Submitted by: Chris Reif, MD, MPH

Desired actions:

• Bring awareness to members, the public, media and/or specific groups/stakeholders

WHEREAS family physicians support peace, safety and life necessities, including health care for all families;

WHEREAS, in Gaza, thousands of women and children are being killed and many thousands more are being denied food, water, safe shelter and health care;

BE IT RESOLVED that the MAFP will educate members and advocate publicly for an immediate cease fire to hostilities, restoration of basic services and health care and negotiation of a political settlement in Gaza.

Comments in support (9):

Elizabeth Ingersent – The violence towards innocent civilians is totally unacceptable and we should not be silent and allow it to continue. Call for ceasefire is the least we can do.

Carrie Link – I strongly support this resolution!

Tim Ramer – I support this resolution because this continued war is counterproductive for all the peoples of Israel-Palestine.

Nancy Baker – The loss of life amongst non-combatants and health care workers in this conflict is staggering. It is a humanitarian crisis for the armed assault to continue.

Chris Reif – (I am the author). We are healers. As Family Physicians, we embrace our role as advocates and leaders to address the large social issues that affect the health of our patients and our community. We have spoken up against health disparities & racism, domestic violence, environmental degradation, inadequate housing, food scarcity, nuclear war, poverty and for reproductive rights, gender rights, human rights. We acknowledge the controversies embedded in these issues and we seek to educate ourselves to be thoughtful and courageous participants.

Chris Reif – I am the author and support this resolution. We are healers. As Family Physicians, we embrace our role of guidance and advocacy regarding important social issues impacting the health and well-being of our patients and communities. We speak out against health inequities and racism, poverty, domestic violence, environmental degradation, inadequate housing, food insecurities, gun violence, nuclear war. We support universal health care, reproductive rights, gender rights, human rights. We acknowledge there is controversy surrounding these important health issues and we take seriously our responsibility to educate ourselves and address the controversies thoughtfully and effectively.

Prasanna Vankina – Calling for a ceasefire and acknowledging the centuries of harm that systemic mass violence has inflicted upon people around the world is a matter of humanity. I would hope that as an organization, MAFP can act on the principles of primary care, be thoughtful and compassionately critical of what sources/viewpoints we are choosing to emphasize, and avoid hiding under the guise of professionalism and neutrality to not only name what we are witnessing, but also act upon it. Acting upon the situation in Gaza requires us all to understand and support the necessity of ceasefire as a first and certainly not last step in addressing the colonialism, violence, and neglect of the region that has disproportionately impacted Palestinian people for decades. While this resolution could do well with more clarity and concrete actions, calling for a ceasefire in Gaza is not antithetical to condemning Hamas, denouncing antisemitism, or standing in solidarity with Jewish people (again, we must be cognizant of what narratives we are emphasizing and why).

Sally Jeon – This resolution supports health equity and responds to a humanitarian crisis as recognized by the WHO. The AAFP adopts the Healthy People 2020 definition of health equity as, “The attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.” Furthermore, at the 2018 MAFP House of Delegates, a resolution titled “Health Equity” was adopted calling to attention the role of a family physician in providing care for Minnesota’s diverse communities and combating inequitable health outcomes. In the spirit of health equity, a core part of being a family medicine doctor, I believe it is aligned with the values of the MAFP to raise awareness and promote education of not only local, but also global drivers of health inequities, such as the situation in Gaza. I agree that this resolution would benefit from further clarity, particularly with the part about negotiation of political settlement, however, I also appreciate that it remains broad to honor all of the lives that have been lost and healthcare resources that have been severely compromised. As physicians, physician-trainees, and student doctors we are often pressed with holding difficult complex ethical situations and making decisions. I urge members as they decide on their vote for this decision to consider these complexities while appreciating this resolution as it is written.

Pierre Gingerich-Boberg – Prelude to my comments on the resolution: I spent the summer of 1996 as a human rights observer on the West Bank in 1996 with Christian Peacemaker Teams. We tried to witness and reduce the harassment and danger experienced by inhabitants of Hebron/Khalil, regularly attacked by settlers protected and abetted by the Israeli government. Since then the conditions for Palestinians in Israeli-occupied territories have only gotten worse. The daily racially-based oppression experienced in the occupied territories is legitimately compared to the Jim Crow south or apartheid South Africa. Without excusing the horrific form of Hamas’ attack on October 7, it’s worth remembering that history in Gaza did not start on that date. To claim that conditions would be acceptable in Gaza if only Hamas had chosen either submission or the non-violent forms of resistance that I might have chosen is to ignore that prior history. Note that by saying this, I am in no way negating Jewish Israelis’ claims of connection to the land, their rights, or their aspirations to live in liberty and security. Now to the resolution. It’s hardly radical. It simply states the obvious. There is tremendous suffering. It must stop. The preliminary step must be a ceasefire. Then people have to talk to each other. The resolution does not add that not just any lip-smacking is adequate; we would do well to remember that to lead to change, a dialog must take seriously the needs of ALL inhabitants of Israel and Palestine to live in security and free from oppression. As for why American medical bodies should be concerned for people “over there”? It’s because the framework of 75 years of occupation, the bombs that have killed those many thousands of civilians, the utter destruction of medical infrastructure, and the continuing multiple barriers to food assistance– each one of these sordid realities undermines and even destroys the health of millions. Each gives rise to trauma not just now but for generations to come. And each has been supported by and even made possible by the funding of the American government and its special relationship with Israel. So yes, we have something to say here.

Comments against (9):

Leif Solberg – Physicians have no particular expertise on this issue, but have very diverse opinions about the matter. This resolution reflects only the Palestinian position, thereby suggesting that all family physicians have that opinion. It also weakens the impact of all the other resolutions because it makes the MAFP seem like a political organization rather than a professional one.

Andrew Slattengren – If MAFP is to take a position on Gaza, I believe it should be in line with what the WHO has resolved, which is to use “health as a bridge to peace” https://apps.who.int/gb/ebwha/pdf_files/EBSS7/EBSS7_CONF1Rev1-en.pdf. This war has significantly decimated the ability for provide healthcare in the region and this diminished capacity comes at a time of overwhelming medical demands, due to conflict-related injuries and everyday health needs. Further, the specific insertion of “negotiation of a political settlement” in the resolved is beyond our scope as iterations of this have been ongoing since 1948 and the Arab-Israeli War.

Eric Poulin – A political settlement was already achieved in Gaza in 2005. The people of Gaza elected Hamas as their government. If their living conditions were poor, what did Hamas do about it? They used the aid given to them to manufacture the tools of war to attack Israel. This war was started by Hamas on 10-7-2023 with brutality again civilians so grotesque that we as modern citizens of world can hardly believe it. Yet, Hamas took videos of this behavior, putting it all over social media in real time. They were proud of their barbarity—rejoiced in it. Are they the ones Israel is to negotiate with, as suggested by this resolution? I appreciate the author’s good intentions and I also wish the war to be over soon and the human suffering to stop. The war will end on the very day that Hamas militants surrender and release their innocent civilian hostages. I don’t support this resolution because it is purposefully vague and may be used to support Hamas. Any effort to support Hamas by our medical organization is unethical and shameful, for the reasons described above.

George Smith – I totally agree with Dr. Solberg’s comment.

Roli Dwivedi – I agree with the sentiments and in support of those sentiments but not entirely sure if it is with in MAFP role/capacity.

Paul Terrill – I fully support the spirit of the resolution. However, this statement is outside of the scope of the mission and priorities of the MAFP. Members wishing to voice their support for a ceasefire in Gaza have other avenues to do so. Let’s keep the MAFP focused on our mission, which is not international geopolitics.

Robert Koshnick – I agree with Dr. Solberg, too. Is the idea that we must be a referee and then get involved financially in every conflict in the world?

Kim Krohn – This is a very nuanced situation. I would be more in favor of a broader statement regarding all genocidal acts, no matter where they occur in the world. Also agree with Dr. Solberg’s comments.

Emily Benzie – I am in favor of the MAFP speaking up and educating its members and the public about adverse health effects of racism and hate, including antisemitism and Islamophobia. Like many others in our organization, I too am anxious to see the violence end in Israel and Gaza. However, I do not support this resolution. Unless we at the MAFP are prepared to weigh in on all the other violent conflicts happening around the world now and in the future, we should not be taking sides on this one.