Medical Care

The rules on medical care lie at the heart of modern IHL since the adoption of the first-ever Geneva Convention in 1864, and apply to all types of armed conflict. The over-arching principle of protection and care has two facets.

Protection of the sick and wounded

A first set of rules relates to the beneficiaries of medical care in armed conflict. The sick and wounded must be protected and respected irrespective of their status,¹ provided that they refrain from any act of hostility.² Thus, parties to an armed conflict must exercise due diligence to protect the sick and wounded by preventing them from being harmed by others or by natural causes; this includes the obligation to search for them and to collect them to ensure their adequate care.³Once in the power of a party to the conflict, the wounded and sick must be respected and treated humanely and must receive, to the fullest extent practicable and with the least possible delay, the medical care and attention required by their condition, without any adverse distinction on any ground other than medical.⁴ Attacking and ill-treating the wounded and sick are strictly prohibited.⁵ Furthermore, medical personnel can neither be compelled to disclose information about the persons under their care, nor be punished for refusing to give such information.⁶ Finally, when the needs of the wounded and sick are not being met, impartial humanitarian organizations may offer their services, subject to the consent of the relevant authorities, who cannot arbitrarily withhold it.⁷

Protection of medical units, transports and personnel

A second set of rules relates to those persons and objects performing medical care, without whom the treatment of the sick and wounded would not be possible and which are therefore protected in a functional capacity. The obligations of parties to an armed conflict extend far beyond the obligation not to attack medical units, transports and personnel analysed above. Under the obligation to respect, medical units and transports must be allowed to carry out their work without any interference to their functionality: this entails the prohibition on blocking supplies that would make the treatment of wounded and sick impossible. ⁸ Furthermore, fixed medical units and their personnel must be allowed to pursue their medical duties when they fall in the hands of the adverse party,⁹ while mobile medical units, objects and transports may only be requisitioned if particular conditions are met.¹⁰

Correspondingly, medical personnel¹¹ must be protected and respected in all circumstances.¹² Medical personnel, however, are required to provide care without adverse distinction while respecting medical ethics, ¹³ and must be granted all available help for the performance of their duties.¹⁴They cannot be punished for carrying out their medical activities, regardless of who benefits from the care, nor forced to carry out tasks incompatible with their humanitarian mission or contrary to the rules or medical ethics.¹⁵

In order to ensure that medical units, transports and personnel are identified as benefiting from the protection to which they are entitled, the distinctive emblem of the red cross, the red crescent or the red crystal should be displayed.¹⁶

1
Art 12(1) GC I; Art 12 GC II; Art 16 GC III; Art 7 AP II
2
Art 8(a) AP I; ICRC, Updated Commentary on GC I, 2016, para 1344
3
Art 15(1) GC I; Art 8 AP II; ICRC, Customary IHL Rule 109: ‘Search For, Collection and Evacuation of the Wounded, Sick and Shipwrecked’, https://ihl-databases.icrc.org/en/customary-ihl/v1/rule109. There are slight differences if the combat is occurring on land (in which case the obligation to search for and collect is present at all times) and if the combat is at sea (when the obligation only arises after the engagement): see Art 15(1) GC I and Art 18(1) GC II, respectively
4
Art 12 GC I; Art 12 GC II; Common Art 3 to the Geneva Conventions; Art 10 AP I; Art 7(2) AP II; ICRC, Customary IHL Rule 110: ‘Treatment and Care of the Wounded, Sick and Shipwrecked’, https://ihl-databases.icrc.org/en/customary-ihl/v1/rule110
5
Art 12 GC I; Art 12 GC II; Art 11 AP I; Art 7(1) AP II
6
Art 16(3) AP I; Arts 10(3)–(4) AP II
7
Common Art 3(2) to the Geneva Conventions
8
Y. Sandoz et al, Commentary on the Additional Protocols of 8 June 1977 to the Geneva Conventions of 12 August 1949, ICRC, 1986, para 517
9
Art 19(1) GC I
10
Arts 33 and 35 GC I; Art 57 GC IV; Art 14 AP I
11
Art 8(c) AP I
12
Art 24 GC I; Art 36 GC II; Art 20 GC IV; Art 15 AP I; Art 9(1) AP II
13
Art 40 GC I; Art 16 AP I; Art 12 AP II
14
Art 24 GC I; Art 15 AP I; Art 9 AP II
15
Art 16(2) AP I; Arts 9(1) and 10(1)–(2), AP II
16
Art 18 AP I; Art 12 AP II.