In February 2025 two NSW nurses, Ahmad Rashad Nadir and Sarah Abu Lebdeh, had their registration suspended (effective 13 February 2025) after a video recording emerged in which they threatened harm to Israeli patients at the hospital where they worked.

The video recording was posted by Israeli influencer Max Veifer’s, the content creator, who had interviewed the pair. During the interview the nurses bragged about refusing to care for Israeli patients, with Lebdeh stating ‘I won’t treat them. I’ll kill them’ and Nadir concurring, explaining ‘You have no idea how many Israeli dog[s] came to this hospital, and I send them to Jahannam [hell]’.¹

Appalled by reports on the content of the video, the Australian Nursing and Midwifery Federation (ANMF) was swift to respond with media releases stating in unequivocal terms that the kind of hate expressed by the nurses was ‘simply unacceptable and cannot be tolerated’ and had no place in either the nursing and midwifery professions, the health care system or the country.² It reaffirmed its longstanding position:

“We know health and peace are deeply connected – one cannot exist without the other. Through our commitment to care, compassion, and justice, we continue to uphold these values and stand against all forms of violence, hatred, and discrimination. Our strength lies in our unity, and we must always uphold the principles of respect, kindness, and understanding toward one another regardless of background, faith, or identity.³“

Betrayal of trust

The nurses’ utterances in this case constitute a profound violation of the fundamental values of the nursing profession. What makes the nurses utterances so egregious, however, is not that they ‘merely’ breached their codes of ethical professional conduct or policy guidelines on the use of social media. Rather, it is because their hateful utterances betrayed and brought into question the very trustworthiness of the nursing profession itself and the institutions in which nurses practice.

The ripple effect of these nurses’ conduct has the capacity to reverberate well beyond the walls of the hospital in which they worked. Especially worrying is the potential for their hate speech to feed into conspirative narratives, the main purpose of which is to undermine trust in the very public institutions – in this case hospitals – that have been designed to provide citizens with a sense of security and safety and to generally promote the public good. This helps to explain why trust violations are so serious in the context of healthcare.

The question remains, however, of why undermining trust in the nursing profession matters, and what, if anything, can be done to restore it?

The importance of trust

Trust has long been regarded as the cornerstone of the helping relationship and as providing the necessary foundation for the delivery of safe, effective and appropriate nursing care.⁴ It is generally agreed that trust encompasses three key attributes: vulnerability (encompassing the need to rely on others when vulnerable), expectations (encompassing the belief and hope that others being relied on will do and behave as expected), and care (encompassing the expectations and confidence that the ‘moral interests, safety and well-being of the trusting person will be treated as paramount by those in whom they have invested their trust’.^4(p.761)  

Trust has particular significance in the case of vulnerability. This is because trust is inseparable from vulnerability since there is no need for trust in the absence of vulnerability.⁵ When trust is violated, people’s sense of safety and security is undermined. This in turn leads to distrust, prompting people to cultivate preferences and behaviours aimed at avoiding vulnerable situations.⁶ Violating trust in healthcare institutions thus risks people avoiding such institutions and the necessary care and treatment that would otherwise have been available to them.

Restoring trust

Over the past two decades public opinion polls have voted nurses the most trusted and honest profession. The intractable act of hate speech by the two NSW nurses referred to above risks irrevocable damage to the profession’s good standing and reputation in the eyes of the public, with consequences to the public’s health. Just what can be done to restore the trust that has been damaged remains an open question.

In keeping with the disciplinary measures that can be imposed when nurses violate expected standards of care, as noted earlier, Nadir and Lebdeh have both had their registration suspended by the Australian Health practitioner Regulation Agency (AHPRA). Meanwhile, although police have found no evidence that anyone at the hospital has been harmed by the nurses, Sarah Abu Lebdeh has since been charged with three indictable commonwealth offences under the Criminal Code Act 1995 (notably threatening violence to a group, using a carriage [communication] service to threaten to kill, and using a carriage [communication] service to menace/harass/offend). Restoring trust, however, and overcoming the burden of betrayal that the nursing profession is carrying at this time, will require much more than discipline and punishment. It will also require deep reflection on the part of both the profession and the public it serves about what it means to be living in a time when old certainties are shifting and where identifying the ‘right’ course of action to take on difficult issues – on how best to take a stand, without taking sides – poses complex challenges that are fraught with fear and even danger. As argued previously in this Journal,

Deciding a right course of action can be especially difficult in contexts where a clear-eyed view of the world is muddied by populist opinion and personal dogma masquerading as ‘fact’. In this new era of shameless populism, ‘fake news’, and post-truth politics, it is perhaps time for the nursing profession to bring a new scrutiny to its system of ethics and its ability to equip nurses with the capacities they need to achieve the moral ends of nursing.^7(p.19)

As harrowing as this case of hate speech is, it may also serve as a timely wake-up call to re-evaluate how well members of the nursing profession are prepared to uphold the norms and values of the profession, to respond effectively to unconscionable conduct by co-workers if and when it occurs, and to engage in the positive project of preventive ethics to ensure that the highest standards of care expected by members of the public will be delivered without prejudice and in a manner that is cognisant of their vulnerability as human beings.

Meanwhile, it is incumbent on all nurses to call out conduct that besmirches the individuals, groups and communities it serves and join with others in taking a stand for peace and reaffirming the profession’s longstanding commitment to care, compassion, and justice.

References

1. McKinnell J. Longer video released of Sydney nurses bragging about killing Israeli patients, police await unedited version. ABC News online; 2025 [cited 26 Feb 2025]. Available from: https://www.abc.net.au/news/2025-02-14/longer-video-sydney-bankstown-hospital-nurses-israeli-creator/104928962
2. Australian Nursing and Midwifery Federation (ANMF) ANMF statement on NSW Hospital antisemitic video (Media release 13 Feb); 2025a [cited 26 Feb 2025]. Available from: https://newshub.medianet.com.au/2025/02/anmf-statement-on-nsw-hospital-antisemitic-video/87324/
3. Australian Nursing and Midwifery Federation (ANMF) Message from the Australian Nursing and Midwifery Federation: Standing together against hate speech; 2025b [cited 26 Feb 2025]. Available from: https://www.anmf.org.au/media-campaigns/media-releases/message-from-the-australian-nursing-and-midwifery-federation-standing-together-against-hate-speech/
4. Johnstone MJ, Rawson H, Hutchinson AM, Redley B. Fostering trusting relationships with older immigrants hospitalised for end-of-life care. Nursing ethics. 2018; 25(6):760-72
5. Hall MA, Dugan E, Zheng B, Mishra AK. Trust in physicians and medical institutions: what is it, can it be measured, and does it matter?. The Milbank Quarterly. 2001 Dec;79(4):613-39
6. Van Prooijen JW, Spadaro G, Wang H. Suspicion of institutions: How distrust and conspiracy theories deteriorate social relationships. Current opinion in psychology. 2022 Feb 1;43:65-9
7. Johnstone M-J. Is nursing ethics good enough?. Australian Nursing and Midwifery Journal. 2017 Sep;25(3):19
   
   

Professor Megan-Jane Johnstone AO is Adjunct professor in the School of Nursing and Midwifery, La Trobe University, Melbourne. She is also the author of the widely acclaimed text Bioethics: a nursing perspective, 8^th revised edition.