Medical journals should not avoid political issues that have a bearing on health

Criticism of Israeli government policy "is not ipso facto antisemitic, and to label it as such is a tactic to stifle debate," argue leading doctors in an editorial in The BMJ this week.

Referring to a complaint about a letter published in the Lancet, Professor John S Yudkin from University College London and Professor Jennifer Leaning from Harvard School of Public Health, believe medical journals should not avoid discussing political issues that have a bearing on health.

They explain that in April, Reed Elsevier, publishers of the Lancet, received a complaint written by Professor Mark Pepys and signed by 396 physicians and scientists, protesting about an "Open letter for the people of Gaza" published in July 2014, during the latest Israeli assault on Gaza.

It argued that the Lancet was being used for political purposes and for "publication of deliberately false material which deepens polarization between Israelis and Palestinians."

The open letter included a UN estimate of the number of Gazan children killed up to that date during the Israeli bombardment, which the Pepys email implied was exaggerated.

Yet reports on the conflict from the UN Office for the Coordination of Humanitarian Affairs (OCHA), Physicians for Human Rights - Israel, B'Tselem, and Amnesty International all concur that the July letter's allegations of disproportionality in civilian deaths and injuries, and of targeting residential areas, schools, power and water treatment plants, and medical facilities and staff were probably not overstated.

These events raise two issues, write Yudkin and Leaning.

The first is the appropriateness of medical journals discussing political issues that have bearing on health, including civilian mortality and morbidity.

They point to a fear of entering the debate where medicine, politics, and ethics intersect, but warn that to avoid such debate "is to remain obdurately silent in the face of important trends and events that impact negatively on the wellbeing of individuals and groups." Inevitably, controversy will ensue, they write, "but this is a healthy aspect of public discourse on political matters."

The second issue, they say, is the similarity between this complaint's attempt to stifle coverage of the conflict in Gaza and previous examples of writing campaigns provoked by articles in medical journals critical of Israeli policies.

They believe that criticism of Israel, or more specifically of Israeli government policy, "is not ipso facto antisemitic, and to label it as such is a tactic to stifle debate." And they agree with one former medical journal editor who has been subjected to such a campaign that "the best way to blunt the effectiveness of this type of bullying is to expose it to public scrutiny."

As a deputy editor of The BMJ has pointed out, "Future generations will judge the journal harshly if we avert our gaze from the medical consequences of what is happening to the occupants of the Palestinian Territories and to the Israelis next door," they conclude.