The protection of hospitals during armed conflicts: what the law provides

2023-11-02 14:45:00

Does the legislation establish additional legal requirements for attacking a health unit or facility used for the purpose of committing an act harmful to the enemy?

Before launching an attack against a health unit or facility that has lost its protected status, a summons must be issued. Where applicable, the summons must include a time limit, which must not have taken effect for the attack to be permitted. The objective of this warning is to give the possibility to those who are committing an act harmful to the enemy to cease it or, if they persist, at least allow the safe evacuation of the wounded and sick, who are not responsible for that conduct nor should they be victims of it.

If the summons does not have effect, the enemy is no longer obliged to refrain from interfering in the work of the unit or health establishment, nor to take positive measures to assist it in its work. However, even in this case, considerations related to the well-being of the wounded and sick receiving care there, who must be kept safe, cannot be disregarded. To the extent possible, active measures should also be taken to preserve their safety.

These provisions derive from the obligation to respect and protect the wounded and sick, as well as from the general rules relating to the conduct of hostilities that apply to attacks against any military objective. It should be noted that the attacking party must adhere to the principle of proportionality: the military advantage that can be expected from an attack on health units or facilities that have lost their protected status must be carefully balanced against the humanitarian consequences that could arise from the damage or destruction caused. . The attack can have incidental second and third order effects on the provision of health services in the short, medium and long term.

Furthermore, the attacking party is obliged to take precautions in the attack and, in particular, to do everything possible to avoid or at least minimize harm to patients and healthcare personnel, which may be unrelated to those acts and to where the humanitarian consequences can be especially dire. The following measures should be taken to minimize the direct and indirect impact of these attacks on the delivery of health services, wherever possible and operationally relevant:

• Prepare a contingency plan to respond to the anticipated disruption of health services and to restore full provision as soon as possible.
• Evaluate measures for the evacuation of patients and healthcare personnel, as well as for their correct care.
• Discontinue the attack if the establishment no longer meets the criteria that would cause the loss of protective status (for example, if combatants have fled the scene).
• After the attack, facilitate or take measures for the prompt restoration of health services (for example, provide military health assistance for the civilian health facility).