So where has our campaign about IMA collusion with torture in Israel got to so far, which is 13 months since we started?  I hope you recall I circulated the collective open letter to WMA General Secretary, Dr Otmar Kloiber, in early February. This was a summary of events in the first nine months of our campaign since launch in May 2009.  The letter described how our experience had made it crystal clear that the WMA was not fit for the purpose for which it was created, at least in respect of Israel, and that the WMA were in violation of their own codes in their defence of their IMA member in the face of a hugely incriminating evidence base. We can see the election of longtime IMA President Yoram Blachar as WMA President as emblematic of this corruption of the ethical standards the WMA is meant to represent. More recently the new WMA chair, Dr Dana Hanson (Canada) as well as WMA General Secretary Kloiber and the new IMA President were all present at a conference in Turkey last October when Dr Ruchama Marton, one of our signatories and founder of PHR-Israel, presented Case M  – a Palestinian man subject to ill-treatment and torture but where the Israeli doctors who saw him during this period did not protect him, did not protest or report the practice of torture, and throughout sided entirely with the interrogators/torturers.

To date Dr Kloiber, who seems to have been heavily incriminated in all this, has not replied. But- see below- he and the WMA President may not be able to carry on like this.

Our campaign (in conjunction with the excellent work of Physicians for Human Rights-Israel PHRI and Public Committee Against Torture in Israel PCATI) has certainly rattled the IMA and exposed them to public scrutiny and commentary as never before. Our campaign was repeatedly featured in Israeli newspapers, on several occasions in mainstream British newspapers like the Guardian, and in the British Medical Journal and Lancet.  The IMA has of course refused to bow to any of this, not least because this would seem a public defeat for themselves and the interests they represent, but also because of what is at stake: for the IMA to insist that Israeli doctors adhere to the WMA anti-torture Declaration of Tokyo would mean that doctors would need to speak out and could no longer serve in the security units where these abuses take place.  As PHRI Executive Director Hadas Ziv has written, this would bring the torture system in Israel to a halt. So the political stakes are high.

Last 10 May I circulated a copy of a BMJ paper from 25 February 2010 entitled “Helping to stop doctors becoming complicit in torture” by Polatin et al from the Rehabilitation and Research centre for Torture Victims, Copenhagen.  This paper gave a number of documented examples of medical complicity with torture and other abuses, including the 2007 PCATI report “Ticking Bombs” which PCATI sent to the WMA in support of our campaign. The paper noted that on 20 March 2009 the United Nations Human Rights Council passed a resolution on the role and responsibility of medical and other health professionals in “torture and other cruel, inhuman or degrading treatment or punishment”.  The resolution targeted states, urging them to prevent health workers from becoming involved in torture and to protect those who stood out against it.

In addition, very relevant to us, the resolution directly addressed both healthcare professionals and the UN special rapporteur on torture, asking the rapporteur to give particular attention to the problem of “medical complicity”.  This resolution drew on ethical principles previously adopted by the WMA (which we have discovered the WMA are not applying in the case of Israel!).  For the first time in a United Nations document the Hippocratic Oath was presented as a recognised ethical norm.  Compared with previous UN resolutions, notably the 1982 UN resolution on medical ethics, this latest resolution went much further in spelling out the duties of states in respect of the practice of torture etc., as well as affirming the duty of health professionals to report acts of torture or other ill-treatment to relevant medical, judicial, national, international authorities, bypassing the formal state system for filing complaints if necessary.  We could say at this point that this is precisely what our campaign has been doing, an evidence-based appeal to the relevant appointed body, the WMA.

It is potentially very helpful to our campaign that the resolution asked the UN special rapporteur on torture to help enforce the obligations of health professionals in relation to torture specifically.  The present rapporteur is Manfred Nowak.The resolution asks the rapporteur:

  1. To respond to credible and reliable information about health professionals’ participation in torture or ill-treatment.
  2. To ascertain that health professionals remain independent of the institutions in which they serve.
  3. To discuss co-operative efforts with the WHO and other relevant UN bodies addressing the roles and responsibilities of health professionals in the documentation and prevention of torture and ill-treatment.
  4. To report to the Human Rights Council on the problem of health professionals’ participation in torture.

What is significant is that this represents a strengthening of the investigative function of the rapporteur, promising to ensure that the scandal of medical complicity with torture will be subject to public scrutiny and that violators will face disciplinary action, including suspension of their professional licence.(In our case the principal culprit is the national medical association itself).  The resolution also provides more specific guidelines for the WMA to use in helping national medical associations to promote medical ethics and prevent medical misconduct.  The advantage of the new resolution is that it was made by States. Thus medical associations can hold States to a standard they signed up to, not simply ones made by medical associations (assuming of course they have the will to hold a State to this- not the IMA…!).  National medical associations should systematically review conditions applying to all members who have dual loyalty, ensuring that there are effective reporting mechanisms for torture and ill-treatment and no reprisals against doctors who use such mechanisms.

What this amounts to is the opening of a new avenue for us, via the office and responsibilities of the UN special rapporteur who now has enhanced powers.  I am proposing that we formally approach him with the story of our campaign and the story of the refusal of the WMA to address the evidence base to which we point, and of an apparent WMA collusion with the IMA’s crude efforts to smear us as Israel haters and anti-semites, threaten libel suites, ex-communicate Physicians for Human Rights Israel etc.

Please see a letter from the Director General of the Rehabilitation and Research Centre for Torture Victims Copenhagen, to the Danish Medical Association, which further describes these developments. You will see that in the first
paragraph he refers to the Polatin BMJ paper I mention above. He notes the possibility of an alliance between the WMA and
the UN Special Rapporteur, who could act together to ensure compliance with the resolution.  We would welcome this since it would surely oblige UN Special Rapporteur to take stock of what the WMA have been doing to date, and we would certainly hope to influence this, with the IMA as the case in point.

You will note mention in the third paragraph of Sir Ian Chalmers and Prof John Yudkin.  Sir Ian is a fellow signatory and John Yudkin is another prominent UK medical academic working on the IMA/WMA case.

You can also read a letter of 11 March  to one of our UK signatories, Dr Ghada Karmi, from Dr Hamish Meldrum, Chairman of Council of the British Medical Association (BMA).  Some of our UK signatories have been pressurising the BMA about a position that to date had amounted to a defence of a collegiate relationship with the IMA, and a refusal to get involved at the WMA. You will see from the letter that Dr Meldrum says that the BMA has reviewed the public evidence in some detail (the same evidence we’ve been highlighting) and that they have written formally to the WMA to ask them to call upon the IMA to “undertake a rigorous, independent and transparent investigation into the allegations as set out by both Physicians for Human Rights Israel and the Public Committee against Torture in Israel”. (BMA head of ethics Dr Vivienne Nathanson has previously conceded in writing that Amnesty evidence for medical complicity with torture in Israel is ‘credible’. We welcome the BMA letter, though rather wish it had come years ago and without the need for so much persistence on our part). We are now waiting for the WMA to respond, rigorously, independently, transparently.

As you will see from the second paragraph, the BMA also pitches this as part of a broader move to improve accountability at the WMA, a move for which I think our campaign can reasonably claim a lot of credit.  Nonetheless, our basic position remains that the WMA cannot reform itself without specifically addressing our still unanswered case and its evidence base, and that our case remains THE acid test as to whether international medical ethical codes really amount to anything or not in a matter as noxious as medical collusion with torture. If the IMA cannot be indicted on the evidence, no association ever will be.

In a different key there are other efforts underway over here to bring the WMA to its senses but I think at present these need to be kept discreet.

Many, if not most of the 43 countries represented by our 725 signatories are members of the WMA – if in doubt see  I would encourage you to bring all this to the attention of appropriate representatives in your own national medical associations so that they might be persuaded to raise it at the WMA, which right now is a disgrace. And given the enhanced powers of the UN rapporteur on torture, we could perhaps appeal to him directly from a number of countries.

Derek Summerfield