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Chapter 5 - Conclusions and Summary

In recent years, physicians’ strikes have become more and more common around the world. Physicians carry out protest action and sanctions not merely in order to improve their employment conditions and salary, but also in order to improve the welfare of patients and to protect the public healthcare system. Thus, for example, physicians in France, Greece and Luxembourg went on strike in order to advance reforms on behalf of patients and a similar struggle is currently taking place in England, in consequence of the attempt to privatize the healthcare system in that country. Similar struggles that took place around the world have led to important achievements both for the physicians themselves and for the healthcare system and patients. These achievements have been reflected, inter alia, in new agreements between the physicians and the Government and in significant changes that were made to legislation and regulations against which physicians protested.

In Israel, physicians’ strikes that have taken place in the past have led to significant achievements both for physicians and for patients, while improving the whole healthcare system. For example, the strikes in 1983 and 1994 led to an improvement in service in hospitals and internal departments by way of an increase in physicians’ salaries as well as an improvement in the quality of medical treatment by way of strengthening further professional study for physicians. During the strikes, the patients admittedly suffered from an inevitable increase of waiting times for treatment, delays resulting from the sanctions, etc., but the physicians took care not to refuse to provide essential services and to prevent harm to human life. The courts, as a rule, refused to intervene and recognized the physicians’ right to strike, while taking care to balance between the protest and sanctions on the one hand, and protecting the lives of patients on the other.

Contrary to the statements that ‘physicians’ strikes are immoral,’ research on ethical issues shows that the physicians’ struggle to improve their conditions in the healthcare system - even when it involves a strike - actually reflects their responsibility for the long-term welfare of patients, as a part of the ‘social contract’ between physicians and patients, which imposes upon physicians responsibility that does not end with giving the patient medical treatment. Moreover, literature on the subject of ethics shows the potential of physicians’ strikes for alleviating in the long run the distress of patients who in any case (irrespective of the strike) suffer from inadequate conditions.

In conclusion, the current struggle being conducted by physicians to save public healthcare may derive inspiration from physicians’ strikes around the world. These have become common in recent years, and are being recognized as achieving important goals for the benefit of both physicians and patients. In Israel also, previous strikes have led to benefits for the whole healthcare system. Physicians’ struggles in Israel have also been granted legal protection that relied, inter alia, on the physicians’ commitment to provide essential healthcare services even during a strike. Not only is the current struggle not immoral, but it reflects the ethical role of physicians in advancing the welfare of patients in the long term and in realizing their responsibility and leading players in the healthcare system in order to improve the public healthcare system.