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According to the 1949 Geneva Conventions and their 1977 Additional Protocols, “medical personnel” are persons assigned exclusively to medical duties, whether such assignments are permanent or temporary. Such medical purposes include:
- the search for, collection, transportation, diagnosis, or treatment—including first aid treatment—of the wounded, sick, and shipwrecked;
- the prevention of disease;
- the management and administration of medical units or means of transportation.
Launching an intentional attack against medical personnel in the context of an international or non-international armed conflict is a war crime, punishable under international humanitarian law and international criminal law (Arts. 8.2.b.xxiv and 8.2.e.ii of the Rome Statute of the International Criminal Court). It also constitutes a grave breach to the Geneva Conventions when committed in the context of an international armed conflict.
The term also designates the persons assigned to medical units, which are structures such as hospitals and other similar units dedicated to the aforementioned medical purposes. It also covers the military and civilian medical personnel of a party to a conflict, the medical personnel of international relief organizations, and the one of civil defense organizations (API Art. 8).
In times of conflict, humanitarian law establishes a multitude of provisions aimed at protecting members of medical personnel in the exercise of their functions:
- They must be respected and protected at all times, in all circumstances (GCI Art. 24, GCII Art. 36, GCIV Art. 20, API Art. 15, and APII Art. 9).
- They are authorized to wear the distinctive emblem of the Red Cross and must take the necessary measures to be identifiable to the authorities (GCI Arts. 40, 41; GCII Art. 42; GCIV Art. 20; API Art. 18; and APII Art. 12).
- They come under the same protection regime as the civilian population (GCIV Arts. 27–141) but have additional rights so as to be able to accomplish their mission despite the conflict.
- Such personnel shall be given all necessary assistance in carrying out their functions and will not be compelled to carry out tasks that are not compatible with their missions (API Art. 15, APII Art. 9).
- No one may require that they give priority to any one or group of persons, except on medical grounds (API Art. 15, APII Art. 9). Overall, the requisition of medical installations, personnel, material, and transport should be avoided. Specific rules, dispersed throughout the Geneva Conventions and Protocols, limit the times when it is allowed (GCI Arts. 33–35, GCIV Art. 57, and API Art. 14). Such requisitions may only be carried out in temporary cases of emergency, by the occupying powers, and only after ensuring that the medical needs of the civilians, as well as those of the wounded and sick undergoing treatment who are affected by the requisition, continue to be met.
- They must have freedom of movement so as to be able to collect the sick and wounded. Parties to a conflict have the obligation to facilitate medical missions and may not hinder the activities of such personnel (GCIV Art. 56).
- Civilian medical personnel must have access to any place where their services are essential, subject to supervisory and safety measures that the relevant party to the conflict may deem necessary (API Art. 15).
- Parties to a conflict must give civilian medical personnel all available assistance in areas where their services are disrupted because of combat activity (API Art. 15).
- Medical personnel must be allowed access to the scene of a combat to search for and collect the wounded and sick. This provision exists in the case of both international and internal conflicts: “Whenever circumstances permit and particularly after an engagement, all possible measures shall be taken, without delay, to search for and collect the wounded, sick and shipwrecked, to protect them against pillage and ill-treatment, to ensure their adequate care, and to search for the dead, prevent their being despoiled, and decently dispose of them” (APII Art. 8, GCI Art. 15).
- In any situation of armed conflict, members of medical personnel may not be punished for activities carried out, no matter what the circumstances may have been and regardless of the person benefiting from their actions, as long as these were compatible with medical ethics. No one may ever be harassed for having collected and given care to wounded or sick persons (GCI Art. 18, API Art. 16, and APII Art. 10). This protection extends to civilians who may have spontaneously collected and cared for wounded and sick, no matter what the nationality of such persons (API Art. 17, APII Art. 18). This applies in both international and internal armed conflict.
- Medical personnel may not be compelled to carry out acts contrary to the rules of medical ethics or to breach doctor–patient privileged confidentiality (API Art. 16, APII Art. 10).
- Members of such personnel will not be considered as prisoners of war if they fall in the hands of the adversary. They must be freed, unless the number of prisoners of war and their state of health require the contrary, in which case the medical personnel must be given the facilities and rights necessary to ensure the respect for medical ethics (GCI Arts. 28, 29; GCII Art. 37; and GCIII Art. 33). Furthermore, if prisoners of war have medical expertise, they may be required to exercise medical function in the interest of other prisoners. In such cases, they have the same rights as the rest of the medical personnel (GCIII Art. 32).
- In occupied territory, the occupying power has the duty to ensure and maintain all medical activities and must allow medical personnel to accomplish their missions (GCIV Art. 56).
- Every place of internment must have an adequate infirmary. It is preferable for internees to have the attention of medical personnel of their own nationality (GCIV Art. 91).
Rule 25 of the rules of customary international humanitarian law published by the ICRC in 2005 affirms that “medical personnel exclusively assigned to medical duties must be respected and protected in all circumstances. They lose their protection if they commit, outside their humanitarian function, acts harmful to the enemy.”
Rule 26 provides that “punishing a person for performing medical duties compatible with medical ethics or compelling a person engaged in medical activities to perform acts contrary to medical ethics is prohibited.” Those rules are applicable in international and non-international armed conflicts.
For Additional Information: Amnesty International. Ethical Codes and Declarations Relevant to the Health Professions: An Amnesty International Compilation of Selected Ethical Texts . London: Amnesty International, 1994. Available at http://web.amnesty.org/pages/health-ethicsindex-eng .
Baccino-Astrada, Alma. Manual on the Rights and Duties of Medical Personnel in Armed Conflicts . Geneva: ICRC, 1982.
British Medical Association. The Medical Profession and Human Rights: Handbook for a Changing Agenda . London: Zed in association with BMA, 2001.
Henckaerts, Jean-Marie, and Louise Doswald-Beck, eds. Customary International Law . Vol. 1, The Rules . Cambridge: Cambridge University Press, 2005, esp. part 2, chap. 7.
ICRC. The Medical Profession and the Effects of Weapons . Geneva, 1996. Available at http://www.icrc.org/WEB/ENG/siteeng0.nsf/htmlall/p0668?OpenDocument&style=Custo_Final.4&View=defaultBody2 .
The act of intentionally directing attacks against medical services in the context of an armed conflict, whether international or internal, is considered a war crime under humanitarian law. It also falls under the jurisdiction of the International Criminal Court (Arts. 8.2.b.xxiv and 8.2.e.ii of ICC statute).