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When soldiers are hiding in hospitals, what is the morality of attacking them?

The raid on Al-Shifa Hospital in Gaza City is a stark example of the moral dilemma Israel faces in its campaign against Hamas

This week’s raid on Al-Shifa Hospital in Gaza City is the starkest example yet of the moral dilemma Israel faces in its campaign: how to attack military targets that are deliberately located in civilian areas.

What is actually happening is, for now at least, buried in the he-said/she-said of the internet. According to the Israel Defense Forces, soldiers have already discovered rifles, ammunition and other military equipment in the hospital, proving that Hamas is using it as a military base. Hamas says this is all fabricated.

But even if we stipulate that Hamas has located a military installation in and under that hospital, Israel still faces a moral dilemma. Because in fact, Hamas has two sets of hostages: the 240 civilians and Israeli soldiers they kidnapped on Oct. 7, and the millions of Palestinians they have deliberately placed in harm’s way, either to deter Israeli attacks or to punish Israel in the court of public opinion when those Palestinian civilians are killed.

This is not some abstract speculation. It is a horrifying calculation with real human costs.

What’s at stake?

On the one hand, Israel has clear strategic objectives: Remove Hamas’ capacity to ever do this again, show every other would-be terrorist the consequences of striking Israel, and force the release of Hamas’ hostages. The hostages’ lives are at stake, and so is the long-term feasibility of the Jewish state. If Israel surrenders and Hamas is allowed to win, all hell will break loose in the region.

On the other hand, these are real people. These are babies crowded into a single incubator because the hospital no longer has electricity to power the others. These are cancer patients who will die without treatment.

In some sense, the moral conundrum resembles the classic philosophical dilemma known as the Trolley Problem. In that hypothetical, a trolley is on course to kill five people who are stranded on the track ahead. An innocent bystander has the opportunity to divert the trolley, but that would intentionally kill one person. So which is better? Doing nothing means five people die. But diverting the trolley means that the bystander just committed murder by taking an affirmative act that killed someone else.

In the analogy, Israel is the person tasked with making the decision, the five people represent the future victims of Hamas and other anti-Israel terrorists (including the 240 hostages), and the single person represents the civilian population of Gaza.

But the reality is, of course, more complicated.

In the Trolley Problem, we never find out why the people are stranded. But here, Hamas is responsible for all of them: The Israelis held hostage, the future victims of its terror attacks, and the innocent Palestinians who it routinely uses as human shields. As well as, of course, the people it massacred on Oct. 7. There is a single entity responsible for all of this human suffering: Hamas.

But if Israel acts with reckless disregard to human life, if it does not do everything it can to minimize civilian casualties, then at least some of the deaths that result are on its moral account. 

And that, of course, is the vast gray area of the entire operation. How are soldiers to balance the moral imperative of providing Gazans with humanitarian aid against the risk of delay? How much intelligence, and of what degree, justifies the bombing of this target or that one, or the raid of a hospital?

None of these questions can be answered with any precision. Yet they are the very kinds of decisions that military commanders must make every day.

Who to trust?

As a result, the morality of the operation, and of the Al-Shifa hospital raid in particular, quickly becomes less like the straightforward math of the Trolley Problem and more a question of, well, trust.

Of course, the Israeli side says it is targeting bombing locations based on “military objectives” (though at least one IDF spokesperson reportedly said that “the emphasis is on damage and not on accuracy”), and that it is helping innocent Gazans escape to the south. Just this week, the IDF posted footage of soldiers unloading incubators for those babies stranded in Al-Shifa.

But then again, many Israeli officials have used language that is anything but moral, calling for ethnic cleansing, calling Hamas (or even Palestinians) animals, or denying that there even are innocent Palestinians.

To whatever extent they exercise authority, these people want more Palestinians to die; obviously there’s good reason not to trust them with executing this operation in a way that takes as few innocent lives as possible.

Meanwhile, the IDF’s press releases are made in the service of Israel’s interests, not objective journalism. They are telling the story Israel wants to tell.

I’m inclined to believe what I see. But I also know that these images can be faked, and that the IDF has made misleading statements before.

Where does this leave us?

Probably, it leaves us with our priors. If you tend to trust the Israeli leaders, you’re more likely to believe that the military is doing everything it can to save lives. In that case, Hamas is responsible for each and every one of the thousands of Palestinians who have died.

But if you tend to be suspicious (or worse) of Israeli leaders, you might wonder how many innocent people are caught in the crossfire of Israel’s wanton and overzealous attacks, or are even deliberately targeted.

We may never know which is more true.

But there is no denying at least this: Hamas placed all of these people in harm’s way. Even if Israel is overreacting, it is overreacting in the context of Hamas’ cruel calculations, in which the deaths of thousands of Palestinians (who never agreed to be used as pawns) is a price they deem willing to pay in order to destroy the Jewish state.

That, together with the appalling suffering of the innocent, is perhaps the only moral clarity we can hope for.

To contact the author, email [email protected].

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