Whither Medical Ethics?: The failure of the U.S. medical establishment on Gaza

On May 20, 2025, UN Humanitarian Chief, Tom Fletcher warned that more than 14,000 babies face imminent death due to starvation as a direct result deliberate blockade of food, water and medicine in Gaza. Despite hundreds of aid trucks ready to go in, Israeli authorities have repeatedly blocked their entry into Gaza. This extremely dire deliberately created humanitarian crisis raises urgent and important questions about the complicity of U.S. medical societies including the American Medical Association, American Psychiatric Association and American Pediatric Association, by maintaining silence in the face of this genocide. 

The 1948 UN Convention on Genocide, which was ratified by the U.S. government in 1988, defines genocide as 

1. Killing members of the group.
2. Causing serious bodily or mental harm to members of the group.
3. Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part.
4. Imposing measures intended to prevent births within the group.
5. Forcibly transferring children of the group to another group

Leading humanitarian organizations such as Amnesty International and Human Rights Watch have concluded that indiscriminate killing of at least 60,000 civilians, including 20,000 children constitutes genocide. The International Court of Justice has issued orders to prevent genocidal acts in Gaza and the International Criminal Court has issued warrants against the perpetrators of these crimes against humanity.

Physicians have a moral and legal obligation to stand up against medical war crimes and genocide. American Medical Association’s ethical guidelines describe war crimes as a “threat to physician’s humanitarian responsibilities” and “implore all parties at all times to understand and minimize the health costs of war on civilian population generally and adverse effects of physician persecution in particular”. More than 1500 medics have been murdered in Gaza, health care infrastructure including hospitals have been destroyed leaving the entire population of Gaza without any access to life-saving medical care. 

The 1948 Geneva Conventions, which constitute binding law internationally and in the U.S. outlines physician responsibilities during armed conflict and demand a “humanitarian commitment” that “physicians must be committed to the welfare of the sick and injured and prioritize their needs”, over their own political beliefs. 

Under the circumstances, it is impossible to argue that medical ethics do not compel physicians to oppose and demand an end to the worse genocide since the holocaust. Healthcare workers, including doctors and medical students, are being targeted for fulfilling their ethical responsibilities to call for a ceasefire and delivery of life-saving aid to Gaza. Medical societies in the U.S. have failed in their ethical responsibilities for not only taking a moral stand against medical war crimes and genocide but also to protect their members who are simply following their ethical guidelines.

A recent survey of 53 medical and surgical societies in Gaza found that only 13 societies mentioned Gaza on their website, Only four societies published articles about the conflict in their partner journals and only one society provided resources for medical practitioners. None of the medical or surgical societies have condemned the Israeli atrocities or genocide in Gaza. This is in sharp contrast to the almost universal, unequivocal and forceful condemnations of Hams attacks in October 2023.  As Dr. Alice Rothchild, a physician formerly at Harvard Medical School elegantly points out, “the war in Gaza and U.S. funding has exposed several central political and moral issues of our day: the interlinked roles of structural and individual racism, Islamophobia, dehumanization, the impact of settler colonialism on the perception of the human rights of an indigenous population, and the socio-political contexts that lead to the destruction of public health”.

Historically, it is also clear that silence in the face of atrocities, such as during the holocaust, not only enables the medical community to ignore and condone but sometimes even commit grave injustices. Over 50 % German Physicians joined the Nazi party during the holocaust and doctors were central to eugenics, forced sterilization, and “T4” euthanasia programs. This was an institutional failure of the entire medical profession, not just individual physicians. Major medical journals and associations in the U.S. including the AMA remained largely silent during the holocaust years. New England Journal of Medicine, Journal of American Medical Association and others and others failed to report or condemn systematic killings of Jews from 1933 to 1945.

NEJM  finally issued an  apology in March 2024 for Holocaust-era silence, while failing  to acknowledge the unfolding genocide in Gaza and the same silence of medical profession that it decried. Noting this contradiction, the lead author of the NEJM holocaust apology, Dr. Joelle Abi-Rached  wrote a scathing letter in the Lancet, titled “ Palestinian challenge to U.S.  Medical Ethics” and concluded that “ medical doctors are no less vulnerable than others to being absorbed into violent, nationalistic ideologies and misusing their training and power to inflict suffering rather than to support care and justice”.

It’s time that U.S. medical institutions, organizations and societies reevaluate their complicity and silence over Gaza genocide given their ethical mandates and the fact that U.S. is the main funder of this genocide. The suppression of discussion on medical war crimes, starvation of children and genocide in Gaza goes against our oath as physicians and the stated mission and values of our medical institutions. Physicians must speak up within their professional societies and institutions  as well as tell Congress to ensure that life saving aid is allowed freely and unconditionally to the besieged population in Gaza.