As genocide rages, doctors must choose: Care or collaborationism | Israel-Palestine conflict

“The physician is the natural attorney of the poor” was a slogan Rudolf Virchow, a wealthy German pathologist, politician and social medicine activist, helped popularise in the mid-nineteenth century. More than 100 years later, Frantz Fanon – a Martinican-born psychiatrist who resigned from his position in the French medical system in protest against French colonial violence in Algeria – expressed a less-idealised impression of the profession.

Although the physician presents himself as “the doctor who heals the wounds of humanity”, he is in reality “an integral part of colonisation, of domination, of exploitation”, Fanon wrote.

Doctors across the world are familiar with Virchow’s affirming portrait of ourselves as virtuous advocates for the oppressed. But based on the prevailing responses of American, European, and Israeli medical professionals to the US-backed genocide in Gaza, Fanon’s damning assessment of doctors’ complicity with state violence rings far truer.

As the world has been witnessing daily mass killings perpetrated by the far-right Israeli government against Palestinian civilians, including deliberate attacks on hospitals that have killed and maimed medical staff and patients, doctors outside Gaza have been sorting themselves into two camps: collaborationists and resisters.

The majority of us in the Global North appear to have gathered into the first category. Collaboration with colonial violence comes in many forms, from passive silence or prevaricating commentaries that foster evasion of ethical-political responsibility to active censorship by journal editors of Palestinian conditions, history, and perspectives, alongside public calls by Israeli doctors for the murder of their Palestinian counterparts by bombing Gaza’s hospitals.

Especially pernicious are intellectually and ethically bankrupt claims that invoking historical and political-economic analyses of the root causes of current violence linked to occupation and apartheid policies is tantamount to justifying violence committed by Hamas, and is thus impermissible.

Such claims are a standard tactic for manufacturing consent for the perpetuation of colonial domination. They aim to obscure its enduring cruelty and inhibit would-be resisters from using their voices and influence to stop it.

The incentives for collaboration and disincentives for dissent are clear. The US House of Representatives has sanctioned the sole Palestinian-American congressperson, Rashida Tlaib, for calling for a ceasefire and repeating aspirations for Palestinian liberation.

A large number of billionaire donors have used the power of their checkbooks to demand McCarthyist policies on campuses across the country.

In response, most well-protected faculty have remained cooperatively silent, while donor-responsive university presidents at elite institutions like Columbia, Harvard, and University of Pennsylvania have suspended pro-Palestinian and Jewish student groups that have protested against continuing violence in the occupied Palestinian territory.

In this climate of intimidation in which criticism of racist Zionist violence and sympathy for Palestinian lives are cynically conflated with anti-Semitism, various federal and state initiatives have been launched to investigate claims of anti-Semitism on university campuses.

This reality has not been lost on the most powerful figures in American medicine, who generally depend upon university appointments and associated academic honours for advancing their careers.

Not a single major medical professional organisation in the US has come out against the acute-on-chronic genocide of Palestinians in Gaza, let alone rallied their substantial lobbying power to oppose US lawmakers’ active support for it.

Despite this and the risks entailed, many US doctors have begun organising among themselves, joining larger movements beyond our profession, and banding together with a broad array of healthcare workers in search of ways to stop the violence.

Many of those in the US medical field who, to date, have fallen into the collaborationist camp would no doubt vehemently deny the accusation if confronted and express outrage that anyone would dare to impugn their moral standing.

Some might point to their abundant publications, lectures, and research grants related to diversity and inclusion, health equity, global health, or human rights as evidence of their unimpeachable virtue.

But when measured by their effects for those subjected to US-sponsored colonial violence and dispossession in Gaza and the West Bank right now, such defences are worse than hollow. They function to provide cover for the ethical failure of the US medical profession to leverage our substantial political influence to condemn colonial violence and demand that our government stop enabling it.

We can, however, do otherwise. As Fanon noted in “Medicine and Colonialism” and demonstrated through his own life, despite doctors’ structurally conditioned tendencies to align with colonial oppression, we are also fully capable of opposing it – provided that we have the courage to refuse the comforts of complicity and accept personal risks.

When doctors leave their upper-class, professional value systems to instead embrace “sleeping on the ground” beside dispossessed groups while “living the drama of the people”, as Fanon put it, commitment to the trappings of polite “professionalism” gives way to active solidarity. The doctor who commits to working shoulder-to-shoulder with the displaced and dispossessed can transform from an “agent of colonialism” into a physician worthy of the term caregiver.

Few American doctors have delivered care in the occupied Palestinian territory or accompanied the residents of Gaza or the West Bank as they negotiate everyday deprivations under Israeli blockades and occupation.

By what means, then, are we to join in solidarity with an oppressed people thousands of miles away? We should look to and take direction from the Palestinian healthcare workers and the foreign colleagues alongside them who have devoted themselves to caring for the sick and wounded no matter the cost.

While providing medical help under conditions that would cause most doctors in the Global North to give up, one doctor in Gaza has even found time to fill the vacuum of ethical-political initiative left by ineffectual American physicians, suing US President Joe Biden for failing to prevent an unfolding genocide and for his active complicity in it.

“We will not abandon our patients or our communities,” Gaza’s healthcare workers have repeatedly said as their workplaces have been bombed.

We should, in turn, refuse to abandon them.

When we cannot or will not join in caring for the most dispossessed, our minimal ethical responsibility as doctors who claim to value human life is to do all we can to protect our colleagues who are doing this difficult, essential work. As a professional community, we have been refusing to meet even this barest of ethical standards.

Some will dismiss this appeal for doctors to reject collaborationism and to join in action-oriented solidarity with our Palestinian colleagues who are risking – and losing – their lives to care for those in greatest need as “divisive” and lacking “nuance”.

For anyone genuinely interested, dispassionately presented historical accounts of Zionist settler colonialism, the resultant apartheid system, the chronic destruction of Palestinian public health, and nuanced legal appeals to protect the rights of Palestinians have been presented countless times before and are readily available.

But as the murders of Palestinian civilians continue to mount by the hundreds with each passing day, we should refuse to nuance or debate preventable atrocity or to permit the fantasy of a middle ground for those who wish to abstain from “taking a side”.

There is no possible justification for what the Israeli and US governments have been doing in Gaza. The only ethical stance for physicians – or anyone else – is to demand a permanent ceasefire, an immediate end to ethnic cleansing in both Gaza and the West Bank, and the dismantling of the apartheid system that ensures an unending stream of both perpetual and punctuated violence.

In the face of genocide, drawing lines and forcing decisive action is a basic ethical duty, no matter who it offends nor what personal or professional costs it may entail.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.