Shaare Zedek Medical Center director-general Prof. Ofer Merin is one of three doctors on a unique committee determining the death of hostages held in Gaza. (Courtesy of Shaare Zedek)
Shaare Zedek Medical Center director-general Prof. Ofer Merin. (Courtesy of Shaare Zedek)
Interview'There is a clear understanding that people need closure'

How an unprecedented medical committee determines when a hostage held in Gaza is dead

Prof. Ofer Merin explains how he and two colleagues have devised unique protocols for using visual and other intelligence information to decide whether a person is no longer alive

Renee Ghert-Zand is the health reporter and a feature writer for The Times of Israel.

Shaare Zedek Medical Center director-general Prof. Ofer Merin. (Courtesy of Shaare Zedek)

On October 7, Hamas kidnapped 240 people and dragged them to Gaza as part of the terror group’s savage attack on southern Israel, in which 1,200 people were slaughtered and more than 20 communities destroyed.

It is believed that 128 hostages remain in Gaza — not all of them alive — after 105 civilians were released from Hamas captivity during a weeklong truce in late November. Four hostages were released before that, and one was rescued by Israeli troops.

The Israel Defense Forces has confirmed the deaths of 21 hostages, with the bodies of only eight of them having been recovered by Israel. The bodies of three additional hostages — mistakenly killed by the military on December 15 in Shejaiya — have also been returned to Israel for burial.

The task of determining the death of hostages held in Gaza has fallen to an independent committee of three leading Israeli medical professionals. The existence of the committee only surfaced two weeks ago.

A week into the war, the Health Ministry appointed the head of its general medicine division Dr. Hagar Mizrahi, head of the National Center of Forensic Medicine Dr. Chen Kugel, and Shaare Zedek Medical Center’s director general Prof. Ofer Merin to this initially secretive group.

Since mid-October, the three have met for hours several times each week to painstakingly review information provided to them by the defense and intelligence communities regarding suspected deaths of particular hostages.

The doctors draw conclusions only when they have deliberated over and cross-referenced sufficient data to be able to medically and unanimously determine with absolute certainty that a captive is dead.

Inbar Haiman, taken captive by Hamas terrorists on October 7, 2023, from the Supernova desert rave. It was announced on December 16 that she was killed by Hamas in Gaza. (Courtesy)

“You don’t want to be knocking on a mother’s door and telling her that her son is dead, and then is found to be alive, even if critically wounded,” Merin told The Times of Israel in a recent interview.

When the committee makes its decision, it prepares a detailed report explaining how it reached its findings and gives it to the IDF Rabbinate in the case of a captive soldier. If the dead hostage was a civilian, the IDF Rabbinate and Israel’s Chief Rabbinate must sign off on it.

“We give the rabbis the protocol, which explains how we reached the determination of death, but it does not include the actual intelligence material we referred to,” Merin said.

The final step is for the IDF to notify the family, who decides when to notify the public through the media. Families, consulting with rabbinic authorities if they choose, also decide how they want to handle the burial and mourning process without a body present.

L-R: Staff Sgt. Tomer Yaakov Ahimas, Sgt. Kiril Brodski, and Sgt. Shaked Dahan. All three were abducted by Hamas and later declared dead. Their remains are still in Gaza. (Courtesy)

The Times of Israel sat down with Merin at his office at Shaare Zedek Medical Center in Jerusalem to ask him how it is to take on this incredibly difficult task, and how doctors sitting in central Israel can know for sure that a hostage in Gaza — whom they have not seen or touched in person — is no longer alive.

The following conversation was edited for length and limited to what Merin could say without violating national security.

The Times of Israel: Why did you agree to join this unique committee?

Prof. Ofer Merin: I’m realizing more and more why this committee is important. [The hostages’ families] are living now for more than 10 weeks without knowing what’s happening with their loved ones.

In these weeks, I learned the term “ambiguous loss.” It’s the continuous grief day after day of living with uncertainty, always with a slim hope that maybe their loved one is alive or just wounded or okay… There is a clear understanding that these people need the closure. If we know for sure that someone is dead, I think we’re doing right by these families by telling them.

Have you ever been in another situation where you witnessed families not knowing the fate of their loved ones for so long?

For the last 20 years, I have been the commander of the IDF’s field hospital, so I’ve been deployed in missions to numerous disaster areas around the world. In 2015 I was sent to Kathmandu to assist the Nepalese people dealing with a large-scale earthquake.

There were a lot of Israeli trekkers on the mountain, but almost all of them eventually turned up safe. However, Or Asraf did not come back. His father and friends came in and put up a tent in our field and took a chopper up into the Himalayas every day to look for him. Then they found his body after two weeks.

Or Asraf seen in the Himalayas. (Screen capture: Channel 2 via Facebook)

It was impossible to survive in the Himalayas in these conditions for two weeks, but his father still held out hope. I can clearly remember the importance of the look in the father’s eyes when he could say his son was dead and that he could have the closure of burying him. Living with grief — as painful as it was — was better than with ongoing uncertainty.

Were there any models for methodologies for determining the death of a person for whom you have visual and intelligence information, but no tissue or DNA evidence?

No, there were no models out there. This is a hostage-taking event unprecedented in scope and kind. The Red Cross has not accessed the hostages to report on their condition, and Hamas — although it took hostages to [presumably] use as bargaining chips — has given no numbers, names, and no information on which are alive and which are dead and what they want in return for them.

The bottom line is that we are faced with a unique situation.

Israeli Noa Argamani is seen being kidnapped by Hamas terrorists during the massacre of the Supernova desert rave in the south on October 7, 2023. (Screenshot used in accordance with clause 27a of the copyright law)

So what information and criteria are you using to determine a hostage’s death if you can’t examine the body or biological samples?

First of all, we know that people were dragged to Gaza by Hamas either physically unharmed, injured, or already dead.

Some of the initial materials we worked with were videos from inside Israel, such as footage from security cameras from kibbutzim and villages… If a person who was shot is seen lying on the ground in the same exact spot showing no movement at the 7 a.m. mark, at 9 a.m., at 11 a.m., and at 1 p.m., and is then seen being thrown into a car, you can make some conclusions.

We also have videos of GoPro cameras that the terrorists strapped to themselves to document the atrocities they were committing on October 7.

So is this enough to determine a person’s death?

No. I think it would be easier if I explained to you what would not make us say a person is dead: First of all, we make decisions about death based on at least two sources of information — never only on one. So for instance, a video such as the one I just used as an example would not be enough.

We will never rely on still photographs, which can be altered. We will also never rely on any information or material disseminated by Hamas.

An armed Hamas terrorist leads a man at the Supernova music festival, near Kibbutz Re’im in the Negev desert in southern Israel on October 7, where terrorists from Gaza massacred hundreds of people. (SOUTH FIRST RESPONDERS / AFP)

We will not determine that a person is dead based on evidence that they were severely wounded when they were dragged to Gaza. We have no way of knowing whether, when, or even if they received medical treatment. We don’t know the quality of the treatment and whether they survived or not.

Finally, we will not rely on hearsay, including what released hostages report of their experiences in Gaza. There was a case where a returned hostage said she was in a medical place and next to her there was a hostage who was alive, but the next day he wasn’t. We will not go on something like this.

Okay, so you can rely on evidence from within Israel from October 7. But where is the additional information from and how can it be characterized?

It’s from outside Israel. That’s all I can say. Israel is putting huge efforts into getting information about every single person who is in Gaza. As the information comes in, we are given it for evaluation.

So how is Israel getting good quality material that you as doctors can work with and make decisions you are 100% sure of?

Again, I can’t give you details, but I can promise you that we don’t have camera people sitting and filming at the opening of tunnels where hostages are being held. It would be a different story [in terms of the hostages’ situation] if we did. So we’re exposed to other information.

Sahar Baruch was taken captive by Hamas terrorists on October 7, 2023, from Kibbutz Be’eri. It was determined that he was murdered by Hamas in Gaza. (Courtesy)

Are you determining the specific cause of death?

Yes, we try to determine the cause of death. This is one of our rules. It gives us more confidence in deciding that a hostage is dead.

Is there something from what you learned about hostages’ deaths that sheds light on the health of the remaining hostages, who we hope are still alive?

It’s difficult to say. The hostages are being held in different places, in different conditions, and with different medical histories.

Is there a Jewish value or teaching that resonates for you as you do the work of this committee?

There is a Jewish teaching that one of the greatest joys that a person can experience in life is that of resolving doubts. If we have a way to provide that level of comfort to a family in their time of pain, then that is what we need to be doing.

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