The Journal of the American Medical Association (JAMA) recently published "Health Professionals and War in the Middle East" on November 8, 2023. This article has sparked wide controversy. Many find the article to be inappropriate and misleading. At such a moment, health professionals expect health institutions and medical publishers to commit to their oath, honor human life and dignity, and protect patients and healthcare workers. Publishing such a biased article not only undermines these standards but also does the exact opposite: lends a blind eye to the horrendous humanitarian situation in Gaza under the guise of the political "complexity" of the Middle East and moral equipoise and contributes to a political climate which massively supports siege and asymmetric assault. 

 

At the time of the publication of this petition, 10500 people were killed in Gaza due to Israeli aggression, including more than 4000 children. About 1.5 million Palestinians are internally and forcibly displaced. It is estimated that there are 26000 injured persons. Due to the further tightening of its 17-year-long siege, healthcare facilities in Gaza lack all the means to provide proper care, including food, water, electricity, fuel, and medicine. Physicians are reporting infected burns and wounds, surgeries without anesthesia, and collapsing intensive care units. Al-Alhli Hospital was attacked on October 17, leading to the death of more than 400 patients and refugees. Since then, 18 hospitals have been forced out of service due to lack of fuel or direct strikes. Reports estimate 270 attacks on healthcare facilities. On November 9 alone, four hospitals were attacked with explosives or shrapnel-producing bombs: Al-Shifa, Al-Rantisi Children Hospital, Al-Awda, and the Indonesian Hospital. 

 

In the face of such atrocities, it is utterly irresponsible to amplify the voice of those justifying attacks on healthcare facilities sheltering patients and displaced Palestinians seeking refuge. While some seek to cast doubts on death and casualty reports, we point out the following:

 1- there is ample evidence, in photographs and videos, of the severity of the catastrophe, including accounts from independent, local journalists and news organizations. 

2- reputable organizations like Doctors Without Borders and the United Nations (UN) have issued statements raising concerns about the unprecedented horrors in Gaza. The UN estimates a record loss of 88 aid workers killed in one month (1, 2). 

3- many humanitarian agencies find that death toll reports from the Health Ministry in Gaza have proven to be reliable (3). 

 

We also would like to highlight the following dangerous claims and opinions in the viewpoint: 

1- the writer accurately starts with premises emphasizing how the moral failure of medical professionals in the Nazi era had facilitated its crimes and that history teaches us that dehumanization is the precursor of genocide. However, nowhere - in his biased account - does he acknowledge the severe and asymmetric death toll of Palestinians or their continuous dehumanization in political and journalistic statements since October 7, 2023. The writer should have referred to primary sources, the 2017 Charter, instead of repeating secondary conclusions propagated through a platform not necessarily known for its fair coverage of the Middle East. 

2- The writer says, "health professionals have special responsibilities to speak out against certain war crimes." Yet, he fails to denounce the following war crimes, well-documented by several news agencies, committed by the Israeli army: deliberate strikes on healthcare facilities, destruction of civilian infrastructure in Northern Gaza, recurrent targeting of bakeries, targeting of journalists, and occasionally their families leading to the death of at least 39 journalists (4), use of prohibited White Phosphorus weapons, as documented by consistent Palestinian reports and Human Rights Watch (5), cutting water and electricity from 2 million people, and complete siege. 

3- the writer reiterates Israeli propaganda, claiming Hamas personnel hide or launch their attacks from hospitals and use human shields. He fails to provide sources supporting such claims as none, as far as we know, exists. He also fails to document repeated calls to have UN observers oversee these facilities' status and their non-involvement in military operations. He is given a space, in a leading medical journal to rationalize whether or not a "legal", "proportional" attack on Healthcare facilities is morally justifiable before he concludes with open-ended questions. Knowing that hospitals are now sheltering thousands of war-injured patients and thousands of displaced Palestinians seeking refuge, these claims and statements are dangerous, abhorrent, and indefensible. Instead, space should be given to defend patients as it's our primary moral imperative. When the wisdom and compassion of the medical profession are most needed to give humanity a sobering perspective, we are appalled to see "bioethics experts" and medical journals justify and rationalize genocide. Our healthcare colleagues in Gaza had to issue multiple interviews and video statements asking to save their failing medical system and protect their hospitals from aggression. We should not fail them.

 

Medical journals like JAMA should maintain higher standards of accuracy and ethical responsibility in their publications. Moreover, JAMA is alienating and offending a wide section of its diverse readership. We urge JAMA to retract this controversial article immediately. By doing so, JAMA will reaffirm its commitment to maintaining integrity and trustworthiness in disseminating accurate information related to healthcare.

 

History will not judge us kindly. Words matter. The "viewpoint" of medical professionals at such times is a responsibility. 

 

Please sign this petition if you are a Medicine or Health Science professional and agree that JAMA should retract their controversial "Health Professionals and War in the Middle East" publication. 

 

1- Reuters. UN bodies make united call for humanitarian ceasefire in Gaza, November 6 6, 2023 .

2- Kaamil Ahmed. Israel-Hamas war is deadliest ever for UN aid workers, with at least 88 killed. The Guardian, November 6 2023. https://amp.theguardian.com/global-development/2023/nov/06/israel-hamas-war-deadliest-for-un-aid-workers-agency-leaders-ceasefire-call

3- Gabrielle Tétrault-Farber. Despite Biden's doubts, humanitarian agencies consider Gaza toll reliable. Reuters, October 27 2023. https://www.reuters.com/world/middle-east/despite-bidens-doubts-humanitarian-agencies-consider-gaza-toll-reliable-2023-10-27/

4- Committee to protect journalists. Journalist casualties in the Israel-Gaza war, 9 No 2023

5- Human Rights Watch. Israel: White Phosphorus Used in Gaza, Lebanon. October 12 2023. https://www.hrw.org/news/2023/10/12/israel-white-phosphorus-used-gaza-lebanon