On Tuesday night, after two weeks of constant bombardment that killed dozens of doctors, patients and refugees, Israeli forces entered Al-Shifa hospital and raised the Israeli flag over it.

Just hours before, White House Press Secretary Karine Jean-Pierre asserted that “Hamas and the Palestinian Islamic Jihad use some hospitals in the Gaza Strip, including Al-Shifa, and tunnels underneath them to conceal and to support their military operations and to hold hostages.”

The US media went even further, with Fox News describing Al-Shifa as a “hospital used as Hamas underground terror HQ.”

These claims proved to be a complete lie. The Israel Defense Forces (IDF) produced no hostages, no underground bunker. After searching a sprawling hospital complex that at one point housed 60,000 people in the middle of an active war zone, the IDF could only show a few assault rifles and two flak jackets as “evidence.”

The real reason Al-Shifa was attacked was symbolic. The hospital’s medical workers, subject to continuous bombardment and sniper fire, defied orders by the IDF to leave, saying they would rather die than abandon their patients. Their courage and defiance in the face of Israel’s genocide won the solidarity and support of millions of people all over the world.

The First and Second Geneva Conventions of 1949 stipulate that hospitals and other medical units must not be attacked and should be protected at all times. This includes civilian and military hospitals. Attacking hospitals and medical personnel is a war crime under international criminal law.

In the face of emphatic declarations by the United Nations, the World Health Organization (WHO), and countless human rights organizations that hospitals are “not a target,” Israel and its imperialist backers are sending a different message: Yes, they are.

While the US repeatedly attacked hospitals during the “war on terror,” it sought to present these actions as accidents. In October 2015, a US airstrike killed at least 22 people in a Doctors Without Borders (MSF) hospital in Kunduz, Afghanistan. At the time, US President Barack Obama issued an apology, claiming the strike was a “mistake.”

Now, however, the United States is upholding attacks on hospitals and other war crimes as legitimate acts of “self defense.” As US officials have repeatedly declared in response to Israeli massacres at hospitals in Gaza, there are no “red lines.”

Since the start of Israel’s assault on Gaza, the WHO has recorded at least 137 attacks on healthcare facilities, resulting in 521 deaths and 686 injuries, including 16 deaths and 38 injuries of health workers.

These statistics do not include the most horrific attack on a hospital, the October 17, 2023 Al-Ahli Arab Hospital bombing that killed between 250 and 471 people, but which Israel and the United States, citing evidence that was quickly disproven, claimed was the result of a rocket fired from Gaza.

Israel’s war on hospitals is part of a systematic campaign of genocide. The deliberate targeting of civilian populations, children, medical workers and aid workers has been elevated to a governing principle.

These war crimes have been carried out within the framework of public declarations of genocidal intent, with Israel’s agriculture minister proclaiming “Nakba 2023,” and its interior minister proposing the expulsion of the Palestinian people from the enclave.

Israel’s actions in Gaza are a “textbook case of genocide,” wrote Craig Mokhiber, former director of the New York office of the United Nations High Commissioner for Human Rights, in an October 28 resignation letter. “Explicit statements of intent by leaders in the Israeli government and military leaves no room for doubt or debate,” he wrote.

While the United States has for decades systematically violated international law, its open embrace of Israel’s actions against the people of Gaza under conditions in which Israeli officials are bluntly stating their intention to commit war crimes and genocide marks a significant new stage in the normalization of war crimes.

Throughout the past 50 years, actions by the state of Israel have been used to set a precedent for US policy. The most significant example is the doctrine of “targeted killing,” that is, state-sanctioned assassination. “Israel has used assassination and targeted-killing more than any other country in the West,” noted Israeli investigative journalist Ronen Bergman in 2018.

On September 17, 1948, a group of Zionist terrorists ambushed and killed the Swedish mediator for the United Nations, Count Folke Bernadotte, in Jerusalem. Yitzhak Shamir, who later became prime minister of Israel, played a role in the approval and planning of Bernadotte’s assassination.

In November 2000, Israel became the first state in the world to “openly acknowledge that it operated a policy of targeted killing,” wrote Nils Melzer, who served as United Nations Special Rapporteur on Torture, in 2009. Soon after, the United States moved “to openly adopt the method of targeted killing.”

“The term ‘targeted killing,’” writes Melzer, “denotes the use of lethal force attributable to a subject of international law with the intent, premeditation and deliberation to kill individually selected persons who are not in the physical custody of those targeting them.”

The US conducted its first known drone strike outside a war zone in Yemen in 2002. In 2011, US-born cleric Anwar al-Awlaki and his son, both US citizens, were killed in separate drone strikes in Yemen. In 2020, a US drone strike in Iraq killed Qasem Soleimani, a high-ranking Iranian military official, while on an official visit to Iraq.

As with the adoption of “targeted killing,” the war crimes now being committed by Israel will become the new baseline for even greater crimes by the United States and other imperialist powers. This is the significance of their open acceptance of Israel’s genocide and war crimes.

The US is engaged in escalating global warfare—an intensifying war against Russia, preparations for war with Iran and China—which will require violence on an unprecedented scale. The crimes Israel is perpetrating, including the mass murder and forced displacement of an entire population, are setting a precedent for the use of homicidal violence, including the use of nuclear weapons. The ruling classes aim to desensitize the population to the prospect of hundreds of thousands, or even millions, being killed.

But the war abroad is a war at home. Facing a mounting strike movement and mass protests against the slaughter in Gaza, the American ruling class will increasingly use the tools of mass terror against urban populations, being pioneered in Gaza, against mounting internal opposition.

The events in Gaza are a warning: The imperialist ruling classes, desperate and cornered, will stop at nothing to secure their global interests, including mass murder. The future of humanity requires breaking the stranglehold of the financial oligarchy over society, which requires the building of a mass socialist movement of the working class.