In 2022, former American Medical Association president Dr. Gerald Harmon released a statement strongly condemning Russia’s military actions in Ukraine, calling the targeting of civilians and health care workers “unconscionable.” Subsequently, the AMA Foundation contributed $100,000 to Ukraine and adopted two policies to support the flow of humanitarian aid into the country. The AMA House of Delegates also advised that state medical boards grant hardship waivers for all international medical graduates affected by the conflict.
In stark contrast, since Oct. 7, 2023, the AMA has refused to condemn the U.S.-funded destruction of hospitals and murder of more than 500 health care workers. In November, the Medical Students Sections and Residents and Fellows Section put forth a resolution calling for a ceasefire. While the AMA Board of Trustees released a statement on the “humanitarian crisis,” the ceasefire resolution itself was dismissed from further consideration at the November Interim Meeting.
In June, when the AMA reconvened at its Annual Meeting, the MSS and RFS reintroduced the ceasefire resolution in addition to a new item. Resolution 610 called on the AMA to oppose U.S. funding to entities that violate international law, denouncing the use of collective punishment in regions such as Gaza. Resolution 603 called for a “ceasefire” in Gaza to protect civilian lives and health care personnel.
Those in support of the resolutions frequently mentioned the horrific imagery they had seen from Gaza: of bombed hospitals, mass graves and beheaded children. One supportive physician introduced herself, saying that her only conflict of interest was “being a pediatrician.” On the other hand, a delegate opposed to the resolutions called them “highly divisive,” and worried that it could result in “further declines in [AMA] membership.” Multiple delegates claimed that isolating Israel’s actions specifically was antisemitic. In response, many Jewish physicians and medical students condemned this weaponization of antisemitism to defend genocide.
The most common opposing argument echoed former AMA president Dr. Andrew Gurman’s sentiment that the taxpayer-funded bombing of hospitals was a “geopolitical issue” that “goes beyond the purview” of the largest medical advocacy organization in the country. When it came to a vote, the AMA once again refused to demand a ceasefire, opting instead to pass “Alternate Resolution 603” calling for “peace” instead.
But how can peace be accomplished without a permanent and lasting ceasefire? And why should peace exist in the absence of justice? Why has AMA leadership only ever spoken out against U.S. adversaries, and never once condemned a U.S.- funded military action? This selective empathy extends a nearly 200 year old AMA tradition of hiding behind “medical neutrality” to avoid extending humanity to women and colonized people.
AM’s tradition of “medical neutrality”
The AMA was founded in 1847 with the intention of “standardizing” medical education and practice. To gain legitimacy as the voice of the profession, “maternal” health care professions were excluded and issues of race and gender were sidelined. In the post-Civil War period, the founder of the AMA, Nathan Smith Davis, argued that decisions of admission for women and Black physicians should be left to local societies. In 1870, the AMA enshrined this perspective, voting 114 to 82 that issues of racial and gender discrimination were “not of a nature to require the action of the American Medical Association.”
At the turn of the 20th century, the AMA commissioned the Flexner Report, a controversial survey of U.S. medical education ostensibly aimed at elevating the scientific rigor of the medical profession. However, the report also resulted in the closure of all but two Black medical schools; the report argued that “the negro needs good schools rather than many schools,” and that Black medical school curricula should accentuate “hygiene, rather than surgery.” This created a shortage of Black physicians that still exists today. In addition, while medical schools rightly embraced the biomedical sciences, courses in public health, preventive care and Indigenous health concepts were sidelined.
This imbalance ultimately led to a health care paradigm focused on individual patient care and acute interventions rather than addressing their underlying social conditions. Medical missions exported this model to U.S. colonies acquired through the Spanish-American war: Guam, Puerto Rico and the Philippines.
The primary funding for the Flexner Report came from Andrew Carnegie, who donated extensively to social causes under the explicit belief that philanthropy could positively sway public perception of capitalist businesses. To help win the hearts and minds of medical schools and professionals, oil baron John D. Rockefeller continued in Carnegie’s footsteps, giving millions to medical universities and hospitals. The Rockefeller Foundation also funded infectious disease eradication programs. Unsurprisingly, these efforts were driven by profit, not altruism. Hookworm and malaria had immense negative impact on capitalist enterprises, as they reduced worker productivity, and made investment in affected oil-rich areas less attractive.
The foundation systematically favored “vertical” programs, which favored pharmaceutical approaches to target specific diseases rather than comprehensive “horizontal” health programs that offered a full range of preventive and curative services. Business magnates, oil barons and pharmaceutical companies successfully popularized a culture of health care that largely ignores the social underpinnings of illness. The AMA has fully adopted this view, becoming one of the major lobbies against universal healthcare. This rationale of “medical neutrality” is only possible within a culture that has normalized the myth of an “apolitical health.”
Rudolph Virchow once said that “[m]edicine is a social science, and politics is nothing else but medicine on a larger scale.” Often regarded as the founder of modern pathology, Virchow is widely known by medical students for his many biomedical contributions. However, many are unaware that he was also a revolutionary who participated in the Berlin uprisings of 1848. Through his study of pandemics, Virchow developed a theory of disease and human suffering that saw material conditions as the primary driver of health. If we take this seriously, then health care workers have a moral obligation to go beyond the clinic. We must confront the global systems that reproduce these conditions. We must fight not just for a ceasefire, but for an end to imperialism — the common thread linking the suffering of poor and oppressed people around the world.
“There’s a difference between peace and liberation, is there not? You can have injustice and have peace. You can have peace and be enslaved, so peace isn’t the answer — liberation is the answer.”
– Kwame Ture
Feature photo: Medical students and health care workers protest the AMA’s failure to condemn the genocide in Gaza. Photo credit: Medical Students for Justice in Palestine
