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Pervasive violence against hospitals, patients, nurses, doctors, and other health workers has become a horrifically common feature of modern war. These relentless attacks destroy lives and the capacity of health systems to tend to those in need. Inaction to stop this violence undermines long-standing values and laws designed to ensure that sick and wounded people receive care.


Book is available from Columbia University Press (including e-book), Amazon and other booksellers.

Listen to the Public Health on Call podcast interview with Len.

Watch book conversations with Robert Siegel, former host of NPR’s All Things Considered, at Beth El Hebrew Congregation, J. Stephen Morrison at the Center for Strategic and International Studies, Professor Naz Modirzadeh at Harvard Law School, and Professor Matt DeCamp at the Center for Bioethics and Humanities at the University of Colorado.

Read text of interview with Titilope Ajayi of The New Humanitarian.

Read the Guardian editorial endorsing the book’s recommendations for addressing the problem of violence against health care

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About the Author

Len Rubenstein has spent his career, spanning four decades, devoted to health and human rights. A graduate of Harvard Law School he is now Professor of the Practice at the Johns Hopkins Bloomberg School of Public Health, and Director of the Program in Human Rights, Health and Conflict at its Center for Public Health and Human Rights. At Johns Hopkins, he is also a core faculty member of the Berman Institute of Bioethics and the Center for Humanitarian Health.

Praise for Perilous Medicine

 

Rubenstein shows “that the fight to protect medical and humanitarian workers is not new, but we are running out of time before it becomes futile. . .  Rubenstein identifies [the leader of the campaign for the first Geneva Convention’] Dunant’s central truth—that the real story of war is suffering. This is the moment to build the infrastructure to safeguard the people who are trying to protect the innocent. Attacks on health care aren’t a niche concern—they are war crimes. The global stakes are high.”

—  From a review by Annie Sparrow in the New York Review of Books

 

“Walt Whitman lamented the American Civil War’s ‘unending universal mourning-wail’ and saw the conflict’s ‘Untold and Unwritten History’ in hospitals where ‘the marrow of the tragedy [was] concentrated.’ Leonard Rubenstein quotes these words and he concisely describes both the principles meant to safeguard medical practice in wartime and the repeated failure to live up to them. It is a sad and necessary read. Sad, because the brutal targeting of doctors and nurses has become a familiar fact of modern warfare, and necessary, because our civilization depends on a willingness to bear witness to our moral failures. Recognizing our failures is our only hope, however slim, of not repeating them.”

— From a review by Michael Roth in Washington Post

 

“Few people have worked as tirelessly to protect doctors, nurses, and other health workers on the frontlines of catastrophes and conflicts as has Leonard Rubenstein, and in this much-needed, eagerly awaited book, he brilliantly details how ruthless leaders, militaries, and terrorists deliberately target hospitals, patients, and their health workers for destruction, kidnapping, and murder. Bravo, Professor Rubenstein, for speaking truth, however inconvenient it may be for world leaders.”

— Laurie Garrett, Pulitzer Prize-winning writer and author of Betrayal of Trust: The Collapse of Global Public Health

 

“ . . an indispensable tool to shame governments and decision makers in international bodies into action to protect health care in conflict settings. In this way the book fulfils its objective of addressing one of the most heinous phenomena of modern war. “  

— Dr. Samer Jabbour, from a review in The Lancet

“Perilous Medicine: The Struggle to Protect Healthcare from the Violence of War, a major new book on healthcare in armed conflict from Leonard Rubenstein, is destined to become a landmark in its field. . . The backbone of this sobering, deeply humane book is a series of case studies—accounts of the targeting or politically motivated corruption and misuse of healthcare during times of conflict. Many of the places the book visits have become bywords for inhumanity, places of bitter, often enduring hostility or calamitous political failure. . . Perilous Medicine is an important and necessary book. Partly this is to do with the precision and thoroughness of its account of violations of health-related IHL. But also because it deliberately asks an urgent question. Although it is unlikely that there was ever “a golden age” of warfare, where restraint prevailed in pursuit of just military goals, it can nonetheless feel as if we are sliding back into barbarism.

 

— From a review by Julian Sheather, Special Advisor on Human Rights and Ethics to the British Medical Association

 

“Rubenstein provides a comprehensive account of the drivers of the growing number of attacks on health care during armed conflict. He offers insights and ideas we desperately need to shake off complacency and insist on compliance with the norms and principles of the Geneva Conventions. Governments, including the United States, have the power to protect health care from violence. As leaders and citizens, we have a duty to ensure they do.”

— Representative James P. McGovern (D-MA), co-chair of the Tom Lantos Human Rights Commission

 

“Providing health care in combat zones often means delivering such care in the face of looting, fires, shelling, bombing, and plague. Leonard Rubenstein takes a deep dive in answering why violence against health care seems to be more visible. Perilous Medicine presents a well-documented series of case studies on such tragic attacks. This colossal work demonstrates how hospitals in war zones remain the last patch of humanity in times of utter chaos.”

—Joanne Liu, former president of Doctors Without Borders

 

 “A superb overview of the terrible number of horrendous and unlawful attacks against health care in wars worldwide. Rubenstein’s unmatched knowledge, experience, and expertise shine through on every page to make this the definitive text on the subject and an urgent humanitarian call to keep health care safe in war.”

—Hugo Slim, Institute of Ethics, Law, and Armed Conflict, Blavatnik School of Government, University of Oxford