US Secretary of State Antony Blinken said Wednesday that Israel must decide if its military campaign in Gaza is worth the cost in civilian lives.

Coming just days after an Israeli strike killed dozens of displaced Palestinians in Rafah, Blinken said Israel should ask itself whether “incremental gains” against Hamas “stack up against” the “unintended horrific” consequences of military action.

Israel “has to ask whether, and especially in the absence of a plan for the day after in Gaza, further incremental gains against Hamas, but gains that may not be durable, in terms of Hamas’s defeat, in the absence of the plan, how that stacks up against some of the, again unintended, horrific consequences of military action in a place where the people you’re going after are so closely embedded with civilians,” Blinken said during a news conference in Moldova.

Though the Biden administration has been urging Israel to do more to protect civilians in the war against Hamas for months, Blinken’s remarks were some of the most pointed he’s made to date. However, the US has not gone as far as allies like France in condemning the Rafah strike, with the White House making clear it believes Israel has not crossed a red line that would lead the US to withdraw military support.

Blinken called the scenes from the weekend “horrific,” reiterating Biden administration calls for Israel to investigate how the Rafah attack led to so many civilian deaths.

“I don’t think anyone who has seen the images cannot be deeply affected by just on a basic human level. We have been very clear with Israel and the imperative and this is as in other instances, to immediately investigate and determine exactly what happened and why it happened,” Blinken said.

Blinken said he could not say which weapons were used in the strike, though a CNN analysis suggests US-made munitions were used. Israel has said the resulting fire was not caused solely by weapons it used in the strike and that it is trying to determine whether it was set off by a nearby weapons stockpile.

“We’ve heard from the Israelis, but again, absent a completed investigation, I can’t verify any of this, that small-diameter weapons were used in a targeted fashion to go after specific terrorist leaders of Hamas,” Blinken said. “Again, I can’t vouch for that at this moment. We have to see what the investigation shows.”

Blinken said that even if one takes what Israel is saying at face value, the Rafah attack reveals that even targeted strikes can have awful consequencs.

“I think we also see that even limited, focused, targeted attacks, designed to deal with terrorists who killed innocent civilians that are plotting to kill more, even those kinds of operations can have terrible, horrific, unintended consequences,” he said.

On Tuesday, White House National Security Council spokesman John Kirby called on Israel to take precautions to protect civilian lives and warned there was a danger in Israel becoming more isolated from its traditional allies, though he asserted there were no indications yet that it had waged a military campaign that would prompt President Joe Biden to withhold aid or weapons.

“As a result of this strike on Sunday, I have no policy changes to speak to. It just happened,” Kirby told reporters at the White House. “The Israelis are going to investigate it. We’re going to be taking great interest in what they find in that investigation. And we’ll see where it goes from there.”

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