Ashkelon – Despite the Israel Medical Association’s forceful statement in recent weeks urging its thousands of members to oppose force-feeding of security prisoners against their will, dozens of prominent and senior Israeli doctors, scientists, ethicists, jurists and philosophers have joined together to voice the antithetical view. The “rebels” include four Israel Prize laureates.
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Their statement noted that they were “strongly opposed” to the IMA position that a physician is “forbidden” to save the life of a hunger strike against his will. The IMA also used “professional threats” against those who believed – and were willing to act – differently.
The medical association argued that international conventions support its policy, and that only if and when a hunger striker loses consciousness can the autonomy of the hunger striker be suspended.
In their position paper, the “rebels” state that saving a human life “is suited to view of the ethics and values well anchored in the laws of the State of Israel, Jewish religious values and the Israel Patients’ Rights Law – and rulings based on it by the Supreme Court and the district courts).
The dissonant group praised the devotion, talents and resourcefulness of Israeli doctors and ethics committees in their hospitals who succeeded in preventing the deaths of hunger strikers in recent years.
“But when a hunger striker completely refuses to stop his hunger strike despite the great efforts to persuade him to do so, the ethical dilemma is finding a suitable balance between the value of preserving life and the autonomy and free will of the individual,” the statement continued.
The signatories argued that the moral value of saving lives and the ethical and professional value of a doctor saving his patient’s life surpasses the hunger striker’s right over his body and autonomy. “The decision on the timing of lifesaving measures and the suitable ways for doing so to save a life have to be left to the physician who is treating the patient and to the hospital’s ethics committee. These difficult decisions will take effect only in extreme cases when the hunger striker’s life is in immediate danger as a last choice before the patient dies or suffers severe brain damage,” their statement continued.
The dissidents’ opinion follows the ruling by the High Court of Justice to suspend the detention of Muhammad Allan, a 31-year-old Palestinian lawyer and member of the Islamic Jihad terrorist group, who regained consciousness and finally agreed to be fed after 65 days of refusing solid food.
The dissident group added that the medical system and doctors have to be “disconnected from political considerations of all kinds” and act in an equal way regarding every hospitalized patient independent of the reasons that brought him to this serious medical situation.”
The conscience of the physicians involved must be taken into consideration, the rebels declared. A doctor who has an ethical problem with treatment on the hunger striker – even if this means means the person’s death – should leave the treatment team, but only after ensuring that there is another doctor who is willing to care for him. A doctor who regards life as the utmost value, the rebels continued, over and above the patient’s autonomy, should have the right to give the patient the necessary treatment, even against the hunger striker’s will, to keep him alive – and not to see a person who doesn’t want to die to end his life, they argued. This decision must be discussed and approved by the institution’s ethics committee before it is taken, and no pressures or threats should be made against the doctor to prevent him from acting according to his conscience, the position paper continued.
Among the signatories were Prof. Rivka Carmi, president of Ben-Gurion University of the Negev and a prominent pediatrician and geneticist; Prof. Jonathan Halevy, director-general of Jerusalem’s Shaare Zedek Medical Center; bioethics Prof. Yechiel Bar-Ilan of Tel Aviv University’s Sackler Medical Faculty; BGU emeritus Prof. Shimon Glick, bioethicist and former dean of the BGU Faculty of Health Sciences; Prof. Michael Gross, ethics expert in the international relations department at the University of Haifa; Dr. Ofra Golan, an attorney and chairman of the ethics committees of a number of Israeli hospitals; Dr. Rabbi Mordechai Halperin, head of the Schlesinger Institute of Medical-Halachic Research at Shaare Zedek Medical Center and a former Health Ministry adviser on Jewish medical ethics; Prof. Michael Tal, chairman of the ethics committee at the Hebrew University; emeritus Supreme Court justice Zvi Tal; TAU philosophy Prof. Assa Kasher, an Israel Prize winner; Prof. Charles Sprung, head of the intensive care unit of Hadassah University Medical Center and former chairman of ethics committees in international societies for urgent medicine; Prof. Karl Skorecki, chairman of the Rappaport Institute at the Technion-Israel Institute of Technology; and Prof. Avraham Steinberg, head of Shaare Zedek’s medical ethics unit, pediatric neurologist and Israel Prize laureate.
Most, but not all, of the signatories are modern Orthodox Jews.
Asked to comment, the Israel Medical Association spokeswoman said that “the holiness of life is an important and central value for every physician. However, the discussion on force feeding doesn’t deal with the holiness of life but with the participation of doctors in torture, which is forbidden to doctors and unthinkable. IMA doctors have successfully treatment hunger strikers and prevented their deaths in public hospitals – all with the full support of the IMA chairman and head of its ethics committee.”
She added that the IMA “will not go into political positions.”
Content is provided courtesy of the Jerusalem Post