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The BMJ has been overwhelmed with readers' responses to the debate and poll about whether there should be an academic boycott of Israel. Many of the responses criticised the BMJ's decision to run the debate. Editor Fiona Godlee defends the decision. We also print a summary of the poll results by the BMJ's features editor and an edited selection of the rapid responses
We expected a strong response to this debate (BMJ 2007;335:124-5 doi: 10.1136/bmj.39266.495567.AD). Let me try to answer the question some of you have raised about why the BMJ decided to include it as one of its head to head features. The BMJ aims, among other things, to reflect current debates—including political ones—that impinge on the future of health care and health research. The question of whether there should be a boycott of Israeli academic institutions is currently under serious consideration in the United Kingdom. It has been raised by trade unions that represent university academics and health workers, and it has been widely discussed in the UK media. In retrospect I think we could have made this context clearer.
The debate was not initiated by the BMJ, but it has potentially important implications for our readers around the world. Doctors and medical academics are among those lobbying for a boycott and, as some of you describe in your responses, doctors and medical academics are in turn being lobbied to take one side or another. However, the question has not been discussed openly within the medical academic community. We took the view that, as part of our regular debates on a range of issues, BMJ readers should have the opportunity to see arguments on both sides and to contribute their opinions, which you have done and are doing. While some of you do criticise the BMJ for taking up this issue, others on both sides of the argument have welcomed the opportunity to debate it. The level of interest can be judged by the response.
Some of you will still maintain that to discuss it at all is wrong—that it is out of place in a medical journal, and that by raising the issue at all the BMJ is legitimising the idea of such a boycott. I do not accept this view and find it interesting that some of those who speak against boycotts on the grounds of academic freedom are those who are most determined to silence debate on this issue. I am also interested by the extent to which just posing the question is seen by some to align the BMJ with those in favour of a boycott. To my knowledge this assumption of an alignment with one side of the argument has not happened with previous debates we have posed (for example, “Should Muslims have faith based health services?” BMJ 2007;334:74 doi: 10.1136/bmj.39072.347720.68).
At issue here, and addressed by some of your responses, is the question of whether academic boycotts can ever be justified. The BMJ believes that they cannot, except possibly in cases where science itself has been debased, as in Nazi Germany. The BMJ's opposition to academic boycotts was clearly articulated in 2003 (www.bmj.com/cgi/content/full/326/7379/0/g) and has not changed. As Jacob Amir reminds us in his response (see below), it is a fundamental principle of the universality of science and learning that academics do not discriminate against colleagues on the basis of factors that are irrelevant to their academic work, such as race, religion, nationality, or sex. Some of you raise more practical objections in this case, including the difficulty in agreeing the desired objective of such a boycott. The voices of Palestinian doctors and academics against a boycott of Israel are particularly compelling.
Our readers' poll has come out strongly against a boycott (see box for poll results). But what if it had come out in favour? Would this have led the BMJ to change its position? No. In our last poll most readers said that journals should not carry drug advertisements. Does this mean we will stop carrying these advertisements? No. The polls are useful in reflecting readers' views, but they don't decide BMJ policy. We knew that this poll risked being hijacked by pressure groups, and we have evidence that this happened on both sides of the debate; we have copies of emails calling on people to vote one way or another. We make no pretence that our polls are scientific—another issue that has not previously been raised in relation to these polls. Most people see them for what they are: a means of engaging with our readers.
The BMJ will continue to champion academic freedom and encourage open discussion of the challenges to health, equity, and human rights around the world. We have received many eloquent and enlightened responses to this debate, too many to do justice to in the letters pages of the journal, but some of which are included below.
Deborah Cohen, features editor, BMJ
The BMJ carries web polls, but in no way do we claim that they are scientific. They are simply a means of engaging with the readership. Despite this, newspaper articles and blogs around the world have carried the results of the poll on whether there should be a boycott of Israeli academic institutions.
The raw data showed that 28178 votes were cast. Of those, 6616 (23%) were for a boycott and 21562 (77%) were against.
Of the voters who stated their country of residence over 40% (10637) came from the United States. The second most active country was the United Kingdom with 6571 (25%) votes, followed by Israel with 2119 (8%), then Canada with 1957 (8%).
Just under a third (8735) of the votes came from the general public, 21% (6035) from medically qualified doctors, and 20% (5500) from academic researchers.
But can these results be trusted? The simple answer is no. Readers can vote more than once (several people emailed us confessing they had voted more than once), making the process open to abuse. Our efforts to track duplicated votes revealed examples of internet provider addresses (IPAs) that provided multiple votes, such as one in Jordan that registered 1071 “yes” votes on 24 July and another in the US that registered 142 “no” votes. These voters attempted to disguise their multiple voting by changing the type of visitor they were and the country they said they were from.
When we removed all the multiple votes from single IPAs—including all the genuine votes from gateway servers—there were still more than 20000 votes cast. The breakdown between the yes and no votes remained similar to the percentages given above.
Lobbying to vote occurred on both sides. The BMJ's editorial team was sent copies of campaigning emails and links to blogs that contained direct links to the vote. The poll went live at midnight British time on Thursday 19 July. By the end of the weekend 95% of the votes were against a boycott. By Tuesday 24 July those voting for a boycott started registering their votes in larger numbers.
We also canvassed voters' reasons for voting as they did. Most people were willing to comment on the content of the articles, but many probably had not read them: during the week that the poll was open we registered only 4902 full text page impressions and 148 PDF downloads of the web version of Tom Hickey's article in favour of the boycott and 2591 full text pages and 143 PDF downloads of Michael Baum's argument against.
So, what conclusions can we draw from these figures? Not many, other than that this is a subject that some people around the world feel strongly about.
En masse condemnation of Israeli academia for state sanctioned malfeasance or discrimination sounds heavy handed. If there is a proven case of a specific person or institution involved in inhuman, unethical, or dubious practices, then they should justifiably be blackballed by the academic community.
Anthony Papagiannis, respiratory physician, St Luke's Hospital, Thessaloniki, Greece
The motion's scope needs to be widened: what about Palestinian academia, which has consistently failed to condemn state sponsored acts of terror and violence against unarmed citizens both in Israel and Palestinian territories? If you really care about the fate of these two states, you should apply the same measure to both sides.
Ehud Emanuel, citizen, Israel
Boycott proposers often state that boycotting South Africa worked, so why not Israel? The glaring difference is that whereas supporters of the apartheid regime supported the ideology, Israelis as a whole have voted in at least the last three elections against the occupation and in favour of a two state solution. I also feel there is no substitute for meeting the “enemy” directly—for example, at academic meetings, as happens regularly in Israel and elsewhere, and breaking down stereotyping, something which Tom Hickey seems determined to restrict.
Andrew Fink, consultant ophthalmologist, Ra'anana, Israel
Today, I read that the BMJ chose to question my academic freedom. I was born in Glasgow to Scottish parents, trained in medicine at Kings College Hospital, London, and now am an internationally recognised researcher in neonatology at the Hebrew University of Jerusalem. Today, as ever, my rights to academic freedom and self determination are as absolute and inviolable as those of Tom Hickey.
Eric S Shinwell, professor of neonatology, Hebrew University, Jerusalem
Nearly a century ago my grandfather had to move to Austria from Hungary to study medicine. The trend towards academic boycotts against Jews culminated in the forcible removal of all Jews from universities by the Nazis. Hickey refers to how Israelis and Jews particularly value education and academia that was long denied to Jews in Europe. He understands that he is seeking to undermine Israel's most valued institutions, including Hebrew University, which was partly founded by Albert Einstein; he wants to hit Israel where it hurts.
Michael Szanto, private investment adviser, Chicago
Poor old BMJ! Allow me to come to the defence. Several doctors, as far as I know all BMA members, have wanted to start a medical boycott of Israel for a few years. For a short time I did join an email list, before deciding I was against. So there really is an issue here, and I prefer to think that the BMJ has done a service in bringing it into the open. And should we not be grateful that, after all, the “poll” is currently running at over 80% opposed to a boycott. So who's complaining?
Brian Robinson, psychiatrist, Milton Keynes
Israel has systematically denied academic freedom to the Palestinians for decades. This has ranged from closure en masse of educational institutions to limitations on the freedom of movement of students and academics. Israeli academic institutions have often provided the justification that legitimises these acts to the Israeli electorate.
Tahseen Chaudhry, surgical trainee, Barts and The London NHS Trust
Israel and its academic institutions, including medical ones, are complicit in the denial of human rights and basic health care in the illegally occupied territories. The Israeli Medical Association has consistently failed to oppose the use of physical methods of interrogation or human rights abuses. If an academic boycott forces Israel to face these realities and begin to redress them, then it is worthwhile.
Edward Morris, GP, Witney
The BMJ is wading in murky waters. Its continued focus on Israel is inappropriate for a UK based medical journal. Its call for an unscientific online poll which is open to abuse by interested parties flies in the face of its avowed aim of upholding scientific rigour. Is boycotting the BMJ and BMA a rational response to your irrational focus? Probably not. But it is hard to know how else to express my extreme disquiet about your agenda.
Ann Robinson, GP, London
I recently signed with my wife, an accident and emergency consultant, the petition to call for a boycott of the Israel Medical Association. The IMA has breached a moral code by refusing to condemn the torture of Palestinian prisoners and the callous treatment of ill persons and pregnant women at military road blocks. If governments refuse to act, it is we the people who need to take action. I boycotted Outspan many years ago. Now I enjoy oranges from South Africa and boycott Jaffa oranges. I hope the time will come that I will enjoy Jaffa oranges again and have tea with my colleagues from the IMA.
Ben Alofs, GP principal, Ynys Mon, Wales
The principle of the universality of science and learning—that academics do not discriminate against colleagues on the basis of factors that are irrelevant to their academic work (such as race, religion, nationality, etc)—is well established. To boycott academics by reason of their country of residence breaches this principle.
Jacob Amir, retired physician, Jerusalem
This is no time for mud slinging, racism, or rudeness. Israeli academics and doctors, except for a very noble few, have connived in the illegal and cruel acts of their government. The real facts are readily available in reports from such as Amnesty International. It is one of the duties of a general medical journal to express views of the profession, and here we have horrifying examples. Congratulations to the BMJ for exposing them.
Christopher J Burns-Cox, locum physician, Wotton-under-Edge
Why just Israel? As a Palestinian I know at first hand the damage done by calling to boycott Israel, academically or economically. Not only does it validate everything the Palestinians are saying, including support for suicide bombing, it is hurting any chance of peace and is taking away any chance for help from Israel. Maybe if the world wants to help they should have the courage to boycott the Arab countries until they give the Palestinians living there citizenship status and maybe some rights.
Saleem Abdallah, political analyst, West Bank, Palestine