糖心vlog

To the Editor A recent Viewpoint¹ addressed the importance of protecting the sacredness of health in the context of the conflict in Israel and Gaza. While we share the authors鈥� commitment to protecting the inviolability of health in conflict zones, we are concerned about their interpretation and application of international humanitarian law (IHL) in this armed conflict. In our opinion, the authors鈥� 鈥渙bjective law-based assessment鈥�¹ was misleading. We acknowledge the humanitarian crisis in Gaza and we are profoundly distressed by the loss of civilian lives.

The authors asserted that the Israel Defense Force (IDF) targets health care facilities, alleging a violation of IHL.¹ Hamas, a recognized terrorist organization, uses hospitals for military purposes and embeds military personnel and equipment within health infrastructure. Substantial evidence suggests the existence of a command center under Al-Shifa hospital, designating it a military target.^2,3 The authors鈥� assertion that 鈥淚sraeli attacks on Palestinian health facilities also predate the current conflict鈥�¹ lacks supporting evidence and contradicts their claim of providing 鈥渇act-dependent judgments.鈥�

The Viewpoint authors contended that the death toll in Gaza reflects Israel鈥檚 鈥渄isproportionate鈥� response.¹ The concept of proportionality must consider intention; Hamas鈥� use of misinformation, inclusion of combatants in death tolls, and use of Palestinian civilians as human shields complicates the assessment. The IDF asserts efforts to avoid civilian loss in its attempts to dismantle terrorist infrastructure. Israel has a right under international law to defend against the threat posed by Hamas, which includes taking military action that is necessary to ensure that Hamas terrorists cannot repeat the atrocities of October 7, 2023, which they have vowed to do. While every civilian death is tragic, there is a moral difference between the inadvertent death of noncombatants in conflict zones and the deliberate, calculated, and depraved massacre of innocent civilians by terrorists.

Notwithstanding the authors鈥� dedication to safeguarding health in times of war, they have omitted significant facts. There has been no provision of health care by the International Committee of the Red Cross or other humanitarian agencies to the hostages taken from Israel, many of whom are severely injured. Additionally, this Viewpoint overlooked Hamas鈥� heinous sexual violence against Israeli women. In an article focused on the sacredness of health in war, these omissions are very concerning.

With a sense of responsibility toward fostering constructive dialogue and maintaining academic rigor, we encourage accurate, balanced, and meaningful discussion surrounding the conflict between Hamas and Israel, and the intersection of armed conflict and health.

Corresponding Author: Nikki R. Adler, BSc, MBBS, PhD, School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3000, Australia (Nikki.adler@monash.edu).

Published Online: March 13, 2024. doi:10.1001/jama.2024.4438

Conflict of Interest Disclosures: None reported.