Last Friday, Israeli forces, just days after killing over 200 children in a single 24-hour period, blew up the only cancer hospital in Gaza, along with an adjacent medical school. By then, it was clear that Israel had fully resumed its war on Gaza’s hospitals, health workers, and essential health infrastructure.

The next morning, The New England Journal of Medicine published its first-ever article acknowledging the devastation in Gaza. Over the preceding 17 months of what UN investigations and others have declared is an unambiguously genocidal Israeli assault on Palestinian civilians, the NEJM, which is widely regarded as the world’s most influential medical journal, had received countless submissions on the subject and rejected every single one of them. Amid these decisions, the Journal was subjected to repeated criticism for silence and hypocrisy in the face of one of the most pressing, preventable public health catastrophes in recent history.

At long last, the Journal’s silence has been broken. Its long-awaited intervention comes in the form of an article titled “Health Care Bridges—Pathways toward Trust in Gaza and Beyond.” A piece on such a charged subject would have been carefully edited by the Journal’s staff, including, most likely, its editor in chief. For a powerful American institution that has waited until now to address US-backed violence in Gaza, the article is as evasive and anti-political as we might have expected.

The piece—written by Yasmeen Abu Fraiha, a Palestinian citizen of Israel, Israelis Noam Alon and Avner Halperin, and Abdalrahman Ahmed, a Palestinian from Gaza—rejects any rigorous accounting of Israel’s crimes against Gaza’s medical infrastructure in favor of gauzy platitudes about how healthcare can be an avenue for “building trust” between two warring populations. “The four of us, Palestinians and Israelis, firmly believe in the need to foster hope and build trust,” the authors write. “While watching hospitals turn into battlefields, we’ve also witnessed firsthand the power of healthcare to overcome animosity and bridge the divides between populations in conflict.” It takes great pains to describe the destruction of Gaza’s hospitals and the deaths of its doctors and patients as an unfortunate byproduct of war, as though bombs simply fell from the sky independent of anyone motivated by genocidal intent and without any connection to a long-standing colonial project.

Fraiha, Halperin, and Alon have appointments at Harvard Kennedy School’s Middle East Initiative, which last year hosted Jared Kushner to discuss “finishing the job” in Gaza so as to clear the way for developing Gaza’s “very valuable, from a real estate perspective…waterfront property.” (Ahmed’s work is based at Brandeis University.) In a conspicuous conflict of interest that is omitted in NEJM’s author disclosure forms, at least one of the authors, Alon, worked for nearly three years in the IDF Special Intelligence Unit, according to her own LinkedIn page. (The length of compulsory military service for Israeli women is two years, meaning that Alon actively chose to serve in the Special Intelligence Unit for the remaining years.) Special Intelligence includes various units expressly devoted to psychological warfare via covert influence campaigns to shape perceptions, undermine adversaries, and control narratives about matters involving Israel or Palestinians. Alon and—presuming they were aware of this easily accessible public information—the NEJM editors appear to have decided that her years at Special Intelligence did not constitute one of the kinds of “relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, what [the authors] wrote in the submitted work.” Also unusual for an author published in the NEJM is the fact that Alon, according to her LinkedIn profile, has no background in medicine, public health, or health policy.

It is no accident that, after previously at least avoiding the directly genocide-enabling decisions of its peers at the Journal of the American Medical Association, this is who and what the NEJM has strategically allowed to appear in its pages. This editorial choice is not merely inadequate—it actively obscures the truth.

One of the most insidious aspects of the NEJM’s article is its failure to explicitly name Israel as the actor responsible for the devastation it describes. Instead, in moves we have come to expect from genocide-laundering editors at major American news outlets (such as The New York Times, The Wall Street Journal, The Washington Post, and The Atlantic) aligned with US imperial foreign policy, the article speaks in the passive voice. We get references to “hospitals turned into battlefields,” and lines about medical institutions having been “raided, bombed, and destroyed.” Who did the raiding, bombing, and destroying? We never learn. The phrase “targeted destruction” appears, but without a subject.

The omission is no accident. This kind of deliberate vagueness allows the reader to imagine war as a chaotic, directionless phenomenon rather than a calculated campaign of destruction. It is a textbook example of “the Palestine exception”—the systematic censorship and distortion of Palestinian suffering in mainstream medical, academic, and humanitarian discourse. It is an editorial choice that functions to shield Israel and US foreign policy from accountability while allowing the NEJM to claim that it has, at last, addressed Gaza.

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The piece insists on a depoliticized humanitarian framing (only where Palestinians are concerned—it comfortably mentions Hamas by name), and is silent on the decades of brutally oppressive colonial conditions that provoked a violent revolt. All of these are acts of complicity. By refusing to confront the reality that Palestinian health infrastructure has been deliberately obliterated as part of a broader settler-colonial and genocidal agenda, the Journal has chosen to launder repeated attacks on hospitals, health workers, and patients and broader civilian populations through the language of medical neutrality.

The ongoing genocide against Palestinians is only possible because of unwavering US government support, first by Joe Biden and now by Donald Trump—through the direct provision of thousands of MK-84 bombs designed for mass destruction, of financial assistance, and of diplomatic cover that shields Israel from accountability in international courts and governing bodies. But this truth is nowhere to be found in the piece. As a US-based journal and a leading representative of the American medical profession, the NEJM has an obligation not only to recognize the scale of Israel’s crimes but also to condemn the US government’s role in facilitating them. Anything less is an abdication of moral and professional responsibility via a retreat into self-serving illusions of medicine and public health as apolitical fields.

The Journal’s new article fits into a long history of imperial medical institutions claiming neutrality while, in practice, reinforcing the power structures responsible for mass violence. As Frantz Fanon warned in his 1959 essay “Medicine and Colonialism,” the medical profession is often an “integral part of colonization, of domination, of exploitation.” Whether through silence or selective narrative framing, institutions like the NEJM play a crucial role in making colonial violence appear reasonable, unfortunate, or at worst, a regrettable tragedy rather than intentional, preventable, and beneficial to a version of medicine aligned with empire.

The piece presents healthcare as the ultimate peace initiative, describing it as “one of the few spheres in which Palestinians and Israelis work together and interact on a daily basis, treating each other with respect and dignity.” The decision to publish this narrative amid an ongoing genocide ignores the obvious reality that Palestinian health workers are not operating within a neutral space but under military occupation and blockade imposed by the occupying power.

It is not “trust” that is lacking; health workers in Gaza have been murdered while performing surgeries, abducted from their hospitals, and tortured in Israeli prisons. An estimated 1,000 Palestinian health workers have been killed since October 2023. Israeli doctors have openly called for bombing Gaza’s hospitals, and reports indicate that some are complicit in the torture of Palestinian detainees. Trust is not possible in a system where one people depends on the erasure of another.

Contrast the Journal’s aggressively anodyne approach with the findings of the International Court of Justice, which ruled in January 2024 that Israel is plausibly committing genocide. The ICJ focused heavily on Israel’s deliberate destruction of Gaza’s health system, its use of famine as a weapon of war, and its targeted killing of doctors, paramedics, and patients. These legal and political realities are entirely absent from the NEJM’s framing. To publish an article on Gaza’s medical devastation while ignoring the ICJ’s findings is not just negligent; it is providing cover for and genocide denial in real time.

The Journal’s failure here is part of a broader characteristic of the American medical profession: the persistent, self-serving illusion that medicine can function as an apolitical space at all, let alone in the midst of colonial war. Doctors from rich nations like the United States, France, Britain, Germany, and elsewhere frequently present themselves as “neutral observers” rather than as participants in systems of power and the reproduction of inequalities. The assumption is that simply bearing witness to suffering is sufficient, that cataloging the wounds of the oppressed is a meaningful contribution even if it does nothing to stop the violence that creates them.

This approach to medical humanitarianism—treating healthcare as a technocratic intervention rather than a political terrain—has long served to mask state crimes. The Red Cross, for example, famously refused to condemn the Holocaust in real time, choosing instead to maintain its “neutrality” in order to retain access to Nazi concentration camps. (The Red Cross later called this a “moral failure.”) Today, major global health organizations, including those with direct ties to the US government, are maintaining the same silence in Gaza.

The NEJM’s approach is a form of violent collaborationism. By centering “bridge-building” rather than settler-colonial violence, it advances a narrative that is politically useful to those who wish to obscure the reality of genocide. It allows Western institutions to acknowledge Palestinian suffering without indicting the power structures responsible for it. It offers the appearance of engagement without the risk of consequence.

“Building bridges” isn’t possible while simultaneously refusing to name, condemn, or try to stop ongoing war crimes and genocide—not to mention occupation and apartheid medicine. The NEJM’s publication record amid US-backed, Israeli-perpetrated genocide in Gaza will and should be remembered, much as its history during Nazism is now, as a profoundly shameful, cowardly, and—even worse than during Nazism, given the direct role of the US government in Israel’s actions today—collaborationist.

Insistence on medical cooperation without accountability mirrors a broader American medical approach to Palestinian suffering: endless calls for reconciliation while the bombs continue to fall. This is not a peace-building strategy—it is a mechanism for indefinitely deferring both accountability and any possibility of justice. It’s to have a share in the harm, while pretending to do none.

As the writer Robert Jones Jr. has aptly put it: “We can disagree and still love each other unless your disagreement is rooted in my oppression and denial of my humanity and right to exist.” With this, Jones is not referring to indefensible claims by Benjamin Netanyahu’s government to a right to exist regardless of its actions (and foundations) but rather to the universal rights of human beings to exist—something the Israeli government is denying to Palestinian people on a daily basis. The NEJM’s insistence on a depoliticized framework for trust-building disregards the foundational truth that trust cannot be built between those who are actively murdering and those being murdered. More generally, it cannot be built between colonizer and colonized..

The destruction of Gaza’s health infrastructure is not an unfortunate side effect of war. It is a core feature of Israel’s strategy to make Gaza unlivable, to dismantle Palestinian life at its most fundamental level. It is a war on hospitals, on doctors, on patients, on the Palestinian people, on Palestine. Any discussion of Gaza’s medical catastrophe that does not begin with this premise is not simply inadequate; it is a tacit endorsement of genocide.