Feb 14

Feb 14 Protest At The AMA

Demonstrations, Public Declarations, Protest

Over the last four months, health care workers often have been highly visible at pro-Palestinian rallies and marches. Given the death and destruction in Gaza, their presence and concern is not surprising.

Today, 30 to 40 health care professionals staged a mid-day demonstration outside of the American Medical Association’s headquarters overlooking the Chicago River. I knew the rally would be a small one, but I was headed to the gym, so I stopped by for the event, which included several speeches and chants. The group then staged a march, which I did not stay for.

The speakers highlighted the horrendous health-related conditions in Gaza, including: (i) widespread damage to hospitals; (ii) acute shortages of medicines and anesthesia; (iii) conditions that foster the spread of dysentery and other communicable diseases; (iv) severe shortages of food and potable drinking water; and (v) dangerous, and often deadly working conditions that health care workers are subjected to as they try to provide medical assistance. Against that backdrop, the demonstrators demanded that the AMA take a stronger pro-Palestinian stance.

I wasn’t surprised that health care workers would demand that their trade association take a stand on behalf of the Palestinian people, but I also understand why the AMA’s Board of Trustees issued an anodyne statement on November 9, 2023 addressing “[t]he conflict unfolding in Israel and Gaza [italics added]”—language designed to maintain neutrality.

The AMA’s membership undoubtedly includes both pro-Israeli and pro-Palestinian health care professionals, so taking a position favoring one side over the other would undoubtedly anger a portion of its membership. Like consumer product and other highly visible companies, neutrality is the safest and most appropriate stance. After all, those entities’ primary purposes are not public policy think tanks or advocates for positions that are unrelated to their core mission. For that same reason, the Chicago City Council should not have passed a pro-Palestinian resolution regarding the conflict. The people of Chicago do not elect a mayor or a city council to weigh in on matters of foreign policy.

At the AMA’s interim meeting in mid-November, the organization’s house of delegates declined taking up a resolution on the Israel-Hamas conflict. MedPage Today reported that one delegate, in referencing the November 9 statement, said, “we believe the largest physician group in the United States can and should do more than that. This issue is too vital for us to evade discussion.” That demand was aligned with the demand made by today’s demonstrators that the AMA call for a ceasefire. I believe that the group also hoped that the AMA would call out what the group believed is a genocide.

In responding to the call for a resolution at the mid-November meeting, Dr. Andrew Gurman, a former president of the AMA, opposed a debate, arguing that, “This resolution deals with a geopolitical issue, which is in no way the purview of this house.” According to MedPage Today, Dr. M. Zuhdi Jasser, another delegate, went even further, noting,

It is not the role of the House of Medicine to get into 'just war' or 'unjust war,'" ... "I can tell you, ... as a Syrian American, many times I've felt the inclination that ... I wanted the house of medicine to weigh in on the fact that my family was a few miles away from chemical weapons attacks in Syria, that I wanted ISIS decimated ... And yet, that was not appropriate, and I never did that …

While I agree with the sentiments expressed by Doctors Gurman and Jasser, I believe the AMA’s apparent effort to remain neutral as between the Israelis and Palestinians is undermined by at least in part by one prior AMA position; a position pertaining to the Russian invasion of Ukraine. I have yet to find a formal resolution, but in an article appearing in the Journal of the American Medical Association, Dr. Gerald Harmon, a past AMA president, included the following quotation, which indicates that the AMA did take a position:

The AMA is outraged by the brutal assault of the Russian military in Ukraine, and we stand with the World Medical Association and our other international partners in calling for an immediate ceasefire and an end to all attacks on health care workers and facilities. And for however long this conflict continues, it is critical that international humanitarian and human rights laws are upheld and that we protect civilians and medical personnel at all costs.

While the quote doesn’t explicitly state that the AMA supports Ukraine, it comes close to doing so by using the phrase “brutal assault.” Moreover, Harmon, begins the article with a reference to “the proud people defending their homeland from this unprovoked attack by the Russian military.”

In my view, the Russian invasion of Ukraine presents the easy case. Except for the Freedom Caucus, Donald J. Trump, and the MAGA base, most people and governments have condemned Russia’s naked and unwarranted act of aggression against Ukraine, which most likely explains the AMA’s apparent position.

Yet, the Hamas-Israeli conflict demonstrates why the “easy cases” are nevertheless problematic for organizations that take stances unrelated to their core missions—in the AMA’s case as a trade association. Once an organization steps outside the boundaries defined by its core mission, members and others will ask it to continue overstepping those boundaries. Sometimes doing so leads to controversy. By speaking out on the easy cases, organizations like the AMA set a problematic precedent—one that invites members to demand that the organization take controversial positions on other matters.

[Click on an Image to Enlarge It. The Images Are Not Necessarily in Exact Chronological Order]