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Torture in Israel and the Occupied Territories

Evidence of Israeli physician compli-city in the torture of Palestinian de-tainees was described at the two-dayinternational conference held lastmonth in Tel Aviv and sponsored bythe Association of Israeli and Palesti-nian Physicians for Human Rights(AIPPHR) and the Public CommitteeAgainst Torture in Israel. Accordingto Dr Ruchama Marton, founder ofAIPPHR, a "Form of Medical Fit-ness", obtained by an Israeli attorney,Tamar Peleg, and first revealed in thenewspaper Davar (May 16, 1993),requires that the physician examiningdetainees before interrogation indicatewhether there are any limitations touse of an isolation cell, binding theprisoner, covering his head and eyes,and subjecting him to prolongedstanding. The form also requires thatthe physician note evidence of physicalinjuries "before entering interroga-tion". Amnesty International andB’Tselem, an Israeli human rightsorganisation, deem that the pro-cedures for which detainees have to becertified fit, and other associated prac-tices, constitute torture because of

their severity and duration.Studies by international human

rights organisations have revealed thatdetainees under interrogation mayhave their heads covered with foul-

smelling hoods, be deprived of sleep,be threatened with physical injury(including rape and death) or withtorture of members of their families,and, in many cases, be severely beaten.In some cases, documented by inter-national forensic specialists, these

practices have resulted in death orhave probably contributed to suicideof detainees. Routinely, detainees areforced to sign confessions which areused in military courts to incriminate

them. Human rights specialists inIsrael estimate that since 1988 Israeli

intelligence and military personnelhave subjected at least 5000 Palesti-nians a year to these practices.

: Several case-histories were

described. One was that of Dr Mam-douh Al-Aker, a Palestinian urologist,who appealed to the Medical Associa-tion of Israel to investigate and disci-pline physicians guilty of complicity in

the torture of detainees and to con-

demn these practices. He had beendetained in 1991 by the General

Security Services (Shabak) for 40

days, during most of which he hadbeen held incommunicado in a tinycell and subjected to many of the

physical discomforts listed above. Hisappeal to the medical profession wasechoed by others at the conference.: The conference also reviewed the1990 Landau Commission guidelines

under which "moderate physicalpressure" is allowed in the interrog-ation of detainees. These guidelinesare accompanied by a secret appendixthat details the psychological and

physical measures permitted. Variousspeakers called on the government topublish this appendix.; According to press reports, on June21 (a week after the conference) DrMiriam Zangen, president of the Is-raeli Medical Association, informedthe Prime Minister, Yitzhak Rabin,that the association has told its mem-bers not to fill in the fitness formbecause the act would representcomplicity with torture. Israeli mili-tary sources have denied that the formin question is currently in use.

Jonathan E Fine

Dis-association of

drug firms

The pharmaceutical industry’sassociation in Germany (Bundesver-band der Pharmazeutischen Industrie,BPI) might not survive into the nextyear. too of the 436 member firms havegiven notice of their intention to leavethe association by the end of this year ifit is not reorganised to their liking.The first threats to depart were madeat the end of June by the few bigGerman firms involved in research,and they were followed by noticesfrom the German branches of the

major Swiss, British, and Americancompanies. Several of the smaller Ger-man firms and producers of genericdrugs have also given in their notice. :Recent legislation to limit numbers

of prescriptions have reduced profitsfor several firms by more than 20%.And there is no end to this downturn in

sight. The large firms see their invest-ment into research for new productsfading. One reason why the phar-maceutical industry was ineffective inopposing the health system reform

(see Lancet Feb 13 p 427) is that themembers were not speaking with onevoice. Some members are producers ofinnovative drugs, whereas others aremanufacturers of generic drugs orover-the-counter preparations. Theformer group wanted patients to paymore for drugs for milder ailments sothat health insurance companieswould have enough money to coverdrug costs for the more disabling andlife-threatening diseases. This policywas not adopted because, whether bigor small, a firm has only one vote, eventhough the contributions to BPIfinances are based on turnover. Largecompanies have thus suggested thatsubgroups within the BPI be allowedto speak publicly for themselves.

Furthermore, the big firms want to beable to influence policy decisions in away that properly reflects their posi-tion in the drug market. :"We do not wish for confrontation.

It would still be the best to have acommon association", says Dr WalterWenninger from Bayer. However, ifthe BPI does not yield, it faces a masswalkout, which would more than halvethe association’s income, so a collapse

of the BPI is likely..

The German pharmaceutical indus-try’s feeling that it is not well served byits national association is shared bylarge firms elsewhere with a high levelof research activity. They thus metthis week in Switzerland to form aninternational organisation to presentthe drug industry’s ideas to other

interest groups and to the public.

Annette Tuffs

Prof J-P Allain

The appeal hearing in Paris for peopleconvicted in connection with the FrenchHIV-contaminated blood scandal (seeLancet 1992; 340: 360) came to an end inmid-June. On Tuesday of this week, theappellate court’s decision was announced.Prof Jean-Pierre Allain, who currently hasacademic and blood transfusion appoint-ments in Cambridge, UK, had his sentenceof four years’ imprisonment (two suspen-ded) confirmed. He appealed immediatelyto the Supreme Court and could have beenreleased, pending that higher decision. Yethe is now in jail. Dr Michel Garretta,already serving a prison sentence, had thatconfirmed too.