The dual suicide bombings in the Neve Shaanan pedestrian mall in south Tel Aviv in 2003 forced us, the doctors, to look at the new reality in all its ugliness. Twenty-three people were killed in this terrible terrorist attack, and over one hundred injured. Among the injured were Israelis, alongside foreign workers that live and work in the area. While the rescue teams hurried to transfer the Israelis to the hospitals, the foreign workers, though injured and bleeding, preferred to hide in a secure corner for fear of the police. Their fear of being arrested and deported from Israel, as part of the mass deportation policy declared against them, took precedence over their need for urgent medical treatment. Even the generous announcement of the then Minister of Interior, Mr. Eli Yishai, that the injured and their families would be granted temporary residence permits did not ease the apprehension of the labor immigrant community. Many of the foreign workers avoided coming to hospitals to visit their hospitalized friends for fear of deportation. This signified a new and ugly height of inequality in access to and benefit from health and medical means available in Israeli society.

Approximately one month after this event, the IMA Ethics Bureau held a discussion about the status of labor immigrants in Israel. The Bureau members maintained that they must express an unequivocal position concerning basic human rights of individuals at the bottom of the social ladder in Israel. Representatives of organizations assisting foreign workers also participated in the discussion – “Kav Laoved” (Worker’s Hotline) and “Physicians for Human Rights - Israel”. At the end of the discussion the Ethics Bureau members adopted the following position paper:

•  Immigration for work purposes is a worldwide phenomenon that cannot be solved by purely administrative measures.
• The fact that hundreds of thousands of labor immigrants reside in Israel requires State institutions to address the basic human rights of these workers, including their welfare, health and medical condition.
• The medical condition of labor immigrants has a direct effect on the health of the entire population. Hence, the dual duty of the authorities to care for the health of these immigrants
• Appropriate living and work condition standards should be set and enforced in order to prevent exploitation of labor immigrants and incidence of disease among then.
• A proper legal framework should be created to enable all labor immigrants free access to medical services, while collecting health tax from them.
• Every physician has the ethical duty to provide emergency medical treatment to labor immigrants who do not have medical insurance.
• Providing non-emergency medical treatment to labor immigrants is the discretion of the physician, even if such treatments are not covered by the National Health Insurance Law.
• As part of the general maintenance of patient confidentiality, the medical confidentiality of labor immigrants requesting medical treatment shall also be preserved.
• ·The IMA Ethics Bureau calls on doctors that are IMA members to volunteer and contribute their professional experience for the benefit of labor immigrants in Israel.