JERUSALEM—The Israeli Medical Association (IMA) has ruled that medics arriving at sites of terror attacks must first treat the most severely injured person at the scene, even if he is a terrorist.
The ruling replaces an earlier directive—informally referred to as the "charity begins at home" approach—which enabled medics to treat victims first, even if they are less severely injured than the perpetrator.
A spokesperson for the IMA’s ethics panel, Dr. Tammy Karni, said that the previous guidelines required medical personnel to identify who was the victim and who the attacker, a sometimes impossible task. Apart from that, she said, "doctors are not judges."
Said Karni: "The implication of the previous directive was that the doctor needs to investigate who was responsible and punish him by not giving him treatment. There have been cases in which victims were mistaken for perpetrators and left for later treatment, which sometimes was responsible for their death."
The ethics panel’s ruling applies to all medical personnel, including doctors, paramedics, emergency services, and nurses.
The Israeli equivalent of the Red Cross, Magen David Adom, whose ambulances usually arrive first at the site of terror attacks with medical personnel, does not attempt to distinguish between attacker and victim, said its director general, Eli Bein, in an interview with the radio station Kol Barama. "The rule of Magen David Adom is to treat the most seriously wounded person who is in life threatening danger," he said.
The "charity begins at home" directive was laid down in 2008 by previous members of the ethics panel. One of them, Dr. Pini Halperin, director of emergency medicine at Ichilov Hospital in Tel Aviv, criticized the new approach Thursday.
"If there is, for example, a life or death decision to be made regarding casualties," he said, "it is appropriate to first treat what matters to me, that is to say the victims of terror, Jews and Arabs alike—and only afterwards the enemy who carried out the terror attack."
Avigdor Lieberman, leader of the right-wing Yisrael Beiainu Party, termed the new directive "a disgraceful decision."
Said Lieberman: "Those who made this decision simply don’t live in reality. Doctors must rise up against this decision and change it."
Close to 25 Israelis have been killed in the "lone wolf" attacks that have swept the West Bank and East Jerusalem during the past three months. Several times that number have been injured in these attacks which sometimes involve vehicles being deliberately driven into groups of soldiers or civilians waiting at bus stops. In most cases, the perpetrators have been shot by soldiers or armed civilians but the shots have sometimes wounded, rather than killed.