Department of Nursing, Jerusalem College of Technology, Jerusalem, Israel.
School of Public Health, University of California, Berkeley, CA, USA.
Glob Public Health. 2023 Jan;18(1):2171087. doi: 10.1080/17441692.2023.2171087.
This article explores the meaning, manifestations, and ramifications of medical neutrality in conflict zones. We analyse how Israeli healthcare institutions and leaders responded to the escalation of the Israeli-Palestinian conflict in May 2021 and how they represented the role of the healthcare system in society and during conflict. Based on content analysis of documents, we found that healthcare institutions and leaders called for cessation of violence between Jewish and Palestinian citizens of Israel, describing the Israeli healthcare system as a neutral space of coexistence. However, they largely overlooked the military campaign that was simultaneously taking place between Israel and Gaza, which was considered a controversial and 'political' issue. This depoliticised standpoint and boundary work enabled a limited acknowledgement of violence, while disregarding the larger causes of conflict. We suggest that a structurally competent medicine must explicitly recognise political conflict as a determinant of health. Healthcare professionals should be trained in structural competency to challenge the depoliticising effects of medical neutrality, with the aim of enhancing peace, health equity, and social justice. Concomitantly, the conceptual framework of structural competency should be broadened to include conflict-related issues and address the needs of the victims of severe structural violence in conflict areas.
本文探讨了冲突地区医学中立性的含义、表现形式和影响。我们分析了以色列医疗机构和领导人如何应对 2021 年 5 月以色列-巴勒斯坦冲突的升级，以及他们如何在社会和冲突期间代表医疗体系的角色。通过对文件的内容分析，我们发现医疗机构和领导人呼吁停止以色列犹太人和巴勒斯坦公民之间的暴力，将以色列的医疗体系描述为一个共存的中立空间。然而，他们在很大程度上忽略了同时在以色列和加沙之间进行的军事行动，这被认为是一个有争议的“政治”问题。这种非政治化的立场和边界工作使得对暴力的有限承认成为可能，而忽略了冲突的更大原因。我们认为，结构胜任力医学必须明确将政治冲突视为健康的决定因素。应该培训医疗专业人员掌握结构胜任力，以挑战医学中立性的非政治化影响，目的是促进和平、健康公平和社会正义。同时，应该扩大结构胜任力的概念框架，以纳入与冲突相关的问题，并满足冲突地区严重结构性暴力受害者的需求。
