After US weapons ravaged Gaza’s hospitals, US doctors can’t remain silent

In October, a video from Gaza spread around the world, causing shock and horror. In the video, an injured teenager lay on a hospital gurney, an IV line inserted into his arm. Flames engulfed him, and he could only flail his arms in agony, helpless.

The flames that consumed Shaban Dahdouh, also taking the lives of his mother, younger brother, and sister, were caused by a bomb dropped by the Israeli military inside the grounds of the Al-Aqsa Martyrs Hospital in Deir al-Balah. Dahdouh was there receiving treatment, having previously survived injuries from another Israeli bombing.

The video of Dahdouh's death has been likened by many observers to epoch-defining images of atrocity, such as the 1972 Pulitzer Prize-winning photograph of the Vietnamese girl, Phan Thị Kim Phúc, burned by US napalm. However, this is far from an isolated nightmare. Over the past 15 months, there have been thousands of violent deaths of all kinds in the Gaza Strip, many caused by weapons supplied to Israel by the US government. These deaths are not simply individual tragedies or accidental consequences, but rather symptoms of a comprehensive war and overwhelming terror strategy waged by Israel against an entire people. This reality, and how we must respond to it, is most clearly reflected in the ruins of Gaza’s hospitals.

A recent peer-reviewed study, co-authored by one of the authors of this article, analyzed the patterns of Israeli bombing of the Gaza Strip in the first 40 days after October 7, 2023. The study specifically analyzed Israel’s use of US-supplied MK-84 bombs in the vicinity of hospitals. Under international law and basic ethical requirements, hospitals are supposed to be afforded special protection in acts of war. The MK-84 is a 2,000-pound (900-kilogram) air-dropped explosive, also known as a “bunker buster,” designed to destroy infrastructure and kill people within hundreds of meters of its landing point. They are weapons of indiscriminate destruction and annihilation, not “precision strikes” aimed at specific targets.

Using geospatial data, the study found that in the first 40 days of the war, Israel dropped MK-84 bombs within the blast radius of over 80% of hospitals in Gaza, with one bomb landing just 14.7 meters (48 feet) from a hospital, effectively a direct hit. Many hospitals had not just one, but multiple of these massive bombs dropped around them. Two hospitals had over 20 MK-84 bomb craters within 800 meters of their facilities, the upper limit of the blast radius of the MK-84 for infrastructure damage and severe injury; another had seven craters within 360 meters of its wards, the lethal range of the MK-84. Thirty-eight MK-84 bombs were detonated within hospital grounds in areas designated as evacuation zones by Israel.

During the initial phase of Israel’s massive destruction of Gaza, there was fierce international debate about whether Israel had bombed even a single hospital. The Israeli government and media, along with their counterparts in the US and Europe, repeatedly denied that Israel would attack hospitals, which is a violation of established international humanitarian law. At the same time, supporters of Israeli violence, shamefully including senior US physicians and bioethicists, began publishing so-called justifications for any such potential actions. By December 2024, with over 1,000 Palestinian healthcare workers dead from Israeli attacks, it is now clear that not just one, but nearly all hospitals in Gaza have been deliberately and repeatedly attacked by the Israeli military using US weapons. What was once considered an outrageous and slanderous accusation is now understood to be a key component of Israel’s daily military operations.

In May of this year, eight months after observing Israel use thousands of US-supplied bombs to destroy densely populated areas of Gaza and kill countless civilians, the Biden administration implicitly acknowledged this reality by pausing the shipment of MK-84 bombs to Israel, switching to the shipment of 500-pound (227-kilogram) bombs instead. Last week, the Trump administration announced it would unconditionally resume the shipment of MK-84 bombs to Israel.

The philosopher Adriana Cavarero describes this terror through a framework she calls “horrorism.” She uses this word to describe a form of non-personal aggression rooted in disfiguration, such as burning patients alive in their beds, and massacres, like what we are seeing daily in Gaza. The concept of “horrorism” requires us to see violence not from the perspective of the perpetrator, but from the perspective of the victim. Only the victim has the right to name the violence, to determine its meaning and value. In Cavarero’s view, the image of the defenseless victim is most clearly embodied by children, such as the thousands of Palestinian children who have been maimed and killed by Israeli soldiers and US weapons over the past 15 months.

The hope of “horrorism” as an ethical paradigm is that by shifting our focus away from the “terrorist” and re-examining violence from the perspective of the most vulnerable or those in need of care, we may be able to end the endless “war on terror,” which has continually manufactured terror for the world’s most impoverished people, who, unsurprisingly, continue to resist. In this paradigm, the actual effects of violence, rather than its intent or justification, are what matters most. As vividly illustrated by the firsthand accounts and desperate pleas from doctors, nurses, and other healthcare workers in Gaza, “horrorism” likely resonates more deeply and intensely in hospitals than in any other setting. Doctors, who are privileged to have access to the most defenseless people and are obligated to care for them, while possessing tremendous collective economic, cultural, and political power, are uniquely positioned to apply the lessons of “horrorism” to condemn and stop violence.

“Horrorism” implores us to view and judge violence from the perspective of the hospital—a refuge for the displaced, the disabled, and the dying. Doctors, therefore, should be the purveyors of “horrorism,” responsible not only for healing the wounded, but for doing everything in their power to heal the world by condemning and stopping the wars that bring death and disability to those who seek our care.

The horror of colonial war is a core feature of what another philosopher, Jean-Paul Sartre, described half a century ago as the new form of “total war” that emerged after World War II. In her book, Wounded by Reality, anthropologist Nadia Abu El-Haj reflects on Sartre’s description of the French and US wars in Vietnam. As El-Haj states, when an imperial power seeks to crush an anti-colonial movement for independence, “the colonial power maintains an advantage in arms but is at a distinct disadvantage in numbers.” When faced with an “enemy” of armed fighters whose dreams of freedom are supported by the entire population, colonial armies are “all but powerless” if they adhere to the so-called rules of humane war and respect civilian lives.

In this situation, their only hope of defeating the enemy is to throw those rules aside and dedicate themselves to the destruction of an entire people. In this paradigm, bombing hospitals is no longer something to be avoided or prevented by respect for law or life, but rather a strategic necessity. Sartre observed that “total genocide” reveals its basis as a counter-guerrilla strategy. For colonial powers, genocide appears to be the “only possible” response to “an entire people rising up against their oppressors,” leading to a “total war” that is no longer between two armies. Total war under colonial conditions, instead, is a “fight to the finish” by one side against a fundamentally defenseless people. Sartre concludes that this “genocidal blackmail” is not only a threat to the Vietnamese people, but that, because its violence is “taking place before our eyes every day,” it makes all those who do not condemn it “accomplices.”

This dehumanization of the brutalized, the perpetrators, and the passive consumers of this horror led Sartre to conclude that “the group that the Americans are trying to destroy through the Vietnamese people is all of humanity.” The parallels between Sartre’s analysis of US violence in Vietnam and US support for the war in Israel are stark. This war, ostensibly against Hamas, is clearly, as measured by the more than 17,000 dead Palestinian children, a war against all Palestinians in Gaza.

In the days after Dahdouh was burned alive, media outlets around the world published stories about his life and death. One of the anecdotes they told was that he hoped to become a doctor—a detail that underscores the cruelty of his being killed while seeking treatment at a hospital. It also starkly highlights the ongoing refusal of the US medical community to embrace its obvious moral obligation over the past 15 months to use its tremendous political power to oppose the criminal attacks that are being openly waged against hospitals, healthcare workers, and patients, and to demand that the US stop supplying weapons to Israel for these crimes. As US physicians, we have repeatedly called on our profession—a profession that claims to be rooted in a commitment to care, human dignity, and the most vulnerable—to change course and act boldly against the violence in Gaza, in accordance with our stated principles. Now, with a temporary ceasefire agreement in place, this must include critical reflection and accountability for the profound ethical and political failures that we have fully exposed ourselves to in the Gaza genocide.

But we cannot simply stop at words and moral self-reflection. We must insist on remedial actions, including the release of the thousands of Palestinian civilians, including Dr. Houssam Abu Safiya and many other healthcare workers, who have been abducted by Israel, the return of the entire territory of the Gaza Strip to Palestinians, and reparations, paid by Israel, the US, and European countries that have facilitated the genocide, to support the full reconstruction of Gaza, including its homes, hospitals, universities, health infrastructure, and schools that are now rubble. We must also demand an end to the Israeli occupation and the ongoing violent dispossession of Palestinian land and a ban on weapons to the Israeli government, which has demonstrated very clearly that it is willing and eager to use them against civilians in violation of international law.

If the US government supports an Israeli occupation of Gaza, the forced displacement of Palestinian residents, and the denial of the right of Palestinians to return to their homes, as we are seeing early indications of now, then we are obligated to strongly condemn and resist this crime. The reality is that the violence against Palestinians has not stopped, and we must not delude ourselves into thinking that our moral obligations in it have ended. As we organize with one another to begin the impossible but necessary work of atoning for the violence that our nation and its medical field have been and are still complicit in, we must embrace our moral responsibility to the memory of those, like Shaban Dahdouh, who have been killed, and those who must now live in the shadow of immeasurable horror.