Logan Reid
The Geneva Conventions, which form the core of international humanitarian law, are particularly protective of civilian hospitals. Under international humanitarian law, hospitals are protected civilian objects and cannot be targeted even when used for acts harmful to the enemy. However, a building ceases to be a hospital and becomes a legitimate military target when it is used as a base to launch rockets or attacks, or as a shelter for combatants. This transformation from hospital to legitimate military target raises the question of when a building is considered a hospital and when it is not.
| Characteristics | Values |
|---|---|
| Core of international humanitarian law | The Geneva Conventions form the core of international humanitarian law |
| Protection | Hospitals are protected from the consequences of hostilities |
| Exception | Hospitals lose protection if they are used for military purposes |
| Attack | Attacking hospitals is forbidden and is considered a war crime |
| Precautions | All feasible precautions must be taken to protect patients, medical staff, and other civilians |
| Warning | Effective warnings must be given to allow safe evacuation |
| Evacuation | Evacuation procedures must be put in place for patients and health workers |
| Medical care | Medical care must be provided to the wounded and sick |
| Humanitarian principles | Hospitals benefit from the humanitarian principles of distinction and proportionality |
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What You'll Learn
Hospitals are protected civilian objects
According to IHL, health establishments and units, including hospitals, should not be attacked. This protection extends to the wounded and sick, medical staff, and means of transport. The wounded and sick include anyone, whether military or civilian, who needs medical attention and is not, or no longer, taking part in hostilities. They have the right to be respected, protected, searched for, collected, and cared for without distinction based on grounds other than medical ones.
However, hospitals can lose their protected status if they are used for military purposes or acts harmful to the enemy. This includes using a hospital as a base for launching an attack, an observation post, a weapons depot, a centre for liaison with fighting troops, or a shelter for able-bodied combatants. If a hospital is being used for military purposes, the patients and staff inside do not automatically lose their civilian status, and the response must follow the laws of armed conflict, including proportionality and taking feasible precautions to mitigate civilian harm.
In the context of the Israel-Gaza conflict, there have been accusations of war crimes against Israel for its attack on Gaza's al-Shifa hospital. However, Israel claims that it acted within the boundaries of international law. The chief prosecutor at the ICC, Karim Khan, has stated that places like hospitals are protected unless their protective status has been lost because they are being used for military purposes.
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Hospitals as military targets
The Geneva Conventions of 1949 and their Optional Protocols of 1977 form the core of international humanitarian law (IHL) and set a range of minimum standards for the conduct of hostilities. Article 18 of the Geneva Convention stipulates that a building designated as a civilian hospital cannot be the target of an attack. Article 8 of the Rome Statute, which established the International Criminal Court (ICC), defines a long list of war crimes, including "intentionally directing attacks against buildings dedicated to... charitable purposes, historic monuments, hospitals and places where the sick and wounded are collected".
Mathilde Philip-Gay, an expert in international humanitarian law, states that "it is forbidden to turn recognised civilian hospitals into a conflict zone". She adds that if a civilian hospital was used for acts harmful to the enemy, it does not justify its destruction, and the response must be "proportionate". Karim Khan, the chief prosecutor at the ICC, affirms that "those places are protected, unless the protective status has been lost because they are being used for military purposes".
According to IHL, health establishments and units, including hospitals, should not be attacked. This protection extends to the wounded and sick, medical staff, and means of transport. However, a building can lose its protected status and become a legitimate military target if it is used as a base to launch attacks, an observation post, a weapons depot, a centre for liaison with fighting troops, or a shelter for able-bodied combatants.
The United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) emphasises that any military operation around or within hospitals must take steps to protect patients, medical staff, and other civilians, including providing effective warnings and facilitating safe evacuation.
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The Geneva Conventions and IHL
The Geneva Conventions, adopted after World War II, are at the core of international humanitarian law (IHL). IHL sets minimum standards for the conduct of hostilities, based on the distinction between civilians and combatants. Civilians and civilian objects, such as hospitals, are protected under IHL.
Article 18 of the Geneva Convention explicitly states that civilian hospitals cannot be targeted during conflicts. Article 8 of the Rome Statute, which established the International Criminal Court (ICC), also defines a list of war crimes, including "intentionally directing attacks against buildings dedicated to [...] charitable purposes, historic monuments, hospitals and places where the sick and wounded are collected".
However, a civilian object can lose its protected status if it contributes to military action. For example, a hospital can become a legitimate military target if it is used as a base to launch attacks, transmit military information, store weapons, or shelter combatants. Even in such cases, the attacking party must follow the principles of proportionality and precaution. They must take all feasible precautions to avoid targeting civilians, give advance warnings, and ensure the safety of patients, medical staff, and other civilians through evacuation procedures.
International humanitarian law recognises the importance of protecting the wounded and sick, as well as medical personnel and establishments like hospitals. This protection extends to all wounded and sick individuals, regardless of their affiliation, and includes the right to be respected, protected, searched for, collected, and cared for without distinction based on non-medical grounds.
In summary, bombing hospitals is against the Geneva Conventions and IHL, unless the hospital has lost its protected status by contributing to military actions. Even in such cases, the attacking party must adhere to the principles of proportionality and precaution to minimise harm to civilians.
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Proportionality and precaution in attack
The Geneva Conventions of 1949 and their Optional Protocols of 1977 form the core of international humanitarian law (IHL). IHL sets a range of minimum standards for the conduct of hostilities, based on the fundamental principle of distinction between civilians and other protected persons, and combatants. Under IHL, both schools and hospitals are protected civilian objects, and therefore benefit from the humanitarian principles of distinction and
Article 8 of the Rome Statute, which established the International Criminal Court (ICC), defines a long list of war crimes, including “intentionally directing attacks against buildings dedicated to religion, education, art, science or charitable purposes, historic monuments, hospitals and places where the sick and wounded are collected”. However, it makes an exception if the targets are “military objectives”.
The principle of precaution in attack states that constant care must be taken to spare the civilian population, civilians, and civilian objects. This means that even if a hospital is being used for “acts harmful to the enemy”, the other party “does not have the right to bombard it for two days and completely destroy it”, citing the need under international law for the response to be “proportionate”. The attacking party remains bound by the principle of proportionality. The military advantage likely to be gained from attacking medical establishments or units that have lost their protected status should be carefully weighed against the humanitarian consequences likely to result from the damage or destruction caused to those facilities.
The United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) states that: “Any military operation around or within hospitals must take steps to spare and protect the patients, medical staff, and other civilians. All feasible precautions must be taken, including effective warnings, which consider the ability of patients, medical staff, and other civilians to evacuate safely.”
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Evacuation procedures
The Geneva Conventions of 1949 and their Optional Protocols of 1977 form the core of international humanitarian law (IHL) and set a range of minimum standards for the conduct of hostilities. Under IHL, health establishments and units, including hospitals, should not be attacked. This protection extends to the wounded, sick, and medical staff.
However, a hospital can lose its protected status under international law and be considered a legitimate target if it is used for "acts harmful to the enemy". This includes using the hospital as a base to launch an attack, an observation post to transmit information of military value, a weapons depot, a center for liaison with fighting troops, or a shelter for able-bodied combatants.
Even if a hospital is used for acts harmful to the enemy, the response must be proportionate, and certain evacuation procedures must be followed. Here are the steps that should be taken to evacuate patients and medical personnel safely:
- Advance Warning and Isolation: Give advance warning of the military operation and allow patients and health workers to evacuate or isolate themselves in a safe part of the hospital.
- Safe Evacuation: Consider the ability of patients, medical staff, and civilians to evacuate safely and provide effective warnings. Ensure that evacuation routes are secure and accessible.
- Protection During Evacuation: Take all precautions to avoid intentionally targeting civilians during the evacuation process. Provide clear and distinct markings on vehicles or vessels used for evacuation, indicating their humanitarian purpose.
- Impartial Humanitarian Organizations: Allow impartial humanitarian organizations to provide medical care and support during the evacuation process, ensuring that the needs of the wounded and sick are met.
- Rapid Restoration of Healthcare Services: After the evacuation, implement measures to quickly restore healthcare services, such as providing military medical support or deploying temporary medical facilities.
- Respect and Protection of Medical Personnel: Recognize and respect the protected status of medical personnel, including those engaged in the search, removal, transportation, and care of wounded civilians. Provide them with the necessary identification and authorization to ensure their safety during the evacuation process.
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Frequently asked questions
Yes, hospitals are protected under the Geneva Conventions, which form the core of international humanitarian law. Article 18 of the Geneva Convention specifically states that a building designated as a civilian hospital cannot be the target of an attack.
The Geneva Conventions of 1949 and their Optional Protocols of 1977 are a set of international treaties that establish the standards for conducting hostilities during war. They are based on the fundamental distinction between civilians and combatants.
Yes, a hospital can become a legitimate military target if it is used for "acts harmful to the enemy". For example, a hospital can lose its protected status if it is used as a base to launch attacks, as a weapons depot, or as a shelter for combatants. However, even in such cases, the attacking party must follow the principles of proportionality and precaution, taking all feasible precautions to spare and protect patients, medical staff, and other civilians.
Attacking a hospital protected under the Geneva Conventions is considered a war crime. The International Criminal Court (ICC) has jurisdiction over such crimes, and those responsible can be prosecuted and held accountable.
Medical personnel are considered non-combatants and are protected under the Geneva Conventions. They cannot be attacked or taken as prisoners of war due to their humanitarian duties.
