To the Editor:
In their article about the psychological effects of terrorist attacks in Israel, Dr Bleich and colleagues1 did not develop a meaningful definition of "terrorism." Thus, they reduced a complex situation to an ambiguous general term. The use of words such as "terror" and "terrorist" is prejudicial to scientific inquiry. Such language serves a political point of view, not the needs of medicine or public health.
For instance, the authors stated that "For the purpose of this study a ‘terrorist attack' was operationally defined as any armed attack by a self-proclaimed terrorist group, as categorized by the Israel Defense Forces." We believe that this definition is flawed for 2 reasons. First, any organization involved in promulgating violence against civilians, whether state violence or violence by nonstate groups, would rarely describe itself as "terrorist."
Second, using the Israeli army's categories of what constitutes a terrorist group is hardly an objective approach. The Israeli army routinely describes armed attacks against its soldiers in the West Bank and Gaza as terror attacks.2 Palestinians who attack Israelis would consider themselves organizations trying to resist Israel's occupation of their homeland. The oft-repeated statement that one person's terrorist is another person's freedom fighter seems particularly germane here.
At a minimum, the authors should have used a more neutral term such as "violence against civilians." Furthermore, they could have attempted to discuss how actions by the state of Israel, such as the demolition of more than 8000 Palestinian homes since the beginning of the occupation of the West Bank and the Gaza Strip in 1967,3 are impacting the Palestinian population. Since the start of the second intifada, the Palestinian population has experienced a death/murder rate of approximately 84/100 000,4 compared with 14/100 000 in Israel.5
Hence, other less biased and more inclusive research questions are possible. For example, the authors' research question might be reformulated as "How does the occupation of one country by another effect the populations of both lands in regard to violence against civilians?"
Robert Lipton, PhD
Prevention Research Center
Jess H. Ghannam, PhD
Department of Psychiatry
University of California, San Francisco/Mount Zion Medical Center
Joel Beinin, PhD
Department of History
Palo Alto, Calif
1. Bleich A, Gelkopf M, Solomon Z. Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. JAMA. 2003;290:612-620. ABSTRACT/FULL TEXT
2. Israel Defense Force Web site. Available at: http://www.idf.il
. Accessed August 25, 2003.
3. Israeli Committee Against House Demolitions Web site. Available at: http://www.icahd.org/eng/faq.asp?menu
= 9&submenu = 1. Accessibility verified October 9, 2003.
4. Palestinian Red Crescent Society Web site. Available at: http://www.palestinercs.org/intifadasummary.htm
. Accessed August 25th, 2003.
5. Israel Ministry of Foreign Affairs. Victims of Palestinian violence and terrorism since September 2000. Available at: http://www.israel.org/mfa/go.asp?MFAH0ia50
. Accessed August 25, 2003.