JPost: Health Minister German outlaws fluoridation of all tap water

Here is another in our series of posts regarding mandatory medical treatment.

An article by Judy Siegel-Itzkovich reports that the Israeli Health Minister, Yael German, has directed that Israel's water cupply should no longer be fluoridated.

But she added that instead of forcing all Israelis to consume fluoridated water to benefit children’s teeth, the delivery system should be changed so each parent can decide and take action individually if they wanted their child to get dental protection...

Prof. Arnon Afek, German’s director-general whom she recently handpicked and who is an expert in pathology and medical administration (but not dentistry or public health), told The Jerusalem Post Sunday that he personally supported the health minister’s decision to prohibit fluoridation. “Mandatory fluoridation is medical treatment. Individuals have the right to decide if they want it or not. The question is not if fluoride is beneficial but how it should be delivered. We cannot force people. It is legitimate that experts in the field oppose the health minister’s decision, but we have a policy,” said the director-general. “The ministry supported it for over 40 years, but this is a new era. The world has changed, and we can educate parents.”

Israel Hayom | Israel Medical Association opposes force-feeding law

In another story related to coercion of medical procedures, there is this story from Israel Hayom (see prior related posts here, here and here). The proposed law would require doctors to force-feed hunger strikers. If a certain doctor refuses, he would be obligated to transfer the care of the patient to another doctor. There are potentially two people being coerced here, the hunger strikers and the doctors.

According to the article, the Chairman of the Israeli Medical Association claims that this clause would cause doctors to violate the Israeli code of medical ethics. But I am not certain how. Perhaps the relevant clauses are on page 24:

k) The right to continue proper medical treatment 

1. The physician shall respect the patient's right to continue medical treatment with another physician or as part of some other medical arrangement. 

2. The physician shall respect the patient's right to receive continuous treatment, with full cooperation from the physicians treating him. 

If the patient has the right to switch doctors, presumably he has the right to keep his current doctor (who refuses to force-feed him).

I never quite understood the issue with hunger strikes. How exactly do the strikers force their captors or others to release them by not eating? According to Wikipedia, it works mainly by guilt or public perception. The jailing entity does not want to suffer the public outcry that would result from the death of the prisoners while incarcerated. I guess it just depends on the will of the jailor and the striker. 

Israeli Physicians to be Told They Must Treat HIV Carriers- Haaretz

According to a report by Haaretz, the Israeli Medical Association-(IMA)'s ethics committee has decided that it is unethical for a doctor to refuse to treat a patient with HIV. (For the IMA's statement in Hebrew click here.) I'm not sure why doctors would refuse HIV patients any more than patients with other highly infectious and fatal diseases. The article suggests that it may be due to certain prejudices and a stigma that attaches to HIV patients. Now, this statement by the IMA is not a legal decision so if a doctor would refuse to treat a patient it seems that they would not be violating any law but they might be subject to discipline by the IMA.

This new stance is not so clear to me because the IMA's position, found on its website, is that "A physician must offer medical assistance in urgent cases or in life-saving situations. In any other instance a physician may decide not to provide medical treatment to a patient for personal or professional reasons." So I'm not sure whether this new statement is referring to urgent cases or non-urgent cases. If it is referring to non-urgent cases then it seems to signal a reversal of policy. (In Australia, doctors have a duty to provide care, at least in urgent cases, even where there is no previously existing doctor-patient relationship.)

US Doctors to be Waived in to Israel- JPost

According to a JPost article, US doctors who have passed the USMLE need not take the Israeli medical licensing exam but will be waived in.

The exemption from the local licensing exam will be retroactive, granting a license to whoever has passed the USMLE in the past decade.

This is the first time that Israeli health authorities have accepted foreign test results for an MD license.

But someone who has taken an Israeli licensing exam and failed may not ask to take the USMLE exam and receive an exemption; he will be able, however, to resit the local exam instead.

I don't expect to see a similar rule for lawyers anytime soon. First of all, Israel seems to need more doctors so this will help ease the shortage while there is a glut of lawyers in the country. Second, the human body is the same in every country and medicine is fairly standardized whereas the legal system in the US and Israel, while similar, has many differences. On the other hand, lawyers who have passed the bar exam in one of the 50 states and has 5 years of experience need not pass the Israeli bar even if they can barely read Hebrew or know anything about the Israeli legal system. One can always hope...

Man Attacks Estranged Wife in Hospital- New Law Should Prevent Re-occurrence

Apparently, violence in health care facilities is a problem in Israel worthy of its own law.

The JPost reported today that a man attacked his estranged wife and hospital staff in the maternity ward. In May they reported on 3 brothers of a woman who was placed in a emergency shelter for domestic violence victims who went to the social worker’s home with clubs and iron bars and beat up her husband and other family members. According to a report at the Health Policy Monitor:

A comprehensive study conducted in 2003/4 on violence in emergency rooms in Israel (Landau et al. 2004) revealed that 75% of the medical staff reported a violent incident in the past year. Most reports related to verbal violence, but 29% reported threats and 16% physical violence...

This problem receives growing media attention; it was debated in the parliamentary committee for work welfare and health in 2007. During 2008, several academic conferences were dedicated to the issue and discussed measures to address it.