Faced with the destruction of Gaza’s hospitals and the systematic deprivation of Palestinians’ right to health, Israel’s medical establishment has disregarded the field’s most basic ethical principles.
May 31, 2025
In late March 2024 Israeli soldiers raided Nasser Hospital in the southern Gaza Strip. They arrested medical staff and patients, as well as civilians who were sheltering in the hospital compound. H., an orthopedic doctor, was partway through a shift when the soldiers began beating him. They kicked him in the stomach, groin, and testicles, told him to take his clothes off, handcuffed and blindfolded him, and escorted him to the hospital yard. Then they drove him across the Israeli border to the infamous Sde Teiman military base, near the southern city of Be’er Sheva, where at the time hundreds of Palestinians were being held blindfolded and shackled in overcrowded, filthy cages, some forced to sleep on the floor without mattresses or blankets.
In October 2024 H. gave an affidavit to Physicians for Human Rights–Israel (PHRI), a nonprofit where one of us, Guy Shalev, is the executive director and another, Osama Tanous, is a board member. H. recounted that at one point during his sixty-nine days at Sde Teiman his guards put him in a “disco room” with no mattresses, where deafening music blared at all times. Eventually they took him to an interrogation room, where, he testified, “for six days they tortured me by tying my hands and feet to a chair behind my back, hitting my stomach, and slapping me while I was blindfolded.” After forty-three days at Sde Teiman, he was sent to a prison not far from Tel Aviv to be interrogated.
There he saw a doctor, who affirmed that H. had developed inguinal and abdominal hernias as a result of the beatings. “He said I needed surgery and should not be interrogated,” H. said. But he was sent back to Sde Teiman without treatment. “As soon as I returned to the detention facility,” H. recounted, “the soldiers beat me up, banged my head on the ground and rubbed my face in the sand, kicked me and punched me.”
After another three weeks at Sde Teiman, they transferred H. once again, to a prison facility in Ashkelon, near the Gaza border. There he was seen by another doctor, who made him keep his blindfold on during the examination. “We are colleagues in the same profession,” H. said. “You are supposed to treat me humanely.” In response, he remembered, the Israeli doctor “slapped me while I was still blindfolded.” “You are a terrorist,” he recalls the man saying.
A few weeks later, at the Israel Prison Service’s medical facility in Ramleh, H. met with yet a third doctor, who confirmed in a ten-minute exam that he needed a hernia operation—yet the doctor insisted it was not urgent and H. was again returned, this time to Ofer prison. H. recalls in the affidavit that at a court hearing last July the judge extended his detention for forty-five days; neither there nor in the following interrogations was he given access to a lawyer. In August, when he appeared before a judge in a phone hearing, he was told that he is considered “affiliated with a terror organization.” Before the judge abruptly hung up the call, he told H. that he would be remanded to Ofer until further notice. “I am a doctor,” H. protested. Then the judge was gone.
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H. remains incarcerated at Ofer awaiting trial—one of the over 380 health care workers from Gaza who have been detained by Israeli forces since October 2023. (According to Health Care Workers Watch, two dozen of them have been subjected to enforced disappearance and remain missing.) Between July and December 2024 PHRI gathered testimony from twenty-four of these Palestinian medical professionals, who were held across civilian and military prison systems in Israel. Practically all of them described suffering torture in the form of severe beatings, continuous shackling, and sleep deprivation. According to documents that PHRI obtained through a freedom of information request, at least sixty-three Palestinians died in Israeli custody between October 2023 and September 2024, including the doctors Adnan al-Bursh, Iyad al-Rantisi, and Ziad al-Dalou, as well as the paramedic Hamdan Abu Anaba. Since then, drawing on data gathered by rights organizations and the Palestinian Authority, the group has determined that at least twenty-seven further detainees have died in the past nineteen months, bringing the total number to ninety. In comparison, nine inmates died in detention at Guantánamo Bay over a period of more than twenty years.
The affidavits gathered by PHRI reveal some recurring themes. One is the use of dogs to attack and humiliate prisoners. M.T., the head of the surgery department at the Indonesian Hospital in northern Gaza, told PHRI that soldiers from a counterterrorism unit called Force 100 raided his detention enclosure in Sde Teiman with dogs three days in a row, “beating prisoners and allowing the dogs to urinate and defecate on us.” K.S., a twenty-nine-year-old surgeon at al-Shifa Hospital, recounted that “they beat us with batons, with their fists, and let their dogs urinate on us. There are always dogs with them…. They attacked me twice with dogs.”
Another repeatedly cited abuse was pervasive medical neglect. Echoing other detainees, a twenty-seven-year-old general practitioner from al-Aqsa Hospital named M.S. described the scabies outbreaks in his prison ward. “Nobody is treating these infections,” he said, “nor anything else.”
Those who did manage to see Israeli doctors often had experiences similar to the ones that H. described. K.S. recalled a doctor telling him his scabies “would heal on its own.” N.T., a forty-nine-year-old surgeon who takes medication for hypertension, was denied access to a physician for months after he was detained during the March 2024 raid on Nasser Hospital. In his affidavit, he describes being taken to Sde Teiman, handcuffed and blindfolded, and forced to wear only underwear for the first seventeen days. He spent the next month in a detention facility called Anatot, near the Palestinian village Anata in the occupied West Bank, then the next two months at Ofer, where he finally saw a physician. The doctor prescribed medication—but only for ten days.
Neglect can be a death sentence. In his testimony M.T. recounted that another prisoner, M., had a stroke in the enclosure where prisoners with medical conditions were held. “A shawish [an inmate delegated as a go-between by the prison authorities] called for a nurse,” M.T. recalled, “who told him, ‘You’re not a doctor, don’t interfere.’” The following day they alerted the guard, then a Shin Bet officer. “They warned him that the prisoner was going to die,” M.T. said. At last a doctor showed up, “but M. was already dead.”
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In 1989 the South African physicians William John Kalk and Yosuf Veriava treated twenty political prisoners who had been hospitalized in Johannesburg after participating in a hunger strike. When the authorities asked them to send their patients back to detention, they refused, fearing that the men might be tortured. Known in the literature of medical ethics as “Kalk’s refusal,” their action has since served as a moral roadmap for doctors unwilling to violate their ethical obligations toward patients. In 1999 it was cited in the Istanbul Protocol, the most important UN guideline for medical professionals who are documenting cases of torture and ill-treatment, which instructs doctors to refrain from returning a detainee to the place of detention if an examination supports allegations of abuse.
Over the past year and a half, however, a different kind of refusal has characterized medical institutions in Israel. Some hospitals initially refused to treat wounded Palestinian detainees. Later some doctors continued to refuse on an individual level; many who did treat detainees failed to demand that their blindfolds and shackles be taken off. When Palestinian doctors working in Israeli hospitals were persecuted, the medical establishment refused to support them. The overwhelming majority of doctors—not to mention every Israeli hospital and the Israeli Medical Association—refused to condemn the destruction of Gaza’s health care system; some openly praised it and even called for the demolition of hospitals in Gaza. As these offenses accumulated, in most cases the country’s major medical-ethics institutions refused to speak out.
The groundwork for these refusals has been laid for decades. Palestinians in general and prisoners in particular have long been dehumanized. The Israeli medical establishment has long had close ties with the state and security apparatus, not least because most senior officials come from the military Medical Corps.
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Leading hospitals have taken pride in joining war efforts: “In wartime, the civilian and military systems became one,” Yoel Har-Even, vice president of global affairs at Sheba Medical Center, said at the Jerusalem Post’s Miami summit this past December.
But in the first days of Israel’s attack on Gaza, cases of medical neglect and complicity escalated dramatically. On October 11, 2023, Israel’s then–health minister, Moshe Arbel, instructed hospital directors to refuse treatment to “terrorists” and send them back to medical facilities belonging to the prison authorities and the military. (In practice, government officials and the mainstream media tend to apply the word “terrorist” indiscriminately to Palestinian men between fifteen and seventy.) That same day Ichilov Hospital in Tel Aviv and Sheba Medical Center in Ramat Gan denied treatment to Palestinian detainees; a right-wing mob, meanwhile, stormed Sheba looking for “terrorists.” Less than a week later, reportedly fearing another such mob attack, Hadassah Hospital in Jerusalem refused to admit an injured Palestinian man whom the military had brought to the emergency room for serious gunshot wounds. “Sources within the hospital” told Haaretz that treating him would “hurt national feelings.”
Soroka Hospital, in Be’er Sheva, took this practice further. In the ten months following Hamas’s October 7 attacks, according to Haaretz’s reporting, hospital staff called the police on at least three undocumented Palestinian women when they reached the emergency room. (Spokespeople for the hospital stressed to the journalists that this was a policy devised “in coordination with the police,” even after the police themselves “denied that such a directive exists.”) In one instance a pregnant Palestinian woman from the West Bank arrived experiencing contractions. Since 2013 she had been living with her husband in Rahat, a Bedouin town in Israel; her three children are Israeli citizens. Once the physician had seen her, she was detained by the police before even being formally discharged, taken to a West Bank checkpoint, and left stranded there until her husband picked her up and drove her to Jenin, where her parents live. She gave birth five days later.
Even as hospitals turned away Palestinian detainees, their own Palestinian employees—who comprise a quarter of all doctors and almost half of new doctors and nurses in Israel—found themselves under suspicion. About a week after October 7 several people sent complaints alleging that Abed Samara, director of the cardiac intensive care unit at Hasharon Hospital in Petah Tikva, had expressed support for Hamas on Facebook. On October 18 Yinon Magal—a television anchor, right-wing influencer, and former Knesset member—insisted on his telegram channel that Samara had “changed his profile picture to a Hamas flag, agitating and talking about the Muslims’ ‘Day of Judgment.’” The image in question featured a green flag bearing the Shahada, a saying repeated by every observant Muslim five times a day: “There is no God but Allah and Muhammad is His Messenger.”
That same day the hospital suspended Samara after fifteen years of service. Israel’s brand-new health minister, Uriel Busso, insisted on social media that Samara had headed his profile with “Hamas flags” and written “words of support for the terrorist organization that slaughtered and murdered hundreds of Jews in cold blood.” By the time the police and Shin Bet notified the hospital that the picture had been posted in 2022 and merely expressed religious devotion, Samara had been subjected to death threats and hundreds of hate messages and had decided he no longer felt comfortable returning to work.
Other Palestinian doctors and nurses have confided in PHRI that they fear posting anything that could be construed as political on their private social media accounts. Hospitals, they testify, have been suffused with an atmosphere of militarization, scrutiny, and silencing. “Nowadays, to continue working in the hospital, you are required to become inhumane,” one medical worker said in a report issued by the Palestinian research center Mada al-Carmel. “You are not allowed to express sympathy for anyone dying on the other side, even if it is a child.”
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Their Israeli colleagues have felt no such inhibitions about their own speech. Palestinian doctors and nurses who spoke to PHRI described overhearing coworkers suggesting that Israel should “ethnically cleanse Gaza,” “transform Gaza into rubble,” and “flatten it.” They have seen colleagues post messages on social media like the one recirculated on October 21, 2023, by a senior surgeon from Carmel Medical Centre in Haifa. Apparently first posted by someone serving in Gaza, it invoked the famous prisoner exchange Israel negotiated with Hamas for the release of the captured solider Gilad Shalit:
The UN is asking for a proportional response. So here, some proportions: for Gilad Shalit we released 1027 prisoners. One Jew is equal to 1027 terrorists. 1350 murdered Jews times 1027 [equals] 1,386,450 dead in Gaza. This is the proportion we have become accustomed to; I was happy to help.
This and other genocidal calls were not limited to the first weeks and months after the October 7 massacre. Nineteen months into the war on Gaza, Amos Sabo, a senior surgeon at Maccabi Healthcare Services, posted on X that he considered his reserve service a way of advancing public health by “eliminating cockroaches and other loathsome insects.” A few months earlier he wrote: “Gaza should be erased. There are no uninvolved people there.”
Hospitals themselves have likewise rallied on social media around Israel’s war in the Strip. In November 2023 Bnai Zion Medical Center in Haifa circulated an Instagram post featuring doctors dressed in military garb and stationed in Gaza, with the message “sending regards from the front.” A Sheba Medical Center Instagram story from June 2024 covered the “double life” of one of its doctors, who splits his time between the operating room and the cockpit of an F16 fighting jet. There are parallels between combat flying and surgery, the pilot says:
Both take you to the edge and both require precision, responsibility, decision-making under pressure, and the ability to deal with failure. There’s no such thing as “I almost hit the target”—either you hit it, or you didn’t. If you weren’t accurate at altitude, you crashed—if you cut a blood vessel one millimeter to the right, the result could be catastrophic.
These posts appeared at a time when Israel’s aerial and ground attacks were frequently killing scores of civilians a day and producing an extremely precarious environment for health care workers in Gaza, where, according to the UN, the number of health and aid professionals killed in military strikes is unprecedented in recent history.
In early November 2023—around the time the World Health Organization (WHO) reported that the Israeli military had already killed at least 9,770 Palestinians, including an estimated 4,000 children, and injured an additional 25,000—dozens of Jewish Israeli doctors published an open letter calling on the military to bomb Palestinian hospitals. The doctors were not dissuaded by the fact that fourteen out of Gaza’s thirty-six hospitals had already stopped functioning due to air strikes or shortages of fuel, oxygen, medicine, medical equipment, and food. Nor were they deterred by international humanitarian law, which stipulates that medical facilities “must be protected at all times and shall not be the object of an attack.” Because “the residents of Gaza saw fit to turn hospitals into terrorist nests to take advantage of western morality,” these doctors reasoned, they “brought destruction upon themselves.… Abandoning Israeli citizens while granting protection to mass murderers simply because they are hiding in hospitals is unthinkable.” One of the signatories, an American-born Israeli gynecologist named Chana Katan, explained: “I will do everything I can to defend and protect IDF soldiers and ensure they return safely to their homes. It is the IDF’s duty to bomb the terrorists hiding in hospitals in Gaza.” (UN officials as well as human rights organizations, such as Human Rights Watch, repeatedly emphasized that Israel had not provided sufficient evidence to substantiate its claims about militant groups’ use of hospitals. An analysis of Israeli visual material found those claims not credible.)
The acting head of the ethics committee at the Israeli Medical Association, Tammy Karni, soon issued a concise statement in response to the doctors’ letter. “Even in these sensitive days, in times of war, it is the role of doctors to treat the wounded,” Karni felt the need to explain:
Upholding a moral position is what distinguishes the State of Israel. Throughout history, Israeli doctors have not agreed to be dragged into the conscientious and moral decline that our enemy has reached…. The doctors of the IMA will not encourage crimes against humanity.
And yet less than three weeks later the IMA—a professional association that represents 95 percent of physicians in Israel—would itself sign on to a statement that, in effect, justified the Israeli army’s assaults on Palestinian hospitals in the Strip. In mid-November the Israeli military laid siege to al-Shifa Hospital, shelled its surroundings, cut off its supply of water and electricity, and sent ground troops into the compound, which then housed 7,000 displaced people, 1,500 healthcare staff, and 700 patients, including premature infants. Israeli military spokespeople had insisted that “Hamas’s headquarters” were located in tunnels directly under the medical facility—an accusation for which Israel failed to provide substantiating evidence, despite eventually occupying the entire site.
Starting on November 8, 2023, officials with the WHO and UNRWA had denounced the siege for its “disastrous” effect on medical conditions. On November 23 the ethics committees of six Israeli health associations—including the IMA, the National Association of Nurses, and the Israeli Psychological Association—sent a letter to the WHO not to join it in condemning the siege but to castigate it for its “silence” about Hamas’s alleged control of al-Shifa. Parroting the government’s delegitimizing rhetoric about the Palestinian health care system, the heads of the ethics committees explained that “once terrorists or militants see that no objections are raised when hospitals are used for combat, they will feel free to do so on other occasions and in other locations as well.”
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Meanwhile the members of these associations’ ethics committees have remained largely silent as health care staff in Israel violate the profession’s ethical principles. What began as an institutional policy of refusing to admit detained Palestinians in October 2023 soon turned into a pervasive practice of individual refusals by practitioners: late that month, upon the arrival of a fifteen-year-old detainee to a hospital in Israel’s Center District, one nurse refused to provide medical treatment, while another forcibly removed his intravenous drip and demanded his immediate transfer from the hospital. The pattern persisted for many months after the war started; a nurse at Kaplan Medical Center in Rehovot refused to treat a detainee as recently as this past February.
When detainees are admitted, their hands and legs are regularly shackled to the bed in what the guards call “four-point restraints.” One doctor confided to one of us that coworkers “withheld painkillers after invasive procedures, and then explained to colleagues that pain medication is a privilege that Palestinian detainees do not deserve.” After months of complaints submitted by PHRI’s ethics committee, in February the IMA at last issued a letter condemning “the restraint of prisoners and detainees in hospitals across the country.”
In still other cases detainees have received only minimal treatment before being sent back to a detention facility, even when their conditions were life-threatening. On July 6, 2024, a detainee was transferred from Sde Teiman to Assuta Hospital in Ashdod after suffering critical injuries to his neck, chest, and abdomen, as well as a ruptured rectum. The medical examination indicated that he had been subjected to torture and sexual violence while in custody. Immediately after the treatment, however, he was sent back to his torturers. According to Human Rights Watch, detainees at Sde Teiman could hear the screams of other inmates being tortured; doctors at the field hospital—where patients routinely arrived with injuries indicative of severe violence—would surely have heard them, too. Physicians working there were prohibited by military authorities from using their names or license numbers when examining prisoners or signing medical reports. When doctors are asked to conceal their identity in this way, the aim is usually to shield them from future scrutiny over their complicity in the facility’s abuses.
In April 2024 Haaretz reported that an Israeli physician had sent a letter to the ministers of defense and health and the attorney general detailing the harsh conditions to which Palestinian detainees were subjected at the facility and the tacit assent expected from the medical staff. “Just this week,” he explained, “two patients had their legs amputated due to injuries from being cuffed. Sadly, this has become routine.” The doctor went on to describe how patients were fed through straws, made to use diapers for defecation, and kept handcuffed and blindfolded at all times. “Since the early days of the field hospital’s operation,” he wrote, “I have been grappling with challenging ethical dilemmas…. We have all become partners in violating Israeli law. As a physician, I am even more troubled by the violation of my fundamental commitment to provide equal care to all patients—a pledge I made upon graduating twenty years ago.” (In a response to the paper’s reporter, the ministry of health insisted that “the medical treatment provided at Sde Teiman complies with the international rules and conventions to which Israel is committed.”)
Between February and April 2024 PHRI published two reports detailing how incarcerated Palestinians had been systematically deprived of the right to health. In both reports the group urged the IMA to ensure that detainees receive medical care in line with Israeli law, international treaties, and ethical medical standards. Finally, that April, Yossef Walfisch, the new chairperson of the IMA’s ethics committee, responded with an official statement. “Israeli physicians,” he stressed, “are required to adhere by international conventions, medical ethics principles, and the Geneva Declaration.” They “must provide all necessary medical care, whether in hospitals, prisons, or military facilities, and should be guided exclusively by medical considerations.”
He elaborated on that letter in an article on Doctors Only, a website for the country’s medical community. Yet even here Walfisch paired his lofty pronouncements about the significance of providing everyone humane medical care with attempts to deny the evidence of Palestinians’ horrific treatment. Again and again he referred to Palestinian patients as “Hamas terrorists.” Because the medical staff’s “safety takes precedence over any other ethical consideration,” he explained, the professional bodies responsible for incarceration ought to determine who should be restrained and blindfolded, and although health care staff in prisons and hospitals should strive for “a minimum of handcuffing,” on the whole they should follow the authorities’ guidelines. He invoked Sde Teiman but failed to say a single word about the beatings, torture, and medical neglect there. Instead he revealed that, when he visited the base’s medical team, he found staffers who “work day and night to provide the most suitable treatment within the limitations of this type of facility.” Echoing a self-congratulatory trope often used to describe the Israeli military, he called them “among the most moral doctors I have met.”
It is hard not to conclude that the IMA has failed grievously in its obligations to defend medical ethics. It could have criticized Israeli doctors who posted genocidal messages on social media, investigated health professionals who allegedly facilitated torture, and defended Palestinian doctors like Abed Samara who were wrongly persecuted for supporting terror. Instead it has not just turned a blind eye to these abuses but adopted Israel’s line of defense, blaming Hamas for Israeli transgressions in Gaza that include not only egregious crimes of starvation, murder, and forced displacement—widely acknowledged by rights groups as amounting to genocide—but more specifically the destruction of the Strip’s medical system, the killing of more than 1,400 health care workers, and the unlawful detention of nearly four hundred others.
In recent months the Israeli medical establishment’s silence has grown all the more deafening. Not a single prominent medical official, to the best of our knowledge, spoke up after reports emerged that, in the early hours of March 23, Israeli forces had ambushed and massacred fifteen Palestinian paramedics and aid workers who were carrying out a rescue mission in southern Gaza, then tried to cover up the crime by burying the bodies in a sandy mass grave alongside their smashed ambulances and fire truck; nor when it was revealed that a military spokesperson had lied about the atrocity, falsely claiming that the ambulances’ emergency lights were off when they arrived at the scene and accusing the murdered paramedics of having “advanced suspiciously.” No hospital director, dean of medical faculty, or IMA official said a word even after two witnesses from the UN retrieval team claimed that at least one dead aid worker had his hands bound, nor after the doctor who carried out the postmortems said that several had been killed by gunshots to the head and torso.
A month earlier, Sheba Medical Center was named the eighth-best hospital in the world by Newsweek, a prestigious recognition that reflects not just Sheba’s reputation but that of Israel’s health care system as a whole. In a press release celebrating the designation, it promised that its doctors would “keep striving…to raise the standard of healthcare for all.”
Neve Gordon
Neve Gordon teaches at Queen Mary University of London. He is the author of Israel's Occupation and coauthor, with Nicola Perugini, of Human Shields: A History of People in the Line of Fire, both published by University of California Press.
Guy Shalev
Guy Shalev is a medical anthropologist and the executive director of Physicians for Human Rights Israel. (May 2025)
Osama Tanous
Osama Tanous is a pediatrician, public health scholar, and board member of Physicians for Human Rights Israel. (May 2025)
