Centre for Military Ethics

Medical Resources

Care of prisoners/detainees

The Third Geneva Convention of 1949 makes specific provision for the care of prisoners of war. This places responsibilities on those detaining prisoners of war to treat them with dignity, humanity and to ensure that they have access to appropriate medical care. Articles 29-32 of this Geneva Convention cover medical attention, medical inspections, and prisoners on medical duties. Article 33 covers the rights and responsibilities of deemed personal including medical personnel retained to care for prisoners of war. In addition, there is the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment that came into force in 1987

Unfortunately, in times of war and armed conflict, prisoners may not be treated according to these provisions. This may include unethical behaviour by medical and healthcare personnel. Perhaps the worst examples of such practice were the experiments conducted on prisoners under the auspices of the Nazi regime in Germany and by Unit 731 of the Japanese Army during the Second World War. There is evidence of mistreatment of prisoners during the counter insurgency operations during the so-called wars of liberation such as in Malaya, Kenya, Aden, Algeria, Vietnam, the Belgian Congo. More recently there has been evidence of mistreatment of prisoners in Northern Ireland, the Balkans wars, Iraq and Afghanistan. This includes the involvement of medical personnel and psychologists in the assessment of ‘fitness for interrogation’ and advice on physical and psychological techniques to break prisoners’ morale. Specific examples include the abuse of prisoners by US forces in Abu Ghraib prison in Iraq, the Baha Mousa case concerning UK Armed Forces, transfer of Afghan detainees by Canadian forces to the Afghan security forces, and killing of Afghan detainees by Australian Special Forces.

Since these events, many countries have issued specific guidance for the handling of prisoners or war and detainees to ensure compliance with International Humanitarian Law. Military and military medical personnel need to understand their legal and ethical duties towards the care of prisoners of war. They also need to understand the distinction between a prisoner of war (subject to protection under the Geneva Conventions) and a detainee or other term to describe a person deprived of their liberty under national criminal law.

Key references

Convention (III) relative to the Treatment of Prisoners of War. Geneva, 12 August 1949.
UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. 10 Dec 1987
Principles of Medical Ethics relevant to the Role of Health Personnel, particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. UN General Assembly resolution 37/1

Academic Papers

Wilks M. A stain on medical ethics. The Lancet. 2005 Aug 6;366(9484):429-31.
Pont, J. (2008), "Ethics in research involving prisoners", International Journal of Prisoner Health, Vol. 4 No. 4, pp. 184-197
Miles SH, Freedman AM. Medical ethics and torture: revising the Declaration of Tokyo. Lancet. 2009 Jan 24;373(9660):344-8.
Rubenstein LS, Annas GJ. Medical ethics at Guantanamo Bay detention centre and in the US military: a time for reform. The Lancet. 2009 Jul 25;374(9686):353-5.
Moy RJ. Ethical Dilemmas in Providing Medical Care to Captured Persons on Operations. BMJ Military Health 2012;158:6-9.
Simpson RG, Wilson D, Tuck JJ. Medical management of Captured Persons. BMJ Military Health 2014;160:4-8.
Charles A, Rid A, Davies H, et al. Prisoners as research participants: current practice and attitudes in the UK. Journal of Medical Ethics 2016;42:246-252.
Xenakis, S.N. (2018). Ethical Challenges in Treating Detainees and Prisoners of War. In: Roberts, L., Warner, C. (eds) Military and Veteran Mental Health. Springer, New York, NY.
Evans NG, Sisti DA, Moreno JD. Ethical considerations on the complicity of psychologists and scientists in torture. BMJ Military Health 2019;165:248-255.
Annas GJ, Crosby S. US military medical ethics in the War on Terror. BMJ Military Health 2019;165:303-306.
Khaji, A., Tabatabaei, S., Mashkoori, A. Protection of Prisoners of War from Torture with Proper Selection of Soldiers Taking Care of POWs: An Ethical View. Trauma Monthly, 2020; 25(2): 67-70. doi: 10.30491/tm.2020.213548.1020
Lillywhite L. Medical services policy in respect of detainees: evolution and outstanding issues. BMJ Mil Health. 2021 Feb 1;167(1):23-6.

Videos and other media

EXPLAINED: Prisoners of war and the Third Geneva Convention ICRC

Policy Publications

World Medical Association. Declaration Of Tokyo – Guidelines For Physicians Concerning Torture And Other Cruel, Inhuman Or Degrading Treatment Or Punishment In Relation To Detention And Imprisonment. Revised by the 67th WMA General Assembly, Taipei, Taiwa
UK Ministry of Defence. Joint Doctrine Publication 1-10. Captured Persons. 4th Edition 2020.
Health in prisons. A WHO guide to the essentials in prison health. WHO Europe Regional Office. 2007.
Prisons and health. WHO Europe Regional Office. 2014.
UN General Assembly Resolution 70/175 17 Dec 2015. The United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules).
Health Systems and Needs Assessment in Prisons - Practical Guide and Toolkit. ICRC 2020

Playing Card Scenarios

Queen Clubs. A badly injured enemy combatant claims that his injuries were caused after he had been captured. How do you respond?
Ace Clubs. Special forces capture a combatant whom they believe has vital information about a future terrorist attack. The combatant refuses a life-saving treatment stating that he would “rather die than live as a prisoner and traitor”. What can/should yo

Other websites

The Practical Guide to Humanitarian Law. Prisoners of War. Medicins Sans Frontiers.