A reception for 12 visiting Israeli Colorectal Surgeons was held at UCL on 12th March 2012.

The visitors (below) were from a wide range of Israeli hospitals, and were hosted first by Dr Richard Cohen (UCLH), with help from Dr Andrew Williams (St Thomas’s Hospital and Dr. Joseph Nunoo-Mensa (King’s College Hospital).

Financial support came from the Israel, Britain and Commonwealth Association.

Dr Reuven Weil [Group leader; Rabin Medical Centre, (Beilinson) Petach Tikva]

Dr Abu Arar Anwar (Soroka Medical Centre, Beer Sheva)

Dr Michal Braha (Assaf Harofeh Medical Centre, Tzerifin)

Dr Zakhar Bramnik (Western Galilee Hospital, Nahariyah)

Dr Galit Even-Bendahan (Meir Hospital, Kfar Saba)

Dr Shahar Grunner (Rambam Health Care, Haifa)

Dr Evgeny Karasik (Assaf Harofeh Medical Centre, Tzerifin)

Dr Nadav Slijper (Bnei Zion Medical Centre, Haifa)

Dr Anatoly Simanovsky (Kaplan Medical Centre, Rehovot)

Dr Alexander Tatarov [Rabin Medical Centre (Golda), Petach Tikva]

Dr Veascheslav Zilbermints [Rabin (Golda) Medical Centre, Petach Tikva]

The reception was followed by a discussion meeting about Medical Professionalism in the two countries. Professor Irving Taylor spoke about the changes within the profession, and in societal approaches to professionalism, that are taking place in the UK; and Dr Alex Deutsch reflected on how Israeli medical professionalism has also evolved during his working life. Several of the London surgeon supervisors and sponsors of the visit were present.

Before the discussion meeting a Jewish Medical Association (UK) Scholarship award holder, Aaron Hughes, told the meeting about his elective experiences in Vanautu.

After their time in London hospitals the group spent the final part of the week at the M25 colorectal surgeons training course in Basingstoke.

This scheme and implementation were due once again primarily to the efforts of Dr Deutsch, a former UK surgeon who has worked for many years in Israel.

Many letters of thanks have been received from the visiting group, and two examples of these can be accessed here.

More than 100 physicians, including many junior doctors, attended a Medical Halacha Conference organised by Drs David Landau and Jacob Opat in November 2011. The main guest visitor, Rabbi Prof Avraham Steinberg took part in all three main symposia, on Organ Donation, End of Life and General themes respectively. He also lectured on Friday morning on Complementary Medicine, and delivered a very well-attended public lecture to a lay audience on Friday night covering “Halachic Issues in Childbirth and the Newborn”. Speakers from the UK included Prof Antony Warrens, Prof Daniel Hochhauser, Prof David Katz and Rabbi Akiva Tatz. There were study sessions on Friday and Sunday mornings about aspects of Jewish Law relating to medicine.

Following this conference Prof Steinberg met with the chairs of BMA and GMC Ethics Committees, together with senior UK medical ethics experts and representatives of the Muslim and Catholic Medical Associations, at the Board of Deputies offices. At this meeting he described how the Israeli End of Life law, known colloquially as the “Steinberg Law”, had been developed. Later the same day he met with Sir Peter Simpson and Prof Gurch Randhawa from the UK Organ Donation Ethics Committee. Finally he gave a lecture on the topic of “Recent Developments in Jewish Medical Ethics – the Israeli Experience”. In this talk he outlined four examples of how Israeli law on such issues has developed over the years taking cognisance of both medical and halachic concerns.

Following on the success of the conference Drs Landau and Opat have already convened a meeting to arrange a follow – up event in 2012. The intention is that this will include a symposium at a central London venue on the Wednesday evening before the conference in order to attract as wide a medical audience as possible.

As part of Interfaith week 2012 the student members of the Jewish Medical Association UK (JMA) and the Muslim Healthcare Students Network (MHSN) organised a panel discussion on 20th November 2012.

The background to the meeting was that both Jews and Muslims have had to tackle questions about circumcision practices in their respective communities during 2012 – and the forum provided an opportunity for medical students to learn more about why and how this has happened, and to place the questions in their ethical, legal, medical and religious perspective.

The chair was taken jointly by Hadiya Mahmood (MHSN, from Leeds) and Shier:Ziser (JMA, from UCL). Speakers were Prof David Katz, Shaykh Dr Asim Yusuf and Adam Wagner

Prof Katz (who is co-chair of Milah UK, which aims to increase public understanding about Jewish practices in relation to circumcision), summarised the religious (Biblical) background, and outlined the traditional procedures based upon Maimonidean texts. He noted that neonatal male circumcision has been classified as a procedure of “social, religious and cultural” significance in the UK. The recent decision of a minor German court had been extraordinarily well publicised, and had led to the current public interest.

Shaykh Yusuf explained the Islamic basis for male circumcision under divine guidance and law of mercy. It is regarded as the classic Abrahamic sign, and although not obligatory it is recommended and performed by more than 90% of Muslims. The age at which it is performed is influenced by issues of risk, modesty and amount of pain and discomfort. The methods used are not defined specifically other than as removal of the prepuce.

Adam Wagner reviewed the different legal frameworks under which neonatal male circumcision might be scrutinised. Apart from criminal law, this could include medical law (Gillick), human rights law, and the rights of children. Freedom of religion was part of the European Convention on Human Rights but was not absolute, and the fact that there was no net harm or benefit was important. He concluded that there was unlikely to be a ban as envisaged in the German court’s decision, but that the risks were greater in Europe than in the UK.

At a well-attended meeting in memory of Dr Alan Naftalin z’’l, in the presence of many members of the Naftalin family, Caroline Marcus, a friend and neighbour of Alan’s, gave an illustrated talk on the theme of “Rembrandt, the Rabbi and Dr.Tulip: a flavour of Amsterdam’s Jewish Quarter in the 17th Century”. She linked the themes of art, medicine and Jewish history to pay tribute to his memory. Before her talk Leo Arkush’s presentation added to the event, speaking both about his elective in Jerusalem and about Alan’s work with students.

Rabbi Dr Abraham Levy (patron of the Association) arranged for sponsorship of this meeting by Montefiore College, and explained to the large audience that the occasion had been designated in honour of Dr Thomas Hodgkin, the British physician who accompanied Sir Moses Montefiore on his travels. Hodgkin died while visiting Israel and his grave is in Jaffa.

The objective of the meeting was for Rabbi Prof Avraham Steinberg to educate a British audience – both with respect to halacha and to medical issues – about current Israeli practices with respect to organ donation. There were several orthodox dayanim present in the audience who listened attentively for over two hours to Prof Steinberg’s presentation. He outlined how the advent of organ donation had posed problems for observant Jews, and then focussed on one of these, i.e. the issue of determination of death. He explained that the idea of deciding that a potential donor was dead as evidenced by cessation of brain function was a relatively new concept medically, and then detailed how the leading Jewish religious authorities had approached the question. He then explained the Israeli approach, where stringent criteria have to be met to confirm brain stem death and cessation of cerebral blood flow. There is close collaboration between physicians and Rabbis, and the wishes of the family are respected.

After Prof Steinberg’s talk Prof Anthony Warrens described the clinical need for organ donation in the UK. Prof David Katz clarified that the general principle of Jewish participation in organ donation was accepted in the UK by the religious authorities. Current national UK policies recognise that some people accept brain stem death criteria and others do not. These policies aim to recognise explicitly that the donor family is also a bereaved family.

Mr Ari Jesner (brother of the late Yoni Jesner, whose organs were donated following his death in a suicide bomb attack in Israel) gave a moving account of how the family decision in favour of organ donation had been reached.

During the meeting the audience were informed that a draft document has been prepared already which should allow more Jewish people who want to donate their organs after their death to express their wishes in advance. The idea is that this document will allow these prospective Jewish donors to state specifically that, if the question does arise, then they want their family to discuss the matter with their religious authorities, aiming to respect their wishes. This draft document has been discussed with other faith communities and will be considered when NHS Blood and Transplant reviews their current UK procedures in this regard.

The Jewish Medical Association (UK) hosted Dr Mohammed Al-Hadid at a breakfast meeting on Monday 7th October. Dr Al-Hadid told his audience how he had worked with colleagues to negotiate the admission of Magen David Adom to the International Red Cross. His approach throughout has been to promote positive co-operative initiatives, despite criticism and risk. Similarly he helped found, promote and develop the Masters course in Emergency Medicine at Ben Gurion University, the only such programme in the Middle East. Turning to current events he explained that Jordan lacked the resources of other Middle Eastern countries, but is confronted with a complex humanitarian crisis. The open border with Syria has resulted in a new influx of ~600,000 refugees. These are joining a similar number of Syrians already living in Jordan, as well as large cohorts of Palestinians and Egyptians, and migrant workers, so that today there are 6 million Jordanians and most probably a very similar number of refugees in the country. He explained how this situation creates cultural, educational, health and security problems, and how he and his colleagues are working to tackle them.

A one day meeting was held at the Spanish and Portuguese Synagogue (with generous help from the Association patron, Rabbi Dr Levy, and from the synagogue board) on this theme: There were several panel discussions on selected topics. Rabbi Joseph Dweck and Dr Paul de Keyser introduced the subject, reflecting on the notion that “the child is more than a small adult”. This was followed by a discussion on end of life issues where we were fortunate to have as speakers Prof Alan Jotkowitz from the Jakobovits Centre at Ben Gurion University, and Prof John Wyatt, who is one the UK’s leading experts on medical ethics and faith issues, particularly in the neonatal period, together with Rabbi Wilson. This was followed by sessions on genetics (Dr Ian Ellis, Dayan Binstock, Rabbi Birnbaum and Prof Jotkowitz) and Brit Milah [Prof Glick (Ben Gurion University), Prof Katz and Dr Spitzer]. The discussion on child protection was chaired by Dr Michael Coren, and Drs Cohn, Fertleman and Lindsey addressed the medical issues that are of ongoing major concern in the UK, Prof Glick gave an Israeli perspective and Dayan Gelley spoke on the role of the rabbi in this area. Finally Prof Kottek from the Hebrew University, who is a paediatrician as well as a medical historian, spoke about the way that the embryo is discussed in the Talmud.

On Monday 10th March 2014, when we welcomed a team of Israeli colorectal surgeons:

Dr Reuven Weil [Group leader; Rabin Medical Centre (Golda)

Dr Chiara Grassi (Hasharon Hospital, Petach Tikva)

Dr Nadav Haim (Sheba Medical Centre, Ramat Gan)

Dr Dimitri Norkin (Rambam Health Care, Haifa)

Dr Milad Qarawany (Poriya Hospital, Tiberias)

Dr Sergey Rukavishnikov (Shaarei Zedek Hospital, Jerusalem)

Dr Lior Segev (Sheba Medical Centre, Ramat Gan)

Dr Tennak Vladimir (Asaf Harofeh Medical Centre, Tzrifin)

Dr Erez Atias Yarden (Asaf Harofeh Medical Centre, Tzrifin)

They visted the UK as guests of Mr Richard Cohen (University College London Hospital), Mr Joseph Nunoo-Mensah (Kings College Hospital) and Mr Andrew Williams (St Thomas’s Hospital), and will be attendinga course at Basingstoke Hospital.

The visit was supported by the Israel and British Commonwealth Association John Firman Fund.

“Immunisation Update”

Professor Salisbury was previously Director of Immunisation at the Department of Health, London and responsible for the national immunisation programme. Post “retirement” he works on the WHO Global Programme for Vaccines. He chaired the WHO Strategic Advisory Group of Experts on Vaccines, chairs the European Region Certification Commission for Poliomyelitis Eradication, and is a member of the Polio Elimination Certification Commissions for other WHO regions. Also he had extensive experience in Global Health Security as co-chair of the G7 working group on Pandemic Influenza. He chairs the Jenner Vaccine Foundation Board, is President of the International Association of Immunisation Managers and Associate Fellow, Centre for Global Health Security Chatham House. In his talk to the Association he described the significance of vaccination in general and explained how the impact of such campaigns was analysed and interpreted. The positive impact of both human papillomavirus and influenza virus vaccines had been considerable, and he explored some of the ongoing studies being undertaken in the field at present.

Rabbi Prof Avraham Steinberg, who is widely considered as a leading authority on Jewish medical ethics, and has an international reputation in the field of biomedical ethics, visited the UK in September and delivered two talks which were promoted for members of the Association on 3rd September in London at Kinloss and on 6th September in Manchester as part of the Shema Programme at Stenecourt. In these talks he addressed the highly topical (in view of the UK House of Commons debate the same week) and seasonal (in view of Rosh Hashanah) subject of the “Steinberg Law” – “Who shall live and who shall die”.