AFTER THE publication in The Lancet of a mendacious “Open Letter for the People of Gaza,” Richard Horton, editor in chief of the prestigious British medical journal, visited Israel where he was hosted by Haifa’s Rambam Medical Center.The letter, published at the height of this summer’s conflict with Hamas, triggered a storm in the medical community and in Israel, with its blanket indictment of Israeli doctors coupled with wholesale allegations of a “ruthless assault” and “massacre” carried out by the Israeli army.The Lancet has published unfounded charges against Israel for years, but this was the worst.When NGO Monitor uncovered emails from two of the main authors – Dr. Paola Manduca and Dr. Swee Ang – enthusiastically promoting an anti-Semitic video by American neo-Nazi David Duke, the controversy expanded. The major media coverage in the UK was significant and Prof. Horton could no longer ignore the criticism.So, when Horton addressed an assembly of hundreds of Israeli doctors at Rambam in early October, there was much anticipation. Would he address the tainted Gaza letter and would he retract it? Would he apologize? Would he commit to a vetting process based on a serious and independent peer review mechanism? In a carefully worded speech, Horton said some of the right things, but left more questions than answers.When addressing the promotion of the David Duke video by two of the Gaza letter’s authors he spoke well. He was “personally horrified” by the video and its “abhorrent” worldview, it “must be condemned and I condemn it” and he made that view “very clear directly to those two individuals.”Yet, despite acknowledging its toxic origins, he said nothing about retracting the letter. Nor did he commit to barring Manduca and Ang from publishing in The Lancet. He was also silent about another of the letter’s authors who has appeared in The Lancet frequently: Dr. Mads Gilbert, who is on record as approving the 9/11 attacks on America. Another question remains unanswered. Does Horton view these people as reliable sources on science and medicine? More importantly, he did not apologize for the letter. He only said that he “deeply, deeply regret[ted] the completely unnecessary polarization that publication of the letter by Paola Manduca caused,” which “was definitely not my intention.” What does this mean? Is he sanctioning the letter’s message, regret - ting only the “polarization” it caused? In any event, the problems at The Lancet run far deeper. In his Rambam address, Horton ignored the editorials and numerous published articles in the journal that amount to a general J’accuse against Israel. This body of work is one result of the Lancet-Palestinian Health Alliance formed under his tutelage. In 2013, this Lancet-guided coalition launched a research publication with Medical Aid for Palestinians (MAP), a group cofounded by Swee Ang, bringing us full circle to her promotion of David Duke.In another example of “what goes around comes around,” Manduca co-authored two “scientific” papers published in The Lancet alleging that Israel is responsible for the rise in Gazan birth defects. Funding for one of these studies came from Interpal, for which Manduca has also raised money.The US has designated Interpal as a terrorist entity for being “a principal charity utilized to hide the flow of money to Hamas.” The BBC describes Interpal as “at the heart of a global coalition of 56 Islamic charities called the Union for Good, chaired by the spiritual leader of the worldwide Muslim Brotherhood Movement, Dr.Yusuf Qaradawi... [who] has said of the Israeli-Palestinian conflict: ‘We must plant the love of death and the love of martyrdom in the Islamic nation.’” How “love of death” accords with medicine is inexplicable.Horton has but one moral option – to remove the stain these doctors of hate have brought on The Lancet. To do so, he must apologize, retract their Gaza letter (and all their other articles), and decouple The Lancet institutionally from groups associated with them, like MAP. Anything less would be tantamount to moral medical malpractice that will blemish The Lancet for decades.