The Israeli Medical Association has reversed a 2008 decision mandating that doctors at the scene of a ‎terrorist attack treat victims before the terrorist, regardless of the severity of the attacker’s wounds.

Only a week ago — in the midst of an unprecedented terror wave of stabbings and car rammings — a ‎change was suddenly made to the medical ethics regulations, literally out of the blue. The Israeli Medical Association (IMA) Ethics Board’s guideline stipulated that “charity begins at home” — that is, in a case ‎where personnel or equipment are in short supply in a multi-casualty terrorist attack, the victims should ‎be treated before the terrorists. It was decided to eliminate that instruction and the only rule that ‎remains in place is the one that decrees that the wounded must be treated according to the severity of ‎their condition and ability to survive, and no other criteria. In practice, this means that the terrorist would ‎have to be treated before his victims, if it turns out that his wounds were more severe than theirs, which ‎is entirely feasible, if he has been shot by the IDF or an armed citizen.‎

The IMA not only made its decision without any prior public debate, but it clearly ‎sought to hide it from the public, which is even more troubling and sinister. ‎

Israel Hayom reported that the announcement about the revocation of the previous rule simply ‎appeared on the IMA’s website and that “the IMA was apparently concerned about ‎widespread political and ethical criticism of its decision.” ‎

The IMA has every reason to be concerned. Such a decision of life and death, taken behind the back of ‎the Israeli public and sneaked into policy by a mere announcement on a website is odious in itself. But it ‎gets worse. ‎

The Reason: Hostile NGO’s Political Warfare

One has to ask oneself why the IMA decided to reverse this crucial guideline? Here is the reason in all its ‎tragic simplicity: In October, members of Physicians for Human Rights contacted IMA Chairman Dr. Leonid ‎Edelman and IMA Ethics Board Chairwoman Dr. Tami Karni. Their demand: Cancel the “charity begins at ‎home” clause in the regulations on treating terrorism victims. Physicians for Human Rights argued in a ‎letter that the organization was convinced that the principle went against the ethical principles that have guided the ‎medical community until now. Following the appeal by members of Physicians for Human Rights, the ‎Ethics Board held a discussion on Dec. 1. At its conclusion, a decision was taken to accede to the ‎organization’s request and cancel the “care for your own” clause entirely. According to Ethics Board ‎members, most members agreed with the decision. ‎

It is interesting that one appeal from a nongovernmental organization can reverse the policy on such a crucial question for an ‎entire nation just like that, isn’t it? Since Physicians for Human Rights wield such tremendous influence, ‎being able to sway the entire IMA Ethics Board, it is relevant to look in depth at who they are.‎

Physicians for Human Rights-Israel was founded in 1988 and claims to be “a nonprofit, nongovernmental ‎organization that strives to promote a more fair and inclusive society in which the right to health is applied ‎equally for all.” According to its mission statement, PHR-Israel strives to “put an end” to “Israel’s prolonged ‎occupation over Palestinian territory,” which it views as “the basis of human rights violations.” ‎

The organization has a budget of approximately 9.5 million shekels ($2.4 million) and it is funded by a number of pro-‎Palestinian international organizations that have nothing or little to do with medical issues (Bread for the ‎World, Human Rights and International Law Secretariat, Diakonia and others which are funded by ‎Sweden, Germany, Switzerland, Denmark and the Netherlands). PHR-Israel is also ‎funded by the European Union, the U.N. High Commissioner for Refugees and others. In January 2015, PHR-Israel ‎published “Gaza 2014: Finding of an independent medical fact-finding mission” which turned out to be yet ‎another Israel-bashing report, which NGO Monitor described as having “no independence, no facts, no ‎evidence.” ‎

What we have here is another clear-cut example of foreign and hostile governments and organizations ‎taking a shot at Israel by political warfare. This is just the latest tool in the toolbox of political warfare: ‎Medical warfare. ‎

While the resourcefulness of Israel’s enemies in searching for, aiming at and hitting our softest spots is ‎impressive in its mendacity, it is tragic to watch the ease with which they are enabled to succeed in their ‎most deceitful endeavors. This is warfare and those who wish to undermine Israeli society use all means ‎possible — including hitting our guidelines on saving our own citizens from terrorists.‎

Is the IMA’s Ethics Board Fit?

What is astounding here is not that Israel’s enemies try with all means, but that they succeed with such ‎ease. How is it possible that the IMA did not question the origin of the request, ‎coming as it did from Physicians for Human Rights, a deeply hostile, leftist NGO with a clear agenda of ‎working for the undermining of Israel from within and with ample foreign funding? ‎

Why did not a single member of the IMA question the deeply suspect ‎timing of such a request — in the midst of a devastating terror wave? ‎

Why did no one in the IMA find it necessary to consult with the public or ‎at least members of the public with deep knowledge of an issue that might have ‎absolutely devastating consequences for terror victims if followed? ‎

The irresponsibility of the whole thing is mind-boggling and brings one to question whether members of the IMA Ethics Board are fit for the positions of extreme responsibility that they fill. ‎They simply served as a Trojan horse for the hostile intentions of the backers of Physicians for Human ‎Rights. ‎

Thankfully, the reversal has been met with harsh criticism and requests to reverse the decision. One such request ‎came from Rabbi Yuval Cherlow, who heads the ethics division of the Tzohar rabbinical organization. ‎Cherlow knows the issue of medical ethics first-hand; he is a member of the Supreme Helsinki Committee ‎on Medical and Genetic Experiments Involving Human Subjects, and formerly served as the public’s ‎representative on the National Conference to Expand the Medical Basket. ‎

‎”The dramatic new instructions are a serious mistake,” Cherlow says. “The wounded at the scene of a ‎terrorist attack should always be treated first, and only then the attacker. Only in special cases, in which it ‎can’t be determined who the terrorist is and who the victims are, should medical treatment be given to ‎the most seriously wounded first.” ‎

According to Professor Asa Kasher, a renowned philosopher and ethicist who wrote the Israel Defense ‎Forces’ code of conduct, “The immediate example that comes to mind is the difference in battlefield ‎triage, which has to account for things beyond pure medical considerations, like sending soldiers back to ‎their units as quickly as possible. ‎

‎”The same goes for the scene of a terrorist attack. You can’t run it according to pure medical ‎considerations — that’s just out of the question. Say you have two people seriously wounded, the ‎terrorist and a victim. The terrorist’s wounds are slightly more serious than the victim’s. Would you treat ‎the terrorist before the victim? That’s unthinkable. There is more to the scene of a terrorist attack than ‎pure medical considerations — as there should be. What are we supposed to tell a victim’s family if he dies ‎because we treated the terrorist first? That we’re sorry, but we had no choice but to treat the terrorist ‎first? That’s absurd.”‎

ZAKA emergency response service Director Yehuda Meshi Zahav was outraged by the decision: ‎‎”We will instruct our volunteers to first treat injured Jewish victim, without thinking twice,” he said. ‎‎”And only after [will they treat] the terrorist murderer who carried out the attack. Despite the ethical ‎code which mandates the most injured victim be treated first, you must know morality has a limit. If we ‎will not keep our distinction, we will lose our direction. Even in Halachah, it is written: All who are merciful to ‎the cruel will end up being cruel to the merciful.”‎

Not being merciful to the cruel is what our tradition teaches. Foreign-funded, hostile NGOs such as ‎Physicians for Human Rights must not be allowed to dictate life-and-death issues for Israeli citizens ‎through an unelected body such as the IMA. Everything possible should be done by ‎responsible Israeli authorities, if need be with the intervention of Knesset members, to reverse this ‎shameful decision.‎

By: Judith Bergman
(Originally published in Israel Hayom and The Algemeiner)