Homeless Man Dies in Israeli Jail After Refusing Treatment for Tuberculosis

Patient held temporarily in prison, with court-ordered plan to transfer him to hospital delayed for technical reasons

File photo: An Israel Prison Services facility.
מגד גוזני

A homeless tuberculosis sufferer being held temporarily in a prison after he refused treatment was found dead in his cell Wednesday morning.

G., who was in his 40s, was supposed to be transferred by court order to an isolation room at Hillel Yaffe Medical Center in Hadera, but his transfer was delayed by a day for technical reasons. The Tel Aviv Magistrate’s Court had ruled last week that a person who wasn’t suspected of a crime could not be held in a facility meant for prisoners.

Sources who met with G. recently in the prison infirmary described him as being in terrible condition, suffering from malnutrition, and having difficulty standing or moving. Some said he had told them he was fed up with living, and that the medical system hadn’t done enough to treat his physical condition, which was life-threatening.

During the hearing last week, the court rejected the appeal from the Health Ministry and the prosecution, which had sought to launch criminal proceedings against the man for spreading a contagious disease. This proceeding would have allowed the authorities to continue to hold him in the prison. Magistrate’s Court Judge Tal Levy-Michaeli, relying on a Supreme Court decision in a similar case from 2015, ruled that the prison infirmary was not appropriate and an isolation room in a hospital must be prepared to forcibly hospitalize him.

The Justice Ministry official responsible for forced hospitalizations, attorney Daniel Raz, said, “This case illustrates the cost of the noncompliance with court instructions to set up a pulmonary isolation room under closed conditions.” Raz, one of the few people who had seen G. recently, added, “Unfortunately, not only was he not given any real medical treatment but an effort was made to take criminal action against him which, as noted, was rejected by the court. Let’s hope the state learns a lesson from the difficult circumstances of his death. Legal Aid together with the Public Defender’s Office has asked the court to order an investigation of the circumstances of his death.”

G.’s body was transferred for autopsy to the Institute for Forensic Medicine at Abu Kabir in Tel Aviv.

A native of Hungary who came to Israel in the late 1990s, he was admitted to the Prison Service infirmary in Ramle two weeks ago. He was forcibly hospitalized with the court’s permission, after he’d been in a hospital twice but left both times before completing treatment. Although he left the hospitals in a psychotic state, he wasn’t defined as dangerous, so he couldn’t be committed to a psychiatric hospital.

G.’s death raises questions about freedom of choice. He refused to take medication in the Prison Service facility. In cases of clear risk to the patient’s life, the Patient’s Rights Law allows for the convening of an ethics committee, which can order life-saving treatment against the patient’s wishes if three physicians sign the order, but this was not done in G.’s case.

“The question of how far a medical team has to go to save the life of a person who refuses treatment is complex, and the rules of ethics vary from situation to situation,” said Dr. Tami Karni, chairman of Israel Medical Association’s Ethics Committee. “The sanctity of life is of paramount value to physicians, but respecting a person’s will and autonomy over his body and his life is just as important, even in difficult situations. Since we don’t know what exactly caused his death, it’s hard to know if his life could have been saved.” She added, however, that any steps to forcibly treat him might have merely extended his suffering.

An acquaintance of G.’s said that G. was a Christian who had worked as a policeman guarding a Budapest synagogue. In 1998 he got a gift of a trip to Israel from the congregation, and that he fell in love with the country, converted and came to live here.

“It started as a success story; he worked in the Channel 2 scenery department and got married,” the friend said. However, he subsequently began drinking heavily, eventually losing his job and his wife. “Israeli and Hungarian friends tried to help him. They flew him back to Hungary, where he underwent rehab, and then he returned to Israel.” But his physical and mental state continued to deteriorate until he became homeless.

According to this source, friends visited him at Tel Aviv’s Ichilov Hospital in September to try to persuade him to accept treatment, but he fled the hospital. They tried to visit him in the Prison Service facility last week, but he refused to see them.