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The American Medical Association (AMA) passed a policy resolution calling for peace in Israel and Palestine, but stopped short of urging a ceasefire during its annual House of Delegates meeting in Chicago on Monday.

After substantial debate during committee meetings over the weekend, the AMA passed the policy resolution, with a 522-80 vote, urging "peace in Israel and Palestine in order to protect civilian lives and healthcare personnel." This vote contrasted with the AMA's 2023 interim meeting at which delegates declined to debate a resolution calling for a ceasefire.

The resolution passed Monday also called for support for "the safety of healthcare and humanitarian aid workers, along with safe access to healthcare, healthcare facilities, and humanitarian aid for all civilians in areas of armed conflict," and reaffirmed declaring war crimes "a threat to physicians' humanitarian responsibilities."

Notably, this resolution was proffered in lieu of two combined prior resolutions that specifically called on the AMA to support a ceasefire in Israel and Palestine: to "oppose collective punishment tactics," such as restricting access to food, water, electricity, and healthcare; and to oppose U.S. funding to entities that "do not uphold international law; or ... commit or condone war crimes."

Before affirming the "in lieu of" policy resolution put forward by an AMA reference committee, the authors of the original resolution attempted to amend the policy to reinsert the call for a ceasefire.

A delegate speaking on behalf of the Resident & Fellow Section, who was a co-author of the original resolution, argued that a "ceasefire is the path to peace," and urged fellow delegates to take "a vote of conscience" as they had in opposing the war in Ukraine.

The delegate, who requested their name not be used for fear of retaliation, noted that just minutes before the discussion on the House floor, the United Nations Security Council approved by the U.S. that called for an immediate ceasefire.

"I urge you all to stand by the oath we took, to do no harm, and to vote yes [on this amendment], so we can put an end to this tragedy," the delegate said.

Julia Silverman, a delegate from the Medical Student Section, also spoke in favor of amending the resolution to incorporate the call for a ceasefire.

"I have mourned over the loss of my Jewish brothers and sisters. I've cried for the hostages that have been taken from their families, but with my deepest Jewish value ... 'Love thy neighbor as thyself,' I have also cried for the deaths of the Palestinian brothers and sisters that we have lost," she said. "I do not believe it is our organization's role to speak about how to negotiate for peace in Israel and Palestine, but I do believe that we have the duty to say that further loss of life is not okay."

In committee hearings over the weekend, discussion was respectful but impassioned. Deena Kishawi, MD, an ob/gyn from Chicago, who is originally from Palestine and has lost more than 70 family members to the war, also spoke in support of a ceasefire.

Since October 2023, 28 of the 36 hospitals in Gaza are no longer functional, and the eight that remain are only partially functional. The destruction of these hospitals is a "clear violation of humanitarian law," she stressed.

"Being sick today in Gaza at this time is a death sentence, as anesthetics, pain-relieving medications, and other necessary medical supplies are not being let in," she noted. "A ceasefire would protect the remaining, albeit crumbling, healthcare infrastructure in Gaza."

George Hruza, MD, an alternate delegate for the Missouri State Medical Association, and the son of a Holocaust survivor who has family living in Israel and friends who died in the Hamas attack, argued on Saturday against the ceasefire resolution. Hruza spoke on his own behalf.

"The Hamas-Israel War has stirred strong passions and opinions on both sides. The emails we have been bombarded with have exposed the division on this issue in the House of Medicine," he said. "This resolution fans the flames of discord and distracts from AMA's core mission."

"The AMA does not have the military ... expertise to opine on the conduct of wars and the outcome of this resolution [will] have no impact on the ground in Gaza," Hruza added. "This resolution is highly divisive and will alienate many of our members, resulting in further declines in our membership, and will reduce the impact of the AMA with the regulators and legislators. It will damage the AMA's reputation among the public."

On the House floor on Monday, Michael Goldrich, MD, a delegate for the American Academy of Otolaryngology-Head and Neck Surgery, speaking on his own behalf, argued against amending the compromise resolution.

"As an observant Jew, I pray for peace three times a day," he said. However, as an American, he said he supports the State of Israel and its right to protect itself, adding that a friend of his was killed by terrorists last week.

"I'm disturbed by the distortions and tropes I've heard in the last weeks," he continued. "No other ethnic group, nationality, or country could be targeted at the AMA or on college campuses or in the street with the impunity that Jews have experienced for the last 8 months."

He also expressed his sympathies for anyone who suffered a loss in any war.

"I therefore speak of compromise," Goldrich said. "I think our reference committee [which proposed the alternate resolution] has written a report which satisfies no one, but which with everyone can live. That's what this course is about, hearing another's pain meaningfully and accepting a compromise that serves the greater good."

The amendment to the AMA committee's resolution put forward by the original authors calling for a ceasefire was voted down 195-428, and the compromise resolution passed.

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