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Novak: Horton takes a journey

Dr. Richard Horton (Wikimedia Commons/Russavia/public domain)

Ron Csillag relates how Richard Horton, the editor in chief of the prestigious medical journal The Lancet, posted an editorial in the July 2019 issue on “Medicine and the Holocaust- It’s Time to Teach” and how Dr. Frank Sommers of Doctors Against Racism and Antisemitism (DARA), The University of Toronto Faculty of Medicine, and various professional associations responded positively and were emboldened to begin a process of curriculum development for medical students with relevance to physician responsibility and religious discrimination.

Horton has taken a remarkable journey to reach this profound moment of clarity and ethical maturity in his career. Several years ago, in the aftermath of the 2014 Gaza conflictHorton permitted the inclusion of non peer-reviewed anti-Israel articles that were inflammatory, full of distortions and outright falsehoods. One particular letter published in July 2014, written by authors sympathetic to white supremacist David Duke, served to anger and polarize readership. Readers intimately familiar with the complex geopolitics of the region and the Israeli/Palestinian realities were infuriated by the truth gap and worried about the impact of the issue on rising rates of anti-Semitism and further regional destabilization. They lambasted Horton for embracing politics and peer bias over science. 

 In the spirit of medical kinship and as part of an effort to collectively shift an inaccurate and widely damaging narrative, a group of physician leaders in Israel, led by Rambam Hospital director Prof. Rafi Beyar and Prof. Karl Skorecki invited Horton to visit Israel and review not only facts on the ground but the Israeli healthcare system as a whole, and the ongoing commitment to addressing health equity issues in the country and the region. Horton accepted and, in August 2014, visited Israel for three days. He spent time at Rambam Hospital meeting with staff, a quarter of whom are Arab Israelis, and with Israeli, Palestinian, and Syrian patients treated there. He also met with the chief rabbi of Acre and the chief imam of the city’s Al Jazaar mosque. It was three days of first-hand exposure for Horton, and he felt so impacted by this visit that he gave a parting lecture at Rambam Hospital on Geopolitical Issues and Responsibilities of Medical and Scientific Journals where he shared his regret for the unnecessary polarization.

 Up to that point, Horton had never been to an Israeli hospital or met an Israeli physician (Jewish, Druze, Muslim, Christian, Secular, or any other denomination). It wasn’t about one side vs. another. His viewpoint was unilateral and experientially limited. Although he was editor in chief of a journal purporting to educate the medical and public health community, the gaping holes in his understanding had led to The Lancet becoming an irresponsible and dangerous instrument. 

 The editorial on medicine and the holocaust is evidence of the remarkable evolution of Horton as an academic and, more importantly, as a human being. Indeed, in May 2017, he devoted an entire issue of Lancet to peer-reviewed, scientifically sound articles on the Israeli healthcare system and health equity in Israel. His arguments for including the Holocaust in medical school teaching reflects his understanding and warning of how quickly hubris and political ideology can distort ethical thought and moral behaviour- a message as important today as it was in those fraught times past.

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