Earlier this year, two Harvard medical historians published an article on a leading American medical journal’s willful ignorance of Nazi atrocities in the 1930s and ’40s. The article found that the New England Journal of Medicine, one of the nation’s longest-running and most prestigious medical publications, either chose not to cover the Nazi regime’s racist and antisemitic health policies, mass killings, and medical experimentation, or, in one case, praised the Nazi health care system for its approach to public health.

The New England Journal of Medicine convened a symposium on Wednesday where the authors, Joelle M. Abi-Rached and Allan M. Brandt, could present their findings — and Abi-Rached took the opportunity to call the journal out for repeating its mistakes today.

“Is the silence of the journal regarding the pulverization of the health care system in Gaza, and Israel’s relentless attack on health care workers and the creation of a public health and humanitarian disaster and the weaponization of starvation similar or different to its silence during the Holocaust?” Abi-Rached said toward the end of her talk, joining the symposium virtually from Paris. “What explains the erasure of the predicament of Palestinians in the pages of the journal? What do we mean by the political determinants of health if we precisely ignore the plight, the health, and well-being of marginalized and vulnerable populations?”

Abi-Rached, who recently fled the Israeli bombing campaign in Lebanon, where she grew up and had been teaching, questioned why the journal has yet to publish any articles about Palestinians and Gaza.

During her talk, Abi-Rached cautioned that the destruction in Gaza is a part of “a significant erosion” of the international humanitarian laws and framework born out of World War II and after the atrocities of Holocaust. She then noted that no one should be surprised that her paper with Brandt, published amid the war in Gaza, had “elicited such strong reactions among medical doctors, public health experts and other healthcare personnel, and the wider public, who were rightly appalled by the silence of the journal regarding the suffering of Palestinians.”

She said that it is the role of historians, medical journals, and universities to speak out and raise such questions to reckon with both past and present, referring to Israel’s war in Gaza as “the most glaring and moral crisis of our time.” 

“What is happening today in Gaza is unprecedented. It far surpasses the violations of medical neutrality seen in El Salvador, Chile, Nicaragua, Guatemala, Syria, Sudan, or Ukraine,” Abi-Rached continued. “We are witnessing today the same deliberate and systematic targeting of health care personnel, not only in Gaza, but also in Lebanon where the conflict has moved and shifted.” (“Medical neutrality” refers to the principle of preserving access to medical care during times of war.)

Abi-Rached’s remarks arrive at a moment when many in the medical community are speaking out about atrocities carried out by the Israeli military, largely led by medical workers who have treated patients in Gaza’s hospitals over the past year. 

Most recently, Feroze Sidhwa, a surgeon who worked at the European Hospital in Khan Younis, Gaza, for two weeks in March and April, wrote an op-ed for the New York Times based on the observations of 65 doctors, nurses, and paramedics who saw patients during the war. Doctors provided X-ray images showing bullets embedded in the skulls and spines of patients. Many reported that they repeatedly treated children, often under 12, shot in the head or chest. Pro-Israel critics dismissed the evidence as “digitally altered or completely falsified,” and The Times took the unusual step of publishing a note saying that the paper stood by the reporting after doing “additional work to review our previous findings.”

Throughout the war in Gaza, the Israeli military has targeted hospitals in repeated airstrikes and ground operations. Earlier this week, 19-year-old Palestinian student, Shaban al-Dalou, was seen burning alive while hooked up to an IV drip after an Israeli airstrike on Al-Aqsa Hospital set fire to the tents of hundreds of displaced people sheltering there. 

More than 800 health care workers have been killed in Gaza in the past year, and the majority of its hospitals have either been destroyed by Israeli strikes or are struggling to operate due to a lack of resources amid the ongoing blockade of medical supplies. 

In Lebanon, where Israel recently intensified its attacks by unleashing widespread bombs and airstrikes, about half of its medical centers and clinics have been closed due to structural damage or their proximity to bombardments in recent weeks. 

Abi-Rached and Brandt’s article, “Nazism and the Journal,” received wide attention after its publication in March, including coverage by the New York Times. Even at the time, the article’s omission of Israel’s war in Gaza and its inability to draw through lines from the Holocaust and what experts have called an unfolding genocide of Palestinians generated pushback from other medical experts. 

After Abi-Rached’s talk on Wednesday, applause broke out from the crowd of several dozen in the conference room of the school’s Countway Library. 

Eric Rubin, editor-in-chief of the New England Journal of Medicine, responded to Abi-Rached’s remarks by acknowledging that the journal has yet to publish any works about Gaza. “It doesn’t mean that we won’t publish on Gaza,” he said, adding that he is open to the idea. Yet he mentioned that it has been challenging to find a unique voice on the topic.

“To my mind, it’s not enough to say, ‘Attacks on hospitals are bad.’ That’s been said everywhere, we’re not a unique voice in saying that. It’s not enough to say that medical neutrality is an important value,” Rubin said. “So what is it that we can say that will change people’s thinking?”

“And I am not sure what that is, and we would love to be able to create a unique perspective,” he added. “I don’t think we’ve seen that yet and that’s I think what we’re looking for.”

He also acknowledged the potential for pushback. After the publication of the issue on historical injustices, which included Abi-Rached and Brandt’s article, a number of readers canceled their subscriptions in protest, Rubin said. Gaza is even more fraught, he said.

“We’ve heard in the room that there are legitimate controversies that aren’t so clear,” Rubin said, referring to an earlier question from an attendee. 

Before Rubin spoke, one attendee, who said his family has lived in Israel since its creation in 1948 and whose daughter lost a friend during the October 7 attacks, argued that medical neutrality is being “destroyed by both sides” and pointed to Hamas’s rejection of medical services from the Red Cross, as required under international law. He also mentioned the allegation of Hamas using hospitals “as cover for military activities.” Israeli and U.S. officials often allege that Hamas uses hospitals and other civilian infrastructure as a shield, but the claims have been shown to either be exaggerated or unsubstantiated.

The attendee identified himself as a co-chair of the Jewish Employee Resource Group at Mass General Brigham, and added that a survey of Jewish staff at the hospital showed a quarter feel fear working in the hospital and more than two-thirds “feel unable to declare their fully authentic self while at work.”

“In both settings, we would love there to be neutrality around this, so that Jewish staff would not feel that, and similarly, in war, that health care facilities and health care was observed as a neutral space, by all sides, in context of conflict,” he said. 

Brandt, Abi-Rached’s co-author, answered by decrying what he saw as the erosion of the Geneva Conventions through the various conflicts across the globe and talked of the need to restore trust in such institutional norms. 

Abi-Rached then pushed back on the “both sides” argument from the attendee, arguing that his logic is “a bit dangerous.”

The idea that “by merely having combatants or militants being treated at the hospital, that this is enough of a justification or a pretext to bomb it, and by doing that cause even more harm — one should be reminded that this is precisely what fascists have been using historically as an argument,” she said, referencing a quote from Italian dictator Benito Mussolini justifying his bombing campaign on Ethiopian hospitals in the 1930s.

Abi-Rached previously referenced the effects of Israel’s wars on the health care system in Lebanon in a Boston Review article published earlier this month. In the piece, she detailed the moments when dozens of patients from Israel’s pager bombings poured into the Beirut hospital in which she worked.

“We have become subjects in a morbid experiment,” she wrote. “New weapons are being tested, studied, and perfected on lives deemed expendable, with the approval of the most powerful democracies in the West.”

“Is the unfolding war part of the expansion of Eretz Israel, with more and more illegal settlements, driven by the messianism of the far-right government of Benjamin Netanyahu?” Abi-Rached continued. “Could it be explained by the enduring trauma of the Holocaust that is still lingering generations later, with a disturbing transference of hate of Nazis onto hate of ‘Arabs’ who had nothing to do with the Holocaust in the first place?”