VI International Symposium on Torture as a Challenge to the Medical and Other Health Professions
Buenos Aires, June 1993
The Struggle against Torture in Israel: The White Coat Passes like a Shadow
Ruchama Marton, MD
Chairwoman
The Association of Israeli-Palestinian Physicians for Human Rights (AIPPH)
The Association of Israeli-Palestinian Physicians for Human Rights (PHR) was established in March 1988. This is a group which is not affiliated with any party and whose members are volunteers. Its various activities and the salaries of its administrative staff are financed by contributions from Europe and the United States. When we established PHR, we thought that our role would be small and modest. Today, after more than five years of intensive activity, I know that there is no end to this work. Even if we had twenty more people working with us, we would not be able to respond to all the appeals we receive regarding violation of human rights in the medical sphere.
Everywhere we go in the Occupied Territories we see neglect, deprivation, destruction and bereavement. We as physicians have learned that the primary problem is not to heal the sick, but to mend what human beings do to each other. The worst of these actions is torture. The Israeli Medical Association (IMA) is a signatory to the Tokyo convention against torture, 1975. Unfortunately, many Israeli doctors do not meet the demands and duties of the Tokyo convention,
I will present to you two examples of torture, out of the many appeals which have been made to PHR. It will be clear from the narration of these cases that the Shabak (General Secret Service) tortures people. “Moderate physical pressure” is not in a gray area; it is in the black area of torture. The first example is the case of Nader Raji Michael Kumsiah, 25 year old from Beit Sakhur. He was arrested on the night of May 3, 1993 at his home and taken to the detention camp in Dahariah. Nine days later, on May 12, Nader Kumsiah was brought before judge Altbaur in order to prolong his detention. According to the protocol of the hearing, Kumsiah denied the charges against him and told the judge: "Yesterday and the day before I was tortured in the investigation. They hit me on the testicles and took me to the hospital.” In his decision to prolong the detention, the judge wrote: ”The commander of the interrogation center presented to my request, a report from Soroka hospital, according to which, the prisoner injured in both testicles (a rupture) as a result of a blow…” On May 19, Kumsiah was brought once again before judge Livni, who decided against extending the detention for lack of evidence, but agreed that Nader Kumsiah would be held in administrative detention. PHR was requested by Nader Kumsiah’s family to intervene on his behalf. In the investigation that PHR conducted, we discovered that Kumsiah’s medical file containing the medical report quoted in Judge Altbaur’s decision was missing from the Soroka hospital archives. The only document given to the family was a medical opinion written on May 19, eight days after Kumsiah’s release from the emergency room. This medical opinion, signed by an urologist, reads: “Nader reached the emergency room because of a rupture in the scrotal region. According to the patient, he had fallen down the stairs two to five days before he came to the emergency room…”
This medical letter was written retroactively, without any further examination. The document falsifies facts that were written in the previous letter which was quoted by the judge. It seems to us that it was written in an attempt to blur the facts. The physician did not report the rupture in the patient’s scrotum which had resulted from a blow given to a man under interrogation and was willing to describe the reason for the injury as “falling down the stairs”. Can someone imagine a person falling down the stairs and getting hit in his testicles?
If this physician had had an obligation to report to the Israeli Medical Association (IMA) and the police, and if he had known that the IMA would support him to report torture or other abuses, it is likely that he would not have failed as he did, and would not have been complicit in a crime of torture, contrary to medical ethics and the Tokyo Convention.
The second example is of torture resulting in a severe emotional and mental damage. The role of physicians in this affair is even more horrible. Hassan Bader Abdallah Zbeidi, 34, is a university graduate married and father of four children. He was arrested at his home on September 25, 1992, and brought to Tul-Carem detention camp. For twenty days his family did not know where he was. One month after his arrest, on October 28, Hassan Zbeidi was released from detention without any charges having been laid.
“Released from detention” is a military euphemism. Actually, Hassan Zbeidi was taken to his home in a civilian car which soldiers stopped at a roadblock ordering the passengers to bring him home. Hassan Zbeidi was brought home in a severe catatonic state: he was not able to make any contact with the outside world. He recognized no one, not even his wife, children or his parents. He did not respond or talk spontaneously, and he was incontinent. He had an empty frozen stare and his body was stooped and shaking. He remained frozen at the position in which he was put.
What happened to Hassan Zbeidi in the interrogation wing of the Shabak in Tul-Carem? For a long time we could not know. But we could guess – because at the same time, September and October of 1992, we received five complaints of torture from the Tul-Carem prison. A recurring description of the tortures were: blows to all parts of the body, blows to the testicles, being tied to a pipe, a sack on one’s head, prolonged standing, and being strangled. One of these five prisoners, Mustafa Barakat, died during interrogation, at the same prison in Tul-Carem. The others were released without being charged.
Hassan Zbeidi’s incident is not an exception; he is another person who was severely tortured and returned to his home disabled, perhaps with no hope. I examined Hassan Zbeidi several times, and in cooperation with a Palestinian doctor from Nablus he received medication. His family is warm and supportive, and gradually there was a slight improvement in his condition. I examined Zbeidi few months ago (April 93) he began to speak a little. He answered questions slowly, in a very low voice, with long pauses. He said that he remembers getting hit on his head and chest, that they banged his head against the wall and that he was strangled. He also remembers waking up from the beating in the hospital. It is difficult to describe how many hours of work, telephone calls, faxes and calls to Knesset members, to the IMA, to lawyers and to fellow doctors have to be made in order to find a medical document or any other information that is connected with the Shabak interrogations and tortures. Many times this endless work produces no results.
Our appeal to the Shabak in the case of Zbeidi was answered in the following words: “An investigation was conducted by the Shabak’s controller in regards to the complaint’s of Hassan Zbeidi and Abed Jaber. The conclusions of the investigation were submitted to the justice ministry and no evidence was found which would indicate any deviation from Shabak work procedure.” Does this mean that these are the standard working procedures of the Shabak?
Despite the denials and the concealing of the facts and documents, we obtained a copy of the medical certification from the emergency room of Tel Hashomer Hospital, from 4:07PM, October 15, 1992, the attending physician writes: “Main problem – quieter than usual recently. Memory disturbances. Doesn’t complain of anything in particular. According to the military doctor report: “sad, disoriented as to place and time. Appears to be in spasm.”
Relevant findings:
Calm, no pallor, cyanosis, or jaundice.
Head & Neck – no pathological findings.
Lungs – clean.
Heart – clear voices.
Stomach – soft. Arms and Legs – no pathological findings.
Examination of Psychiatrist – No clearly defined problem.
Examination of emergency room Neurologist – normal. Impression that patient is malingering.
Observations:
1. Follow-up of prison physician
2. Treatment with any placebo
3. If his condition will get worse – send to doctor.”
Four doctors, as far as we know, examined Hassan Zbeidi: an army doctor who referred him to the emergency room, an emergency room physician, a psychiatrist and a neurologist. Even with such clear evidence of the serious injuries inflicted on Zbeidi, not one of them raised his voice to protect him. Furthermore, the emergency-room doctors ignored the fact that the army doctor’s clear, brief, statement that “he is disoriented as to place and time,” described a psychotic state. All three civilian doctors, ignored his serious condition, diagnosed him as a malingerer and gave him a placebo.
These doctors neither put him under medical supervision nor reported to any authority that his injuries had resulted from the Shabak interrogation. They returned him to his tortures, even though their written recommendations implied that they understood the seriousness of his conditions. This can be learned from recommendation number 3 – “If the condition worsens – refer him to the doctor.” The condition of a deceiver cannot get worse; the condition of a patient can. These civilian doctors, who are not under any pressure from military or security commanders, chose to cooperate with the torturers out of their own free will. They also betrayed the trust that was given to them as physicians, on both the ethical and the medical levels. The obligation to report, if it was in existence, and if it was implied in the emergency rooms, would not have enabled the doctors to return Zbeidi, who went mad out of pain and terror, to his investigators/ torturers.
These two cases may illustrate the relevance of torture to the medical professionals. Physicians, everywhere, easily and efficiently internalize the social atmosphere of their time, thus, most of them become loyal servants of the regime in their society. Such was the case in Nazi Germany, in various countries in South America, U.S.S.R. and also in Israel.
A medical fitness form is an official form the doctor fills out after examining a prisoner in an interrogation center in Israel. Notice what it says: “Is the prisoner physically harmed (before he enters the investigation)?” What are we to make of this? That now the one being investigated is ready to sleep depravation, starvation, exposure to intense heat, to freezing cold, to pain from blows, being tied in painful positions for long periods of time, being forced to stand for long periods, having one’s head covered by a stinking and suffocating sack, being humiliated, sexually exploitation, having his spirit broken by prolonged solitary confinement.
“A medical fitness form “ leads the person who is “fit for interrogation” to torture, and the physicians knows that he is giving his services, agreement and approval to a systematic process of breaking one’s soul and body.
Physicians could learn from the legal establishments banning of evidence obtained through torture. Jurists, not physicians, were the first to published evidence in the early 18th century saying that there is no connection between pain and truth. They banned the use of torture for legal purposes and disqualified confessions obtained by inflicting pain or torture. One assumes that the heads of the Shabak, the army, and the police also are aware of this spurious relationship between pain and truth. Nevertheless, torture and brutality are still practiced and physical and psychological “pressure” still applied.
Why do they do this? They do it because the real objective of torture is to break the spirit of the person and destroy his personality. The judicial system necessitates a pragmatic approach, not a moral one. A physician should, on the first place, be committed to ethics and personal morality. What causes a person physical or mental suffering should be unacceptable to the medical profession. The most important statement of Hippocrates’s oath is: Above all do no harm, primum non nocere, as a minimal demand that one must not transgress.
The white coat passes like a shadow through the interrogation procedures: the “coffin”, the “refrigerator”, the “banana tie” and the terrifying darkness of blindfolding. The doctor is present in the background, behind every torturer-interrogator. A doctor makes a pre-torture examination. He gives medical approval of “fitness for interrogation”. A doctor monitors during the torturing process. A doctor examines and takes care of the prisoner after being tortured. A doctor writes a medical opinion or a pathologist’s report. In all these situations, the doctor provides his services to the state, and not to the patient. The doctor who collaborates with torturers is their partner in crime. If a prisoner dies during the interrogation, the doctor is in fact assisting in a murder. Doctors, nurses, medical assistants, and judges, all those who see and know and cover up are partners in the crime.
We must uncompromisingly oppose torture. As humane beings we must oppose it with all our might, and a particular obligation rests on the physicians. We, who live under a democratic regime, should act within the framework of democracy. In other words, we are obliged to refuse to cooperate in committing crimes against human beings.
How the Israeli society is facing the fact that the state of Israel is using torture? There are two main defense mechanisms. The first one is a political argument in which we hind behind the idea that the practice of torture is one of the synonyms of the Occupation, and to console ourselves that it will disappear together. But, Torture belongs to a world-view where human rights have no value. Torture existed before the Occupation and will be there after it is gone if we donnot change our world-view of which it is a part.
The other one is denial. Many Israelis think that torture happens in another place or at another time: in World War II, in South America, but not here and now. It is difficult and painful to think that there are torture cellars in the state of Israel. This is why so many Israeli Jews are unable to allow themselves to know about it. One of the objectives of the Israeli PHR is to show clearly that torture, even if it is called by different names, is carried on here systematically. It is not an exception. We, PHR, would like to disturb the peace of mind achieved through denial and ignorance that lead to passivity. We need to involve the public in an active struggle against torture.
We would like to show that violent and cruel methods of interrogation do not add to our security, even if they are done in their name. The amoral norms not only do not contribute to our personal safety, or to that of the state as a whole, but they lead to increasing circles of social disintegration.
If we citizens or physicians do not ensure that it is forbidden to harm a person’s body or soul for any reason whatsoever, not even for the sake of the state, we will find ourselves supporting directly or indirectly the destruction of the personal and social morality.
In summary, in order to promote the struggle against torture, we cannot rely, unfortunately, on the personal ethics of the citizens and physicians. We must rely on harsher regulations, on the regulations of the law. This is why we support the legislation which is being submitted to the Knesset. Moreover, we demand of the IMA to oblige every doctor to report all instances of torture that a doctor comes across to the IMA’s ethical committee and the police. The IMA must initiate an informative campaign for physicians and give them every support necessary so that they can confront this difficult task in the emergency rooms and in the hospital departments. In this way we will fulfill our personal and professional duties and cease to cooperate with criminal acts on behalf of the state.
