In a study released Tuesday, three rights organizations from Israel and Palestine said the clear policy violates international law, international human rights law, domestic Israeli law, medical ethics, and the UN convention on torture.
Physicians for Human Rights in Israel, the Israeli legal rights group Adalah, and the Gaza-based Al-Mezan Center for Human rights analyzed 48 cases of patients denied permits to cross into Israel during 2009.
PHR appealed the rejections in all of the analyzed cases and provided expert medical reports. Following a rigorous appeals process, researchers found that nine of out 10 life-threatening cases were then approved, while the majority of patients with less severe conditions were ultimately rejected.
A statement from the three organizations explained that "less severe conditions" described in the report included seven patients who, without treatment, were at risk of blindness and another at risk of losing his leg.
Arguing that the evidence from the 48 cases showed a clear policy of discrimination against non-terminal patients, PHR cited correspondence with the Israeli state attorney between September 2007 and 2009 in which the latter stated permits were restricted to “urgent, life-saving cases.”
As the occupying power in Gaza, Israel is responsible for the medical care of Gaza’s population under the Fourth Geneva Convention, human rights groups say. Deliberately withholding medical treatment from patients in need, on political grounds, constitutes collective punishment, prohibited under international law, according to a broadly understood interpretation of the convention.
A Gaza District Coordination Office response, rejecting a permit for a patient requiring advanced urological investigation, said "it is not in line with criteria, as determined from time to time, based on the political and security situation."
PHR said basing access to medical treatment on political considerations is “foreign to medicine and medical ethics,” adding that the sorting procedure to determine whether or not a patient is eligible for any medical treatment at all is “completely unacceptable in terms of medical ethics.”
According to internationally recognized medical ethics, all patients are entitled to the best available medical treatment. Distinctions between patients should only be made when “suitable resources forces medical personnel to set priorities,” and for a limited time, the report explained.
Over the last two months, PHR recorded an “extraordinarily high number of rejections” in what the organization described as “yet another sign of the toughening policies and the tightening closure.” At the same time, its success rate in overturning rejections dropped from 75 percent in 2007 to 35 percent in 2009.
Israel’s High Court approved the permit restrictions in 2007, but with narrow exemptions which the report found the state ignored.
The court’s initial decision left distinctions between life-saving cases and “quality of life” cases in the hands of Israeli security forces. It later ruled these distinctions obsolete, however, the study found that in practice they are still enforced.
PHR volunteer Dr Harel Arzi said, "The difference between causing individuals to suffer from defects on purpose and causing them to suffer from defects or disability by denying them medical treatment for an existing condition – this difference is merely semantic. Whoever prevents patients from accessing medical treatment by restricting their movement is directly responsible for their medical condition, even if he or she did not cause this condition."
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