Dr. Jeffrey Goldstein and Dr. Steve Samuel are members of DARA (Doctors Against Racism and Antisemitism), which seeks to ensure that medical publications avoid promulgation of subjective articles aimed at vilifying any race, nation or country. Visit their website at www.daradocs.org.

“Israeli Doctors Accused of Collusion in Torture”. This is only an accusation, but when it appears in a piece of purportedly credible, medical journalism, it conveys a presumption of guilt. The reality is that this is a recent headline in the medical journal, The Lancet.

Sharmila Devi’s article makes claims and repeats statements inconsistent with objective journalism and clinical medicine. The tragic death of Arafat Jaradat, a 30-year-old father of two and member of the Al Aqsa Martyrs’ Brigade, has been turned into an opportunity to besmirch the Israeli Medical community.

An autopsy conducted the next day by Israeli forensic pathologists concluded the likely cause of death to be a heart attack (myocardial infarction). It is not disputed that vigorous attempts at cardiopulmonary resuscitation were carried out for almost an hour. Palestinian Authority’s chief pathologist, Dr. Saber Aloul, who attended the autopsy, is reported as saying that “bruising on the body was evidence of torture.”

However anyone who has taken basic CPR training knows that the physical force required to provide adequate chest compressions in order to generate the necessary cardiac output invariably leads to chest trauma, not infrequently to rib and/or sternal fractures. Bruising would be clearly visible by the next day. For a doctor to conclude that bruising equals torture is unscientific and unprofessional. A previous study in The official journal of the European Resuscitation Council confirmed this, where fractures were found at autopsy of 18 of 19 patients (95%) who receives CPR. (Source Resuscitation: Volume 60, Issue 2, February 2004, Pages 157–162 andhttp://www.sciencedirect.com/science/article/pii/S0300957203003757)

Dr. Michael Sayre, a spokesperson for the American Heart Association and a professor at the University of Washington in Seattle, has previously said broken ribs are to be expected when doing CPR and the worry of causing a break shouldn’t deter people from helping someone in cardiac arrest.

Dr. Victor Quint, an anaesthesiologist at the Humber River Regional Hospital in Toronto stated, “Anyone who goes through CPR may look like a trauma victim.”

If Israeli doctors had anything to hide, would they invite Dr. Aloul to observe the autopsy? His attendance as the PA’s chief pathologist, contrasts sharply with the events which occurred 6 days following the death of Mr. Jaradat, whenAyman Samara, a 40-year-old Palestinian man, died in the Palestinian Authority’s Jericho Prison.

As Palestinian journalist Khaled Abu Toameh wrote,

“The Palestinian Authority has actively prevented Palestinian journalists from covering the mysterious death of Samara. One Palestinian reporter, who was caught interviewing people outside Jericho Prison, was even detained for several hours by Palestinian Authority security officers.”

The absence of any comment or reference to medical literature or non-biased expertise as relating to trauma induced during CPR, immediately places Ms. Devi’s article outside the realm of objective, medical/scientific publication standards. Responsibility for accepting the article for publication rests on The Lancet editor.

The Lancet is a reputable medical journal. But its unsubstantiated claims and inflammatory headlines vilify rather than inform and educate. The Lancet has diminished its credibility and betrayed an agenda unfit for trustworthy medical literature.

Please send your considered comments to Anne Rosenthal – Head of Public Relations at a.rosenthal@elsevier.com, the journal’s ombudsman at ombudsman@lancet.com or to Bill Godfrey – Chief Information Officer atb.godfrey@elsevier.com.