Shawki Harb, the last Palestinian heart surgeon on the West Bank, agonized before finally deciding yesterday to address a symposium here on the problems of running a hospital under a labyrinth of restrictions imposed by occupying Israeli authorities.

What will happen to heart patients on the West Bank, he fretted, if the Israelis decide to deport him because of his remarks when he returns home?

Munther Salah, a tall, taciturn mathematician and West Bank university president confronted no such dilemma. The Israeli military government on the West Bank expelled him last month for refusing to sign a pledge not to provide assistance to the Palestine Liberation Organization -- a pledge Secretary of State George P. Shultz assailed last week as an infringement on academic freedom. Israel said there was no basis for such concern and that the declaration was similar to ones U.S. authorities require of foreign visitors. It subsequently reformulated the effort to exclude PLO activists.

Harb, Salah and 17 other West Bank Palestinians, including professors, businessmen, journalists, and two elected mayors expelled by the Israeli military government, were here for a symposium Monday and Tuesday sponsored by American University's Center for Mediterranean Studies.

In an interfaith chapel on the university campus that is named for the late Abraham S. Kay, a Washington-area builder who was active in raising funds for Israel, the Palestinians discussed their 15 years of occupation. Hopeful about the promise of President Reagan's Middle East peace initiative, they debated their possibilities in an uncertain future.

Most hold advanced degrees from American universities. Conference organizers said it was the largest such gathering by West Bank Arabs ever held outside the West Bank. They said that would not have been permitted in the occupied territories.

But even here, there were some awkward moments. Rita Giacaman, a pharmacy professor at Bir Zeit University, was one of a group of Arabs who work on the West Bank that quickly darted from a hotel suite after being interviewed by two reporters. They feared that if they were in the same room with the two expelled West Bank mayors, who were to be interviewed next, they might run afoul of military government orders that seemed to forbid such contacts.

"There's fear," said American University sociology department chairman Samih Farsoun, who organized the conference. "Something that the Americans don't quite understand is that this is one of the longest occupations and it's a heavy-handed and aggressive occupation."

The Israeli Embassy, in a statement issued in response to Shultz's criticisms about the anti-POL pledge, said its government has established in the West Bank and Gaza Strip the "most liberal military administration ever instituted in any country."

Late on Tuesday, Shultz met with the two mayors, Fahd Kawasme of Hebron and Mohammed Milhem of Halhoul, who were expelled from the West Bank two years ago in a crackdown following an ambush in which five Jewish settlers were killed.

The two mayors had met with PLO chairman Yasser Arafat before coming to the United States. They said he had spoken of the "encouraging signs" in Reagan's Sept. 1 peace initiative which proposed negotiations between Jordan and Israel to establish a West Bank authority elected by Palestinians. Reagan also called for a freeze on Jewish settlements in the occupied Arab territories.

The mayors said they told Shultz they had no problems with a demilitarized Gaza and West Bank in any plan for a Palestinian homeland. While they insisted on a separate Palestinian state with its own flag and passport, they said they could agree to some kind of a "confederation" arrangement with Jordan as suggested by the Reagan initiative.

They were adamant in their opposition to having Jordan serve as a surrogate for the Palestinians in peace negotiations. Although they insisted that the PLO is the sole legitimate representative of Palestinians, they did not insist that the PLO had to sit at the negotiating table. Rather, they said, other Palestinians, acceptable to the PLO, could.

At the symposium, Harb talked for the long procedures he said Israeli authorities require him to follow to get new equipment for his hospital. He was rebuked, he said, when he collected contributions and bought kidney dialysis machines without first informing them.

Ibrahim Matar, an economist, spoke of the rapid development of Jewish settlements on the West Bank, which was not slowed by Reagan's call for a freeze.

But if there were laments, complaints and apprehension, there was also a feeling that the siege of Lebanon and the massacres in West Beirut had focused international attention on them.

In a speech Monday night, Edward Said, a Columbia University professor and one of four American members of the PLO's parliament-in-exile, said that before the Israeli invasion of Lebanon, Palestinians were merely "a collectivity without any particular distinction."

Now, he said, "for the first time in our history, we can see ourselves acting on the same world stage as our oppressors, suppressed but not in fact eliminated by them."