Israeli Doctors' Dilemma: Treating Black Site Inmates

At the end of our conversation, Nathan (a pseudonym) kept repeating, almost to himself: "Perhaps we should have done more. Perhaps we could have done more. Perhaps there was something we could have done about the camp itself. About the dogs. We kept on hearing the dogs. Every night."

Nathan, a senior surgeon in one of Israel's bigger hospitals, was talking about the Sde Teiman camp, an army camp in the Negev desert in southern Israel which, following the October 7 2023 attack on Israel, was turned into a holding facility for detainees from Gaza.

Initially, this camp served to imprison members of the Nukhba force , the Hamas unit which led the massacre in southern Israel. But since then, and throughout Israel's subsequent assault on Gaza, Sde Teiman has been a "black site" in which Palestinians captured by the Israeli army inside Gaza were held, including many who say they were not involved in the fighting .

The formerly secret camp has become infamous following claims of unprecedented violence , abuse and cruelty that reportedly took place in it . One soldier who served there referred to it as a "sadistic torture camp" .

Nathan never stepped foot in the camp. But he was one of a small number of Israeli doctors who volunteered to work in a medical facility which operated next to it, where some of the most badly injured detainees from Sde Teiman received medical treatment. This facility was set up after many Israeli hospitals refused to admit anyone suspected of taking part in the October 7 massacre, many of whom were severely injured.

Nathan's decision to serve in this facility was not a simple one, he explained to us. While he had no reservations about treating detainees from the camp, and saw it as his duty as a doctor to treat patients no matter who they were (especially if no one else would treat them), his work at Sde Teiman's medical facility - which he has kept secret from family and colleagues - continues to haunt him. "Ultimately," he said, "it made me into a war criminal."

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We interviewed Nathan for a book we have been writing on torture in Israel. In our research , conducted over the past five years with the Israeli human rights organisation, the Public Committee against Torture in Israel ( Pcati ), we investigated the extent to which healthcare systems and other civic institutions have become complicit in the processes of torture that have become more widespread and brutal since the October 7 attacks.

After harrowing accounts also began to emerge from the medical facility , we set out to investigate it. Stories from this facility told of patients held in humiliating and degrading conditions, of sub-standard medical care leading to medical complications (including unnecessary amputations due to constant handcuffing), and of patients dying due to neglect.

Nathan, and two other doctors we interviewed who worked there, provide new insights into the conditions inside the medical facility - and more generally, the conduct of the Israeli healthcare system in the wake of the October 7 attacks. Their stories allow us to see, as they all made clear in various ways, how even people with the best intentions can become complicit in war crimes.

'They were all in unbearable pain'

Shortly after the October 7 2023 attacks, Nathan got a call from the Israeli Ministry of Health asking him if he would be willing to treat some of those who had committed the atrocities. The ministry approached a small number of doctors after many Israeli hospitals and some doctors had refused to treat people widely regarded in Israel as savage terrorists.

Doctors have an ethical obligation to care for all patients, regardless of who they are or what they have done. Indeed, the Israeli healthcare system had prided itself on its long record of treating all patients equally, including enemy combatants , suicide bombers and Hamas leaders . But after the October 7 attacks, for reasons we explore below, hospitals started turning such patients away.

The medical facility at Sde Teiman was set up so detainees held in the main camp could receive medical treatment without having to be admitted to public hospitals. Recalling the first time he visited the facility, Nathan told us: "I had no idea where I was going or what to expect." He did not expect it to be anything but a temporary fix - and certainly did not imagine himself working there for many months.

In the first few weeks, without adequate equipment, suitable medications, a functioning logistical apparatus and even a proper institutional affiliation, the doctors had to improvise and rely on their resourcefulness. "By the end, this facility was well-equipped compared to a field hospital … But the point is," Nathan insisted, "a field hospital should be temporary; you cannot really perform operations in a tent in the middle of the desert."

When we met at the end of 2024, Nathan was not at ease and seemed very worried. Several times during our conversation, he told us that "no one can know who Nathan is". Seeing how concerned he was at being exposed, we were surprised he had agreed to be interviewed at all. But unknown to us, a few days before we contacted him, he had attended a public talk we gave about our research on torture being conducted by Israel. This is probably why, when we reached out, he immediately agreed to meet us.

In addition to Nathan and the two other doctors who worked in the facility, we also interviewed others who were involved in its operation in some way: two members of the Israel Medical Association's ethics board, a medical ethics expert who advised doctors working in the Sde Teiman facility, and human rights practitioners who investigated it. We also interviewed medical staff and healthcare professionals from seven of Israel's largest hospitals, as well as several Israeli government officials working in the healthcare system and Ministry of Justice.

While most interviewees spoke under condition of anonymity, Nathan was particularly guarded. He was mostly scared that he or his family would be targeted by rightwing Israeli activists if they knew he had treated "terrorists". But he was also concerned about his colleagues' reactions - even his direct line manager had no idea what he had been doing, beyond that he had been called up for military reserve duty.

Furthermore, Nathan wanted to protect himself from criticism from members of the leftwing community who saw anyone involved with the Sde Teiman facility as a war criminal. Yet it was clear that he too saw the very existence of the medical facility as a crime - even though he always tried to provide the patients there with the best possible care.

Indeed, Nathan told us that while working there, he had tried repeatedly to get the medical facility shut down. "The patients there could not receive the treatment they needed. They all needed to be admitted to a normal hospital."

After many months, once "it was no longer an emergency situation" - and when Nathan realised his efforts to shut the facility down were futile - he felt he could not "be there any longer", and quit.

Cuffed, blindfolded and wearing diapers

We approached Ben (also a pseudonym) for an interview because of his involvement with another human rights organisation, to ask about the medical treatment of Palestinians in Israeli prisons after the October 7 attacks. It was only during our conversation, when he heard that we were writing about the medical facility at Sde Teiman, that he told us he, too, had been called late in 2023 to serve there.

Ben, a much more junior doctor than the other doctors we interviewed, works in one of Israel's public hospitals. He recalled being asked by a colleague if he would help perform a procedure on a patient from Gaza he had previously treated. He immediately got in his car and drove to Sde Teiman, following the directions he'd been given over the phone - not knowing exactly where he was going.

Once he got to the medical facility, Ben said he was astonished by what he saw. Even though this was late December and the place had been operational for more than two months, "patients were still wearing nothing but diapers". He told us they were still cuffed to their beds and blindfolded at all times, including while receiving medical treatment. They were not allowed to get out of bed, so had to defecate in bed when they needed to relieve themselves.

Ben carried out the procedure he was called to perform. But once he got home, the reality of what he'd witnessed dawned on him: "I decided not to step into that facility ever again."

Because they were cuffed, the nursing staff had to do everything for the patients. They washed them, changed their diapers, and even had to feed some of them liquid food through straws . These accounts were confirmed by the other two doctors we interviewed who had worked in the facility.

Nathan told us several times: "You must emphasise the care and dedication of the nurses" who bathed, fed and cared for people few others were willing to care for. Yet while this was undoubtedly noteworthy, especially under those circumstances, most of these patients would have been able to go to the toilet, shower and feed themselves had they not been restrained to their beds 24 hours a day. Using such restraints indiscriminately on patients violates Israeli law , and is considered a form of torture according to ethical codes both in Israel and internationally .

"At first, [the cuffing] may have been necessary because we treated very dangerous people" who had just carried out a brutal massacre, Nathan explained. He described a severe attack on one female staff member which he witnessed, confirming: "We had several instances in which patients assaulted staff."

But, he continued: "They had no justification after the first few weeks. By then, other precautions could have been introduced, and assessments could have been conducted to determine who might pose a danger to staff and still needed to be cuffed."

Nathan said that eventually, many of the patients seen by the doctors and nurses were not dangerous. "Arrangements should have been made so those patients could be cared for in a general hospital in Israel."

After visiting the Sde Teiman medical facility in late February 2024, members of the Israeli Ministry of Health's ethical committee reported that all patients were still chained to their beds by all four limbs - despite the fact that, by the Israeli army's own admission in December 2023, many Sde Teiman detainees were by then not suspected of being related to Hamas or other militant factions. Many of those incarcerated in Sde Teiman, including some who had been held for many months and were chained to their beds, would eventually be released without charge .

'We did everything we could'

Nathan's account was supported by our third interviewee, Yoel Donchin - a senior anaesthesiologist who also served in the medical facility for many months. Donchin described some of the patients he treated to the New York Times in June 2024, explaining that one was paraplegic, another severely obese, and a third had needed to use a breathing tube since childhood. Donchin concluded it was "highly unlikely" that any of them were involved in the fighting. "They take everyone," he said, referring to the Israeli army's actions in Gaza.

Since he had already spoken publicly about his experiences in the facility, Donchin was easy to locate. Unlike Nathan and Ben, he was happy for us to use his real name, and had no reservations about his involvement there.

After he publicly defended his decision to serve in the facility, Donchin and the rest of the medical team working there was criticised by human rights organisations including members of Pcati's board. Treating patients there, they claimed , was "a moral disgrace and a violation of every ethical principle" to which doctors must commit.

But, a couple of hours into our long conversation in his quiet home in a suburb of Tel Aviv, we began to reconcile the facts we knew about Sde Teiman with Donchin's account of his time working in the medical facility. He equated the situation in Israel immediately after October 7 to "a multi-casualty event", explaining that in such conditions, "medical ethics is different". In the chaos of the first few weeks after the attacks, he told us, "no one knew what they were doing. The hospitals were swamped with patients and the system was overwhelmed."

Donchin said that even some Israeli soldiers wounded in the Hamas attack could not get the full care they needed. In the aftermath of October 7, he told us: "The entire [Israeli] healthcare system was in complete disarray. In the first month, there was no state to speak about whatsoever."

Within this chaos, Donchin told us: "We did everything we could." He explained that when the nutrition patients needed was not supplied, staff would buy it themselves. When a patient needed to be seen by a specialist, they would use their personal networks to bring in colleagues with the needed expertise - either having them come to the facility or, when that was impossible, having them provide advice over a video call.

Yet while these may have been effective emergency measures, "they should not have been the solution". Ultimately, Donchin said, these "compromises and improvisations" meant the doctors were operating under "a black flag of illegality".

According to the medical ethics expert who advised doctors working in Sde Teiman: "In this first month, treating those who'd just taken part in the massacre posed particular challenges", because some were very dangerous and aggressive. "General hospitals are not set up to treat patients who pose such risks to staff."

However, he also said that "Israel had detailed contingency plans in place for such a scenario, which included preparing a dedicated ward for enemy combatants in one of the main hospitals. But those were never implemented."

'He should be left to rot'

Many of the nearly 200 Hamas militants who took part in the October 7 attacks and were captured inside Israel were wounded in the fighting. At first they were taken to general hospitals, but word quickly got out - leading to widespread reports of mobs raiding hospital wards , attacking staff and patients they suspected of being Palestinian.

To protect the safety of both patients and staff, Israeli hospitals began refusing to admit these patients. But some medical staff also expressed their "difficulties" with treating those whom they suspected of having committed the October 7 atrocities.

On October 11 2023, Moshe Arbel, Israel's health minister at the time, officially endorsed this reluctance by issuing an ordinance stating that general hospitals should not treat "terrorists from Gaza". This guidance also enabled Israeli hospitals to refuse treatment to any Palestinian arriving from any incarceration facility.

Staff working in some of these hospitals told us in the aftermath that they had regularly heard colleagues making statements such as "Gaza should be erased" or "as far as I am concerned, all babies in Gaza are terrorists and can die" - sometimes in formal staff meetings and in front of Palestinian colleagues.

We also heard stories of medical staff demonstrating explicit disregard to the injuries and wellbeing of those they suspected were part of Hamas's Nukhba force - and in some cases, Palestinian detainees from Gaza more generally.

For example, Nathan described calling a senior specialist when he needed urgent advice about treating one of the detainees in Sde Teiman, only to be told: "As far as I am concerned, he should be left to rot." And according to Ben: "On October 8, I witnessed a doctor inserting a tube into the lungs of a patient from the Nukhba force without anaesthetising him. There were likely other such cases."

"Paradoxically," Ben told us, "the doctors in Sde Teiman's medical facility had a much deeper commitment and understanding of their responsibility to provide care to these patients." It was in the general hospitals, he said, that he had found more "verbal violence, less care" - and some cases of physical abuse.

As an underequipped and understaffed makeshift facility, according to those who worked at Sde Teiman, if a patient needed urgent treatment that could not be provided on site, they would sometimes be taken to one of Israel's general hospitals. Nathan described spending long hours on the phone each time, calling different hospitals until he could find one willing to admit a patient. But it was the very existence of the Sde Teiman medical facility that allowed many hospitals to shirk their responsibilities, since these patients were apparently already receiving treatment.

And when a hospital procedure was performed, the patients were quickly sent back to the Sde Teiman medical facility, as described in this leaked letter to Israel's Ministry of Health from a doctor working in the facility:

Patients after major operations, such as abdominal surgeries for intestinal resections, are brought back after about an hour of post-op observation to the Sde Teiman medical facility, which is staffed most of the day by a single doctor, accompanied by a nursing team, some with no more than medic training.

Eventually, staff at the Sde Teiman medical facility managed to get some patients released from being handcuffed to their beds by all four limbs, and to enable them to wear hospital robes rather than diapers. But regardless of their effort to provide better care, and regardless of their important struggles and partial successes, to treat people in the Sde Teiman medical facility was, in the view of many observers as well as some of the doctors themselves, to become complicit in violations of international and Israeli law.

The anonymous letter submitted to Israel's Ministry of Health claimed conditions in the facility often resulted "in complications, and sometimes even in the patient's death":

This makes all of us - the medical teams and … those in charge of us in the health and defense ministries - complicit in the violation of Israeli law, and perhaps worse for me as a doctor, in the violation of my basic commitment to patients, wherever they are - as I swore when I graduated 20 years ago.

The doctors' dilemma

Ben only visited the Sde Teiman medical facility once, yet the regret stayed with him. "I should have turned around the moment I saw the patients were treated while naked and cuffed to their beds," he told us. "To treat patients there was not only a violation of our ethical codes as doctors - it was to take part in war crimes, if not crimes against humanity. This was not something I was willing to consider."

He continued: "To serve there effectively mediated the crisis that would have been caused had no doctor agreed to do so. The medical staff allowed the facility in Sde Teiman to continue operating, and the existence of the facility allowed the hospitals to refuse treating those patients."

While the Sde Teiman detention camp held many hundreds of detainees over long periods, its medical facility could treat no more than 15 patients at a time. Usually, only detainees identified with acute injuries were received - often only after their condition had already deteriorated. This meant lesions would frequently get infected, according to our interviewees, leading to amputations of limbs that could have easily been prevented.

In the main detention camp, untreated illnesses led to complications, debilitation and, in some cases, death . The most recent public data shows that between October 2023 and July 2024, at least 36 detainees died inside Sde Teiman. To a slightly lesser extent, the withdrawal of care has also become the standard in other prisons and detention facilities where Palestinians are held. According to the most recent (still unpublished) data we have received from Physicians for Human Rights (Israel) , from October 2023 to July 2025, 52 Palestinians have died within military facilities and 41 inside Israeli prisons.

Denying medical care to an imprisoned person may itself amount to torture. While commonly imagined as breaking someone's bones, pulling out their fingernails or applying electric shocks, torture can take many other forms. When someone is sick or injured, denying them the treatment they need and preventing them from getting any pain relief can be a way of causing unbearable pain and unnecessary suffering.

For Donchin, to refuse to treat patients would have meant becoming an accomplice in this crime. "For me, the alternative - to provide no care at all, to show no compassion - was impossible," he said, adding that it is one thing to think about these questions in theory, a completely different thing when you see a person suffering right in front of you.

In contrast, for Ben, the only right thing to do was to refuse to work inside Sde Teiman's temporary medical facility - especially when state-of-the-art hospitals were only a short car drive away. "Treating patients there doesn't save them, since it leaves them outside the healthcare system that could have given them the lifesaving treatment they so needed," he told us.

But as we were concluding our conversation, he added: "There are no right answers here. It is a huge tragedy, no matter which way you look at it."

The Sde Teiman medical facility was finally shut down in October 2024 when, following a petition to Israel's High Court of Justice by several human rights organisations including Pcati and Physicians for Human Rights, the population of the main detention camp was significantly reduced.

By the time Nathan sat down to talk to us, the medical facility had been shut for a good few months. But the man we met was still utterly defeated, visibly broken. He kept asking himself if he had done enough - or if he should or could have done more. This is when he concluded: "Perhaps there was something we could have done about the camp itself."

While he never stepped foot inside the main camp, he told us he could hear very clearly the yelling and the barking of the dogs. "Maybe we could have done more about the camp itself."

Whereas Ben and Donchin seemed to draw some comfort from their belief that they had done the right thing (despite reaching opposite conclusions), Nathan did not share that conviction. On the one hand, it was clear to him that he had become complicit in crimes. The conditions in the medical facility failed even to comply with what he called the "stripped-down law" that Israel had adapted to treat these people - let alone international human rights law and all medical codes of ethics.

Yet at the same time, Nathan felt he could not abandon these patients. When we met him, he was still torn about what he had done, still wondering whether he had made the right decisions.

A legacy of torture

The use of torture by Israel did not begin in October 2023. In the course of our research , we have analysed more than 1,500 of the torture cases recorded by Pcati in the 25 years preceding the attacks. These cases are all carefully analysed as having met the definition provided by the UN Convention Against Torture .

Comparing our findings with testimonies that have emerged over the last two years, we can say with confidence that the use of torture by the Israeli security forces has increased both in scale and severity since then - though this has been denied by the Israeli government and military .

According to numerous verified reports , many of the detainees in Sde Teiman were subjected to sexual violence ranging from forced nudity and humiliation to rape ; constant cuffing that led to injuries and in some cases the amputation of limbs; and beatings using batons, metal bars and the butts of guns and boots, sometimes until detainees lost consciousness.

Similar practices were reported in almost all Israeli prisons and detention facilities where Palestinians were held after the October 7 attacks.

The stories of the doctors working at Sde Teiman should not distract from the gravity of this wider story of abuse and torture . But the dilemmas the doctors faced, and the impact it has had on their lives, show the complexities, if not impossibilities, faced by Israelis who are trying to resist the atrocities Israel has been committing in Gaza (and the West Bank ) in the aftermath of the October 7 attacks.

In its July 2025 report , Physicians for Human Rights Israel claimed that the "broader targeting of Gaza's healthcare system" amounts to a dismantling of the "existing conditions of life with effects into the future", and should therefore be seen as a violation of the UN's 1948 Convention On Genocide .

The doctors we met, alongside the other medical staff in the Sde Teiman facility, attempted to counteract the dehumanisation and abandonment of life that allows genocides to happen. In different ways , they tried to stop the atrocity that was evolving in front of them and to remedy the conditions that made it possible. Yet they still, in their view, found themselves complicit in the very crimes they tried to prevent.

As much as their story is a story of the impossible dilemmas these doctors faced, it is also a story of people who at least did what they could to counter this almost-inevitable complicity. Not only by insisting on the humanity of the people in front of them, and therefore also of their own, but also by refusing to remain silent.

Response to this article

The Israeli Medical Association (IMA) was contacted by The Conversation during the editing of this article. Its response, which is reflected in the final article, included the following comments:

According to Israeli Ministry of Health guidelines, all patients in the Sde Teiman medical facility were treated according to conventional Israeli medical standards, meaning the level of care there was higher than what they would have received in Gaza.

It is true that the use of indiscriminate restraints violates Israeli medical ethics. The IMA ethics committee has addressed this issue on more than one occasion, including with a statement in September 2023 and a letter to the Israeli Ministry of Health in February 2025 .

The IMA has continuously spoken out on humanitarian issues throughout this war and will continue to do so. On August 5 2025, we reaffirmed our long-standing policy on the assurance of medical care during armed conflict.

The destruction of Gaza's healthcare is tragic, but there is no "mass killing, detention, torture and abuse of medical personnel" [as was stated in the Physicians for Human Rights Israel report , July 2025]. There have been some medical personnel that were suspected or proven terrorists. The IMA has made it very clear that all patients are to be treated equally .

The Israeli military was contacted by The Conversation about the findings in this article, but did not provide a response. When previously contacted by the BBC about allegations of abuse and torture in the Sde Teiman medical facility , it said it "completely rejects accusations of systematic abuse of detainees".

Israel's government has also rejected accusations of widespread ill-treatment and torture of detainees in the Sde Teiman detention centre, insisting it is "fully committed to international legal standards".

Funding for this research was received from UKRI (ESRC grant ES/V012622/1).

Hagar Kotef receives funding from ESRC.