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We feel it necessary to reply to Dr Blachar's letter (December 2001 JRSM1) since we were responsible for quoting the statement he finds so offensive. We must insist at the outset that Professor Dolev did state that ‘a couple of broken fingers’ are a price worth paying for information.
Let us put the matter into context. For several years there has been plentiful evidence that the Israeli General Security Service (GSS), also known as Shin Bet or Shabak, has routinely used harsh techniques of interrogation, euphemistically known as ‘moderate physical pressure’ or even ‘increased physical pressure’, when interrogating Palestinian suspects2,3, even though Israel is a signatory of the UN Convention against Torture. The techniques are so well known that some of them have attracted nicknames. They include hooding, violent shaking, being shackled to a low, sloping chair (shabeh), being forced to crouch for extended periods (gambaz), being subjected to loud music, transient suffocation and sleep deprivation. Following a death caused by violent shaking4, these practices were condemned by the Israel Supreme Court. The Knesset then brought in a Bill to legalize the techniques and to give the GSS impunity but, following strong lobbying by human rights groups, the Bill fell and since then there has been no further attempt at legislation; the procedures remain in use.
There is good evidence that Israeli doctors routinely monitor Palestinian detainees being interrogated by the GSS5. Dr Blachar has stated in his role as President of the Israeli Medical Association (IMA) that, if anyone would give him the names of such doctors, he would take action6.
During a Medical Foundation visit to Israel in November 1999 we sought an interview with Professor Dolev, Chairman of the IMA Ethics Committee, in order to clarify the IMA's ethical stance. We asked him if he could name any doctors involved in interrogations by the GSS but he was unable to do so. During the interview it became obvious that Professor Dolev was sympathetic to the use of ‘moderate physical pressure’, citing the argument of the ‘ticking bomb’. It was in that context that he made the disputed remark that ‘a couple of broken fingers’ were a price worth paying for vital information—a remark which, as readers will understand, was not likely to be forgotten by his audience.
One problem appears to be that, like many defenders of Israel's methods of interrogation, neither Dr Blachar nor Professor Dolev regards ‘moderate physical pressure’ as torture, despite repeated protests by the UN Committee against Torture. Of course, we are well aware that the security situation has deteriorated disastrously since our meeting in November 1999, and apologists for the methods will argue that their use is now even more justified; but increased danger does not excuse the continued use of inhumane techniques. Indeed, it is now even more important that Israeli physicians should take steps to show the world that they respect international standards of ethical conduct. If the IMA rejects Professor Dolev's remark, then logically it should speak out against ‘moderate physical pressure’ and take steps to identify doctors who cooperate in its practice.