**9.2 Society in Israel**

*Education, Human Rights and Peace in Sustainable Development*

remained in the last resort a kind of ad hoc approach.

**assistance programme**

**9.1 Hospital staff**

**9. The effects on society and the region of the Israeli Syrian medical** 

The medical assistance programme in Israel for Syrian patients certainly had important effects on everyone involved. These will be discussed by category:

Many staff members either have fought on the Syrian or Lebanese front themselves in various wars or have or had close family members, friends, colleagues, neighbours or acquaintances who were involved in or wounded, hurt or killed in such fighting. Possibly worse are those who suffered the egregious cruelties and tortures of imprisonment in Syria. These experiences certainly made it very difficult sometimes for those involved to relate to Syrian patients as any other patient. At times the Syrians added significantly to the burdens of an already overworked and understaffed hospital. There were occasions during which there were insufficient resources available for regular Israeli patients because of the large numbers of Syrians. No doubt these facts, combined with the medical complexities of these patients and the resulting extra burdens of work placed upon the staff, led to a degree of dilemma, resentment and even resistance among staff members. I am not aware that these feelings ever rose above the level of occasional grumbling and discontent, yet the hospital certainly had to devote resources to the psychological well-being of staff members, via individual and group discussions and focus groups. On the other hand, when the new hospital director took over his post in 2015, one of the first things he did was to organise hospital-wide consultations about whether to continue or cease the programme of humanitarian assistance, and the conclusions were loud and clear to continue. On a simple human level, when one is faced with suffering and distress, one feels an inner compulsion to help, and this is augmented by one's professional obligations. As Churchill plainly stated regarding a moral obligation, "one can do no other". But dealing with these feelings and dilemmas engenders a cost. In 2016 these issues became the subject of detailed

Another area of ethical concern relates to the area of research. There is no doubt that the huge amount of experience gained and the complexity of the medical challenges faced required documentation and reporting. In many cases clinical protocols and techniques required modification and alteration, and the results of the study of these constitute a form of clinical research as defined by the Israel Ministry of Health. Clinical research in Israel is governed by the principles of the World Health Association's Declarations of Helsinki and other international standards, as given expression by the regulations and laws extant in Israel. Principal among the tenets of ethical clinical research is the requirement for for full explanation to be given to the participant and also for his or her voluntarily given free, informed consent to be recorded on a signed, approved consent form (or in the case of minors or others unable to give legal consent, the agreement of their legal custodian). Putting aside the legal complexities of compliance with these requirements in the case of noncitizens with undefined status, there is the ethical issue of consent from someone who is completely dependent on the medical institution in which he finds himself or herself. Even assuming that the participant can be fully informed, how free can his/her decision be? On the public stage, it is also highly problematic to what extent these dependent noncitizens can be included in clinical research. The settlement of these weighty issues required a high degree of professional and ethical wisdom yet

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The support by gifts and actions that was forthcoming from all aspects of society has been referred to already. To some extent this was the result of identification with civilians caught up in the maelstrom of war and by events beyond their control. There was a widespread hope and belief that good deeds speak from themselves and that inevitably the provision of medical aid would contribute in some way to changing attitudes and opinions on both sides of the border. On a more general level, the national media gave scope to the expression of pride in the altruism and selflessness of a country surrounded by hatred and ferocious aggression responding with kindness and (expensive) humanitarian action. This speaks to the basic Jewish value of "healing the world" ("tikkun olam"), in which every individual is enjoined to help making the world a better place. There is also the strong associated memory of the holocaust during which Jews were the defenceless victims of merciless cruelty, murder and oppression. There is a national consensus that Jews, of all people, cannot therefore stand idly by while similar suffering falls on others.
