise, and consistently so since Amnesty’s 1996 verdict. In the era of evidence-based medicine, why does evidence from authoritative sources not count? The WMA has refused further comment.
Marmot has accorded the IMA once again the support and approval of the WMA, and of himself as President. He has done so without examination of the evidence, old and new, to which we (and PHRI) point. This is good news for the IMA, but bad news for Israeli doctors thrust into ethically compromised roles, and bad news for Palestinian detainees with little to protect them.
The WMA itself risks being morally complicit in this misconduct. The WMA website carries Marmot’s inaugural speech in Moscow last September. In it he affirmed that “the WMA upholds the highest ethical standards of the practice of medicine”. Involvement of doctors in torture is a matter of unsurpassed gravity for the reputation of the medical profession, the WMA, and now of Michael Marmot himself. We again call on the WMA for a thorough and transparent examination of the evidence conducted by neutral parties.
1. Amnesty International. “Under constant medical supervision”, torture, ill-treatment and the health professions in Israel and the Occupied Territories. London: Amnesty International, 1996.
2. Meyers A, Summerfield D. The campaign about doctors and torture in Israel two years on. BMJ 2011;343:d5223.
3. Public Committee Against Torture in Israel/ Physicians for Human Rights-Israel. Doctoring the Evidence, Abandoning the Victim: the Involvement of Medical Professionals in Torture and Ill-treatment in Israel. stoptorture.org.il 2011.
4. Gulland A. Doctors in Israeli detention facilities are complicit in torture, says report. BMJ 2011;343:d7200.
5. Weishut D. Sexual torture of Palestinian men by Israeli authorities. Reproductive Health Matters doi: 10.1016/j.rhm.2015.11.019.
Competing interests: No competing interests