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Israel’s emergency medicine apartheid

Israel’s apartheid state policies and laws which subjugate Palestinian people, were recently highlighted, this time in the area of emergency medical care. Under pressure from the internationally respected organization, Physicians for Human Rights, the Israeli Medical Association was forced to reform one of Israel’s most racist policies concerning the care of the sick and injured. This much-needed reform of an inhumane policy has been met with strong vocal opposition from some of Israel’s most influential public figures.

For years when Israeli paramedics arrived to the scene of an assault or other violent injury, first responders were told they should not treat patients on the basis of which patient is most critically injured (and therefore requires medical interventions first) but rather the Emergency Medical Services crew should first assess the ethnicity of the injured patient and treat Jewish patients first regardless of the severity of their injuries. This was supposedly based on the Talmudic concept “the poor of your city come first.”

In reality the directive was an invention of Israeli politicians who wanted to make sure that in the case of attacks from Palestinians on Israeli settlers that alleged “terrorists” were not receiving medical attention prior to Jewish victims. The directive instructing Israeli first responders to “find their own” amongst the suffering is therefore actually a way of converting medical professionals into judge, jury and executioner who assign guilt rather than provide life saving medical care.

This racist policy, which is in reality only applied when Palestinian patients were present, justified its existence by saying it was based on the idea that first responders should treat victims before the one who is guilty of causing harm. This has been considered a truly unethical position that has been repudiated in international medical ethics panels for decades and goes against even basic common sense and morality. How would guilt-based treatment work in a car crash for instance? Should the driver who caused the accident be rescued last, if at all? Of course not. The proper thing to do in a “mass casualty event” (and what myself and all other medical professionals not living in apartheid Israel are taught) is to base treatment and interventions solely on criteria based on the severity of injury and the possibility of saving the patient’s life.

On Dec. 12, 2015, the Israel Medical Association ethics committee, in response to an appeal by Physicians for Human Rights, finally annulled the “my people first” principle and silently included the change on their website in order to hide from the backlash they knew would come from the Israeli settler community.

According to a recent article in the Jerusalem Post, a few weeks after the policy reversal by the IMA, Rabbi Chaim Kanievsky, one of the leading authorities on Jewish law, instructed members of the United Hatzalah paramedic organization that “in cases in which it is clear to the paramedics who among the wounded is the terrorist, paramedics should not treat the terrorist before those wounded in the attack – even if the terrorist is more seriously injured.” Furthermore the Rabbi instructed that “if the terrorist was in a life threatening condition, they should leave him or her to die.”

Rabbi Yuval Cherlow of the modern-Orthodox Tzohar group, was also quoted by media sources condemning the decision as “a grave mistake” and insisted that victims have priority over attackers. He noted, however, that this might not apply in “special circumstances,” for example “when it is impossible to determine who the terrorist is and who the victim.”

According to Rabbi Cherlow the “special circumstances” when “victim first” patient care should not apply, is when the guilt of the parties are unclear. In reality this means nothing more than when the ethnic identities of the perpetrator are unclear because in apartheid Israel Arabs are always presumed guilty and the Jewish settler population as only victims.

Take the case of Fadi Alloun, the unarmed Palestinian teen who was recently gunned down by Israeli police forces after being chased by an Israeli mob of settlers.

Israeli reports claimed that Alloun was armed with a knife and had earlier injured an Israeli teenager in what they called a “terrorist” attack. No evidence was ever presented linking Alloun with any stabbing and no knife can be seen in the videos or was ever recovered by the police. According to Palestinian sources Fadi Alloun was in fact the victim of settler violence, a common occurrence in occupied Palestine, but because of his ethnicity he was easily dehumanized, vilified and subsequently murdered.

The video of Alloun’s killing confirms he presented no danger when police killed him. No knife is visible as the scared teenager attempts to avoid the fanatical mob but finds all directions blocked.

Before and after he is shot dead, voices of Israeli youth are heard in the video demanding officers kill the boy because he is “a terrorist.” One police officer can be heard being ridiculed by the bloodthirsty crowd after he pulled out pepper spray instead of his gun. The crowd scolded the police officer for not executing the Palestinian teenager quickly enough.

Even though it is unknown what sort of emergency medical treatment, if any, Fadi received his case is just one of many in Israel where Palestinians are on site treated as guilty terrorists deserving of no justice or life saving medical aid.

Physicians make a moral commitment to the oath of Hippocrates, which states, among other principles: “If it is given me to save a life, all thanks. But it may also be within my power to take a life… Above all, I must not play at God.” Revolutionary medical professionals must stand against the genocidal and apartheid state of Israel. It is our duty to expose the hypocrisy of the Israeli occupation forces which treats every act of Palestinian resistance as a terrorist act and are under constant attack by a government who views Palestinian existence as an existential threat.

It is Palestine which continues to be the historical victim of Israeli violence and it is why I will be marching on March 20th in Washington DC in support of Palestine and call on every progressive medical professional to stand with us as well.

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