Since Israel launched its assault on the Gaza Strip, we have witnessed relentless human suffering and loss of life on a scale unimaginable just months prior. Entire cities bombed and razed, with scarcely a house left standing; hundreds of thousands torn from their lives, roaming dusty roads like human shadows, with what little they could take on their backs, searching for temporary shelter; adults and children jostling in endless lines for a little food, risking life and limb for the chance to feed their starving families; and above all, death looming everywhere. This is a human catastrophe being broadcast live from the inferno. Genocide goes beyond the horrific harm to its direct victims. It is an assault on humanity itself: on the fundamental belief that every life is precious, and the core principle that every human being is entitled to basic rights affording protection from arbitrary violence. History shows that attempting to eradicate a group of human beings is a crime with catastrophic consequences — a crime that every person has the duty to oppose and act to stop immediately. This is a moral, legal, and human imperative: to acknowledge the facts, call them by name, stand with the victims, and demand an end to destruction and extermination while they unfold.

The review presented in this report leaves no room for doubt: since October 2023, the Israeli regime has been responsible for carrying out genocide against the Palestinians in the Gaza Strip. Killing tens of thousands of people; causing bodily or mental harm to hundreds of thousands more; destroying homes and civilian infrastructure on a massive scale; starvation, displacement, and denying humanitarian aid — all this is being perpetrated systematically, as part of a coordinated attack aimed at annihilating all facets of life in the Gaza Strip. Moreover, Israel’s decision to continue this assault despite countless warnings and ample evidence of its deadly consequences, combined with repeated public clarifications by Israeli policymakers that the target is the entire population of Gaza, demonstrate the intent of Israel’s political and military leadership to irreversibly destroy Palestinian life in the Gaza Strip.

While genocide is underway in the Gaza Strip, the Israeli regime is leading an assault on the Palestinian population in the West Bank and a policy of egregious rights violations against Palestinian citizens of Israel. The form and extent of these actions may vary across the different areas under Israel’s control, but they are rooted in the same underlying logic: denial of Palestinian humanity. In a process beginning with the establishment of the State of Israel in 1948 and expedited after the criminal Hamas attack on 7 October 2023, the lives and dignity of Palestinians have come to be regarded as disposable by most Jewish-Israelis, and violence against them normalized.

The routine killing and destruction in the Gaza Strip and the forced displacement of tens of thousands in the West Bank would not have been possible without international inaction in the face of the unfathomable scale and severity of these crimes. Most of these crimes have been extensively documented and made public throughout almost two years of war. Yet many state leaders, particularly in Europe and the United States, have not only refrained from effective action to stop the genocide but enabled it — through statements affirming Israel’s “right to self-defense” or active support, including the shipment of weapons and ammunition. Even after the International Court of Justice ruled there is plausible risk that Israel’s actions amount to genocidal acts, and even after the International Criminal Court issued arrest warrants for Prime Minister Netanyahu and then-Defense Minister Gallant on suspicion of war crimes and crimes against humanity, the international community failed to bring these actions to an immediate halt and hold those responsible to account.

The genocidal nature of Israel’s actions in the Gaza Strip and the international community’s failure to prevent them will not only affect Israel’s future conduct toward the Palestinian people. They are also likely to reshape norms of conduct in international relations and the protection of human rights around the world. Trampling fundamental principles of international law underfoot, and blatantly disregarding the moral norms that shaped the post-WWII world order, may turn the use of indiscriminate lethal force and deliberate targeting of civilians into the starting point in the conduct of future violent conflicts. Confronting the immense destruction and moral disintegration requires not only acknowledging the crimes but also commitment to action and to accountability — both international and domestic. We acknowledge that rebuilding after such devastation will be a long and arduous task that will require a fundamental shift in the foundations of the88Conclusion Israeli regime. This change is essential also because the Israeli regime, which has stripped every moral value and obligation of meaning, is a danger to all people under its rule. Therefore, everything must be done to prevent it from claiming more victims.

In the immediate term, the recognition that the Israeli regime is committing genocide in the Gaza Strip and the deep concern that it may expand to other areas where Palestinians live under Israeli rule demand urgent and unequivocal action from both Israeli society and the international community.

This is the time to act. This is the time to save those who have not yet been lost forever, and use every means available under international law to stop Israel’s genocide of the Palestinians.

Physicians for Human Rights Israel (PHRI) presents this health-focused legal analysis of Israel’s military campaign in Gaza since October 2023, concluding that it constitutes genocide under the 1948 Genocide Convention. The evidence shows a deliberate and systematic dismantling of Gaza’s health and life-sustaining systems - through targeted attacks on hospitals, obstruction of medical aid and evacuations, and the killing and detention of healthcare personnel.

Over a 22-month period, Israel’s actions have destroyed Gaza’s healthcare infrastructure in a manner that is both calculated and systematic. The chronology of attacks reveals a deliberate progression: beginning with the bombing and forced evacuation of hospitals in northern Gaza, the health system’s collapse extended southward as displaced populations overwhelmed remaining facilities, which were then subjected to further bombardment, siege, and resource deprivation. Gaza’s health system has been systematically dismantled - its hospitals rendered non-functional, medical evacuations blocked, and essential services like trauma care, surgery, dialysis, and maternal health eliminated. The killing and detention of over 1,800 healthcare workers, including many senior specialists, has decimated Gaza’s medical capacity and rendered recovery nearly impossible. Humanitarian relief has been deliberately restricted, forcing civilians to approach militarized distribution points that have often become sites of mass killings. This coordinated assault has produced a cascading failure of health and humanitarian infrastructure, compounded by policies leading to starvation, disease, and the breakdown of sanitation, housing, and education systems.

This paper also addresses evidence of mass killing and widespread harm. As of mid-2025, over 57,000 Palestinians - primarily women and children - have been confirmed killed, with estimates nearing 100,000 when indirect deaths are included. Tens of thousands have been injured, including thousands of amputees and individuals requiring long-term care that is unavailable due to the collapsed health system. Gaza residents who have been detained and held in Israeli facilities6 report systematic torture, medical neglect, and degrading treatment, contributing to both physical and psychological harm. Children face psychological trauma, while women endure sharp increases in miscarriages, preterm births, and maternal mortality amid famine and lack of reproductive healthcare services.

PHRI concludes that these acts are not incidental to war, but rather part of a deliberate policy targeting Palestinians as a group. They fulfill at least three core acts defined in Article II of the Genocide Convention: (a) killing members of the group; (b) causing serious bodily or mental harm to members of the group; and © deliberately inflicting on the group conditions of life calculated to bring about its destruction in whole or in part.

Despite international legal rulings, Israel has not complied with its obligations, and global enforcement remains weak. PHRI urges international bodies and states to fulfill their duty under Article I of the Genocide Convention to stop the Gaza genocide. The organization also calls on the global health and humanitarian communities to act, as the destruction of Gaza’s health system is not only a legal violation but a humanitarian catastrophe demanding urgent global solidarity and response.