Israel’s medical establishment is reacting angrily to revelations that the country’s Health Ministry is working on a plan to make Jerusalem’s two largest psychiatric institutions single-gender.
The controversy marks the latest in a series of dust-ups over the place of religion in the health care system since the United Torah Judaism party took control of the Health Ministry following Israel’s February general election. But some critics say the push for gender segregation at the two institutions would be the first change under the ultra-Orthodox party’s stewardship in which religious ideology would have a far-reaching operational effect on health care provision.
“It appears that this decision is a bad decision being made by extraneous motives that have little to do with the health care and equality of the patients,” said Michael Partem, vice-chairman of the Movement for Quality Government in Israel, a watchdog group that is lobbying against the move.
The Health Ministry is led by Yaakov Litzman, a Knesset member from United Torah Judaism. He holds the title of deputy minister of health, with the office of health minister being held deliberately vacant in an arrangement tailored to suit the unique political and religious needs of United Torah Judaism. The party, which rejects Zionism on religious grounds, wanted to control the Health Ministry without having to participate in the Israeli Cabinet, as a ministerial position would require.
In April, Litzman garnered international headlines for his order that swine flu be referred to in Israel as Mexican flu because pigs are not kosher. Then, in November, after declaring that he does not recognize brain death, he ordered doctors at Schneider Children’s Medical Center to administer antibiotics and other treatment to a brain-dead baby with Haredi parents, a departure from normal medical procedure. The Israel Medical Association reacted angrily.
The IMA is also opposed to the latest plan for gender segregation at the two Jerusalem psychiatric institutions. The organization wrote to Litzman slamming the plan as “devoid of professional logic in medicine in general and psychiatric medicine specifically.”
The two facilities in question, Kfar Shaul Mental Health Center and Eitanim, have 320 beds between them. Patients are currently assigned to wards, as in most psychiatric facilities in the Western world, according to the severity of their conditions.
At the end of November, news emerged that Litzman wanted to make Kfar Shaul a men-only institution and Eitanim a women-only hospital. In response to a request for an explanation of the plan, the Health Ministry sent the Forward a statement that said: “The deputy minister and the professional staff of the ministry set out to examine the possibility [of segregating] with consideration to the needs of the patients without harming care for them.” It declined to comment further.
But there is a strong feeling among doctors that medical facilities are not the place to be rolling out gender segregation. According to the Israeli daily Haaretz, the head of the doctors’ union at Kfar Shaul condemned the plan in a letter to the IMA. Dr. Gregory Katz wrote: “it is clear that this [proposed] plan runs contrary to any professional and ethical common sense, in medicine in general, and in psychiatry in particular. Moreover, this is religious coercion in its most extreme form and undermines gender equality.”
At Jerusalem’s only other psychiatric hospital, Herzog Hospital, patients are segregated within the facility according to gender in wards and in other areas. The hospital’s director, Dr. Yehezkel Caine, said that the fact that patients in psychiatric treatment can lose inhibitions and social norms makes this sensible. He said that in deciding to institute gender-segregation within the facility more than 25 years ago, his institution “answered a need” raised by the large Haredi and Muslim populations in Jerusalem — and also pleased the families of many non-observant female patients who worry less if they are in female-only wards.
But Caine told the Forward that while he thinks the Health Ministry’s current plan for the other two psychiatric instititions stems from “genuine care on the part of the deputy minister and need we know exists in society and which we here act upon,” he believes that “to go to the extreme he is discussing is unnecessary and could be counterproductive.”
He said that the plan would probably increase costs at the hospitals and make them inefficient. For example, it would complicate the allocation of beds and introduce costs related to the fact that the two institutions currently share one emergency room. Trying to restrict each hospital to a single gender, he said, will mean that doctors will have no flexibility in the allocation of beds as gender ratios of patients fluctuate, he said.
Litzman’s plan appears to be consistent with what observers say is a growing tendency on the part of Israel’s Haredi community to push for more stringent separation between the sexes. The most high-profile push of this sort has been in public transportation, where there are now more than 35 bus lines on which male and female passengers sit separately. There have also been moves to introduce segregated airline flights, and in educational settings some, Haredi communities are segregating children at increasingly younger ages.
“Judaism of our generation in ultra-Orthodox society has become the modesty religion,” Avishai Ben Haim, who covers Haredi affairs for the Israeli daily Maariv, told the Forward. “There are campaigns for modesty everywhere — on buses, in the post office. It’s separation, separation.”
Contact Nathan Jeffay at firstname.lastname@example.org