Perspectives: Turning a blind eye on the evil ophthalmologist?

I propose that a global effort be mounted immediately to strip Bashar Assad of his status as a physician.

By BENJAMIN W. CORN
September 29, 2013 21:50
3 minute read.
Syrian President Bashar Assad giving an interview to Venezuelan state television TeleSUR, Sept. 26.

Bashar Assad interview 370. (photo credit: REUTERS/SANA/Handout)

Bashar Assad is a dictator. He’s also a doctor. However, by no means does Assad’s behavior appear consonant with the latter profession. I propose that a global effort be mounted immediately to strip him of his status as a physician.

Assad graduated from the medical school of Damascus University in 1988 then worked briefly in Syria’s military health care system.

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Four years later, Assad studied ophthalmology at the Western Eye Hospital in London. Following the death of his older brother, Bassel, in a motor vehicle accident, Assad was called back home and groomed to lead his country.

In 2000, when Assad assumed the presidency of Syria, many hoped that the well-educated, clean-shaven, English-speaking scion would rule openly. Official press releases even emphasized that, as head of the Syrian Computer Society, he introduced his country to the Internet. From the outset of his rule, however, Assad has functioned as a tyrant.

Organizations such as Human Rights Watch and Amnesty International document that, during Assad’s reign, the Syrian secret police consistently tortured, imprisoned and killed political dissidents.

Not including fatalities from use of chemical weapons, the death toll in the current civil war is widely acknowledged to be approximately 100,000 people.

Those numbers hardly personify primum non nocere, the Latin maxim that every first-year medical student internalizes as a reminder to be sensitive to harm that can ensue from interaction between human beings.

In 2010, in the Journal of the American Medical Association, Cara Lesser emphasized that professional standards for physicians are predicated on an “...overarching ethos – or value set – and those values need to be cultivated.” Lesser and her co-authors underscored that the medical profession must be more than a theoretical jumble of ideals since professionalism is manifest in the practice of observable behaviors.

Following its publication in 2002, the Physician Charter on Medical Professionalism was widely adopted around the world. From that departure point, experts drafted various guidelines for professional behavior, each edition emphasizing the principles of integrity, accountability, compassion and ethical conduct. It is impossible to conclude that Assad comports with these most basic tenets of the profession of medicine.

Violation of rudimentary precepts is grounds for immediate suspension from the practice of medicine.

But we are not contemplating whether to allow Dr. Assad to remove cataracts at Aleppo’s neighborhood surgical centers.

Our question is whether a mass murderer should bear the honorable title of medical doctor.

MEDICINE HAS traditionally safeguarded itself through self-regulation.

We advise budding physicians to police themselves, implying that if they create a vacuum of supervision, then external authorities will step in to oversee healthcare professionals. Self-regulation sounds pragmatic but is never fully enforced because of a hidden code among physicians that construes bearing witness against colleagues as being distasteful, if not repugnant.

Unlike the legal profession, medicine does not have a clear mechanism for disbarment proceedings to investigate the conduct of its members. On the micro level, how many physicians are suspended or even sanctioned? Meanwhile, on the macro level, the absence of peer-initiated censure in medicine is much more heinous. For example, only in 2012 did the German Medical Association, through the Nuremberg Declaration, acknowledge that many of their predecessors experimented on, and killed, prisoners based not on outside force but on personal enthusiasm. Seven decades is an unacceptable duration for moral reticence.

In 1993, a group of medical ethicists at Boston University called for the establishment of an international medical tribunal to clearly delineate prohibited physician conduct and to create a mechanism for punishing those who engage in such conduct. There is still no authorized entity that is capable of adjudicating crimes against humanity perpetrated by physicians.

In today’s Syria, where no simple demarcation exists between “good guys” and “bad guys,” it does appear difficult to unravel countervailing forces and interests.

Indeed, the member states of the United Nations convened this past week at the General Assembly to address those intricate matters. But rather than creating resolutions at the Security Council, perhaps another UN agency – the World Health Organization – should be taking up the issue of the physician- leader of Syria. Proper channels must be quickly devised to revoke Bashar Assad’s professional credentials; an action that will have both symbolic and pragmatic value.

The body politic of the medical establishment dare not press its own mute button once more. The time is here for all international medical societies and associations to oust Assad.

The author is a professor of oncology at Tel Aviv University and the chairman of the Institute of Radiotherapy at Tel Aviv Medical Center, is the co-founder of the NGO Life’s Door.


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