This Year in Jerusalem

For the past few months Israel has been going through a crisis in its medical system — although it has not affected Jerusalem. The agreement under which doctors in public hospitals were working expired in the spring, and negotiations for a new agreement were long and arduous. The hospitals in Jerusalem — Hadassah, Sha’are Tzedek and Bikur Cholim — were not affected since they are private hospitals.

(It’s a complicated system; they are private hospitals maintained partially by nonprofit organizations, but open to the public and covered by the national health system. Hospitals in the rest of the country are maintained by the government, and thus the hospitals and their staffs have to negotiate with the Finance Ministry for operating funds and salaries.)

A new nine-year agreement between the Finance Ministry and the Israel Medical Association, representing doctors in the public hospitals, was signed in August. However, residents in these hospitals were dissatisfied with the agreement and the terms that it imposed on the residents. As a result, they threatened to resign en masse and turned in resignations to their respective hospitals, leaving hospitals understaffed and forcing cancellation of non-urgent surgeries and other medical procedures.

In response to the state prosecutor’s request that the National Labor Court issue an injunction against the resignations, the court denied the validity of the mass resignations and ordered the residents back to work. Next, the residents turned in individual resignations, but the Labor Court once again denied their validity. The residents then appealed to Israel’s Supreme Court, which ruled that the case had to be submitted to negotiation and appointed mediators.

Currently, the case is in mediation. (It may be possible that by the time you read this article on Dec. 8, the dispute may have been solved. And, then again, maybe not.)

Do doctors have the right to strike?

A very interesting op-ed article on the subject appeared recently in The Jerusalem Post written by an Israeli doctor with a Cincinnati connection — Dr. Shimon Glick, professor emeritus of the Faculty of Health Sciences at Ben-Gurion University of the Negev, who is married to former Cincinnatian Brenda Rubenstein, the sister of Esther Deutch.

Noting that the right to strike is “so engrained in modern societies that it is unlikely to change in the near future,” Professor Glick asks, “Are strikes by physicians different than strikes by other groups?”

His answer: “I believe that physicians are indeed different. They deal with human lives [and] during strikes it is impossible to prevent serious human suffering and unnecessary death.”

Moreover, Professor Glick continues, “the key component in medical professionalism is the primacy of the interests of the patient and the community over those of the physician.”

He goes on to cite the Jewish point of view: “In Judaism, provision of treatment to a patient is not a matter of private contract, or discretion, but is a religious obligation, a biblical mandate. The Shulhan Arukh states, ‘If a physician withholds his services, it is considered as shedding blood.’”

Recognizing that Israel is not governed by Halacha (Jewish law), nevertheless, Professor Glick ends his article by urging the physicians “to find creative and dynamic ethical ways for the settling of labor disputes” through “binding arbitration by objective experts.”

The dilemma is: Will that happen? Or will patients in Israel’s public hospitals continue to be held hostage?