A recent commentary in the Lancet makes the case that the American health care establishment, in light of its silent inaction, is complicit in the genocide against Palestinians in Gaza. While their argument is compelling and uncontroversial, much of the discussion of it has revolved around the technical question of whether it is correct to claim that Israel’s actions amount to genocide. But this is confused. The right to care should not depend on whether the causes of suffering are natural or man-made. For example, it should make no difference to a population’s right to health care whether they’re starving due to ecological drought or man-made famine.

Public health consists of political dilemmas that necessitate political solutions. That is not to say that the physician’s principal clinical concern is political, but it entails that when the cause of a health crisis is bound up with a political problem (as they often are), treatments must not shy away from targeting the powerful mechanisms that allow the proliferation of ill health. We recognize this fact intuitively and intimately: in recent years, most of the world’s governing authorities followed the guidance of public health professionals in implementing policies to combat the COVID-19 pandemic and protect its citizens’ lives, as well as curtailing the pandemic’s future cost on social and economic systems.

Why, then, is it so controversial for physicians and health care workers to point out the obvious in the case of Palestinians? A simple call for a “cease-fire” is viewed as a divisive statement, yet it is the most straightforward treatment for the current public health crisis in Gaza in which the scale of the ongoing war makes medical care almost impossible. In Canada, a country that prides itself on its (almost) universal health care system, as well as its role as supposed enforcer of international peace and human rights, physicians and trainees have faced severe repercussions for showing support for suffering Palestinians, including signing a petition that called for a cease-fire.

Advocating for Palestinian health is often disallowed and even shunned. Somehow, a valedictorian speech calling for a cease-fire and medical advocacy for suffering Palestinians was considered “divisive” and unfit for the context of graduating medical students. The dean of the University of Manitoba’s medical school was “disappointed” with the speech, as if it were in any way controversial for a graduating physician to call for the ceasing of injury, famine, and death.

Advocating for the suffering cannot be preferential; it must be directed at those who need it most — this is the only relevant selection criterion. Currently, Gaza needs it urgently. To call the situation an abomination against humanity doesn’t require technical clarification. Around thirty-six thousand people and counting have been killed, eight thousand injured, and, according to a senior UN official, Northern Gaza is in full-blown famine. Health care workers and their facilities are being decimated by Israel’s unrelenting assault. Per the World Bank’s findings (April 2, 2024), “the cost of damage to critical infrastructure in Gaza is estimated at around $18.5 billion.” The reluctance of health care workers to respond with condemnation to such atrocity begs the question: Are Palestinians considered an exception to the universal right to medical treatment?

Even in their typically empty and superficial statements of support, Canadian medical institutions have failed to mention the dying and suffering people of Gaza in any substantial, humanizing language. Their silence is especially damning considering Israel’s targeting of health care workers and institutions. Looking back at the start of the Russian invasion of Ukraine, their hypocrisy becomes flagrant: while emails and public statements were effluviant in their “unflinching” support for Ukrainians, Palestinians have not received any specific consideration aside from dishonest vacuities about the “situation in the Middle East” as if it were an unfortunate geographical accident. It should be underscored that major international and humanitarian medical organizations, such as the World Health Organization (WHO) and Doctors Without Borders (MSF), have taken firm stances on their opposition to Israel’s assault on the grounds of protecting the sanctity of public health and human rights.

Supporting Ukrainian self-determination is uncontroversial in the Canadian health care community. For instance, the Canada-Ukraine Foundation coordinates “the provision of humanitarian assistance quickly and efficiently to civilians impacted by Russia’s full-scale invasion of Ukraine” but has not faced any backlash for its work. In 2022, the Canadian Medical Association (CMA) made noble statements in defense of Ukrainian health care and patients, emphasizing that it is “deeply disheartened and dismayed by the impact of Russian-led military attacks on several cities in Ukraine” and that “health care workers, medical facilities, and patients must be protected.” The CMA even divested from all Russian Federation investments in the wake of its illegal invasion, but has never uttered a word either in writing or in action regarding Israel’s long-standing illegal and violent occupation of Palestinian territories, as well as its documented system of medical apartheid.

For the current situation in Palestine, the CMA first made a statement on October 15, 2023, rehashing platitudes of “standing together” and calling for an “end to the suffering and loss of life in the Middle East,” as well as a condemnation of Hamas’s attack on October 7. Their statement did rightfully call for the protection of health care providers and facilities but, up to this day, after several months of Israeli assault and the International Court of Justice’s ruling of plausible genocide, no statement has ever been made condemning the cause of Gaza’s destruction.

More shocking than Canada’s silence has been its decision to temporarily defund the United Nations Relief and Works Agency (UNRWA) (which runs twenty-two health care centers, among other essential life-sustaining services) after Israel accused twelve of its staff (out of thirty thousand, so 0.04 percent) of participating in attacks on October 7. That this has not met with widespread condemnation by the Canadian health care community is shocking. Experts knew very well that cutting funding to UNRWA was going to have dire humanitarian consequences. Global health organizations did not hesitate to assert the same.

The absence of accurate diagnostic language when it comes Canada’s medical institution’s discussion of Israel’s actions suggests that the crisis is akin to a natural disaster and not something brought upon by the actions of a rogue state. This is not only dishonest, but it is poor medical practice. Incorrect diagnoses lead to inadequate treatments.