Recently, medical workers at Israeli hospitals told BBC News that Palestinian detainees from Gaza were “ ” while they received treatment. Physicians owe a duty to their patients based on well-established ethical principles. In truth, the doctor-patient relationship is aspirational, and at the bedside, circumstance reveals a much more complex exchange.
At the core of the doctor-patient relationship, two assumptions are needed. The patient must be at liberty, and the patient must want to live. Sometimes a patient wants to die, or at least rejects treatment to allow natural death.
Discourse around doctor-assisted death is important, but such requests are currently under much debate internationally and not specific to Palestinian detainees. When the patient is also a prisoner, the traditional doctor-patient dynamic really starts to fall apart. As a physician, I have worked extensively with prisoners on death row in the US.
My work concerns post-conviction death penalty defense. I have been to death rows in eight states. As an ICU doctor, I may never hear the voice of my patient owing to illness.
I learn about them through friends and families. We improperly call these proxy decision-makers “loved ones.” This is a poor assumption as we cannot know the nature of these relationships.
I cannot know if my patient is the abuser or the abused. Sometimes, patients can advocate for themselves and make decisions about care that are clearly not in what I imagine would be in their be.
