A local patrol commander tells the attached medical personnel to remov · Medical

Q A local patrol commander tells the attached medical personnel to remove their Red Cross arm bands because this disrupts camouflage. Is this acceptable?

Step 1 – IDENTIFY THE PROBLEM(S)

• Briefly state the Scenario

A local patrol commander tells the attached medical personnel to remove their Red Cross arm bands because this disrupts camouflage. Is this acceptable?

• List the Issues that arise from the scenario

There is the question as to whether the Red Cross emblem actually keeps the healthcare professionals more safe or not. It depends on whether the enemy respects the protection offered by the Red Cross Emblem or not. If they do not, then it is unsafe.

The Red Cross is worn to let parties know that whoever is wearing the Cross is protected under IHL and therefore cannot be legally targeted. From a military standpoint of optimising effectiveness of current and future operations, allowing the Red Cross to be worn by healthcare professionals means that the military can protect these people so they can continue to give physical aid to combatants in the future. However, wearing the Red Cross can also disrupt operational effectiveness and so far as to reveal location of military facilities.

• Identify Critical Information required and Assumptions to be made

Step 2 – ANALYSE

Patient: What are the views of the Patient? (and ‘patient group’)? How do 4 principles of : Autonomy, Beneficence, Non-maleficence and Justice apply? Other perspectives?

Beneficence: During operations, wearing the Red Cross emblem could give military combatants a sense of security in being able to identify them during attack if those combatants are in need of urgent medical treatment.

Non-maleficence: Patients would feel more unsafe if location of military facilities were revealed from healthcare professionals wearing the red emblem.

Clinical: What are the clinical diagnosis, prognosis, treatment options? Is this scenario covered by professional regulation or guidance? What are the views of individual members of the clinical team? Other perspectives?

Members of clinical team might think that it is important for military combatants to be identify them in times of need (for example during an attack)

Members of a clinical team might actually feel unsafe from wearing it which could hinder their clinical practice

Is scenario covered by IHL, Geneva Conventions, military law, other law? Other perspectives?

Ethical Principles of Healthcare in Times of Armed Conflict and other emergencies

1. Healthcare personnel as well as healthcare facilities and medical transports, whether military or civilian must be respected by all. They are protected while performing their duties and the safest possible working environment shall be provided to them.

2. In fulfilling their duties and where they have the legal right, healthcare personnel are identified by internationally recognized symbols such as the Red Cross, Red Crescent or Red Crystal as a visible manifestation of their protection under applicable international law.

Geneva Conventions:

The Use of Geneva Conventions is covered by the following International Humanitarian Law:

GC I, Art. 53; AP I, Arts 37–38 and 85; AP II, Art. 12; Customary IHL Study, Rule 59

Red Cross is a symbol that can be present on equipment, personnel, vehicles or buildings that gives that thing protection under international humanitarian law.

For example medical professionals working in armed conflict are protected in the sense that they cannot be legally targeted by enemies.

The personnel is protected in the sense that if there is violation, the country responsible for violation will face legislative consequence.

The purpose of the Red Cross emblem is to let all parties know that whatever has the emblem is protected under IHL.

Just because someone or something does not have Red Cross, does not mean that it is not protected under international humanitarian law. As long as they meet the requirements of function, such as to help deliver healthcare during times of armed conflict, they are protected.

There are also times in which it might be inappropriate to wear Red Cross: like if the enemy are not respecting the protection afforded by the emblem, or display of the emblem would reveal location of military facilities).

The Red Cross emblem can also be misused in three ways: invitation, improper use and perfidy. Invitation is when a sign, that looks like the emblem, is used on something or someone not authorized to wear the emblem. Improper use is when the emblem is used by unauthorized bodies. Perfidy is when the emblem is used to trick enemies into thinking that this equipment/building/personnel is protected under IHL when they are not.

Societal/Military: Is there a military necessity? Is this scenario covered by military regulation or military perspective? Is this scenario covered by public health or societal ethics? Other perspectives?

The law states that the Red Cross emblem should be worn when possible to notify parties involved in the war that these people are protected under IHL. However, it also states that there may be times in which wearing it may be inappropriate, such as if it reveals the location of a military facility.

Step 3 – FUSE

Summarise conclusions

· Insert citations to key reference sources for your analysis

· Determine the exact Decision(s) to be made

Red Cross emblem should be worn when possible to notify parties involved in the war that these people are protected under the IHL.

There are times when this is inappropriate: for example if wearing the Red Cross emblem puts the military operation at risk due to risk of revealing location.

In these cases, the Red Cross emblem should not be worn. But just because the red emblem is not worn does not mean that the person is not techncically protected under IHL.

Step 4 – DECIDE

• What is your Decision?

• Why (can you justify it)?

• Residual uncertainly, need for review?

The Red Coss emblem should not be worn in this case as it would be inappropriate to put the medical professional at risk, and the effectiveness of present and future military operations at risk.

Reviewed and formatted by: Yvonne Zhou MBBS Year 3 King’s College London Dec 2024