Centre for Military Ethics: Ethics Playing Cards

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The commander of a logistic convoy wishes to put food and water into the ambulance of the convoy.

Should this be permitted?

Specific Topic(s):

• This question covers the use of the Geneva emblems and the potential misuse if a warring party seeks to use this protection to enable military activity. The scenario links to 4 Hearts, 9 Hearts and Queen of Hearts.

Key references:

‘Ethical principles of health care in times of armed conflict and other emergencies’ –

10. Health-care personnel, as well as health-care 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.

12. In fulfilling their duties and where they have the legal right, health-care 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 the Geneva Emblems is covered by the following International Humanitarian Law:

First Geneva Convention, 1949 – art. 38-44, 53

Second Geneva Convention, 1949 – art. 41-45

Fourth Geneva Convention, 1949 – art. 18, 20

Protocol I additional to the Geneva Conventions, 1977 – art. 18, 37 38, 85 and annex II.

Protocol II additional to the Geneva Conventions, 1977 – art. 12

Protocol III additional to the Geneva Conventions, 2005

Customary IHL:

Rule 25. Medical personnel exclusively assigned to medical duties must be respected and protected in all circumstances. They lose their protection if they commit, outside their humanitarian function, acts harmful to the enemy. https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule25

Rule 28. Medical units exclusively assigned to medical purposes must be respected and protected in all circumstances. They lose their protection if they are being used, outside their humanitarian function, to commit acts harmful to the enemy. https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule28

Rule 29. Medical transports assigned exclusively to medical transportation must be respected and protected in all circumstances. They lose their protection if they are being used, outside their humanitarian function, to commit acts harmful to the enemy. https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule29

Rule 30. Attacks directed against medical and religious personnel and objects displaying the distinctive emblems of the Geneva Conventions in conformity with international law are prohibited. https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule30

Rule 59. The improper use of the distinctive emblems of the Geneva Conventions is prohibited. https://ihl-databases.icrc.org/customary-ihl/eng/docs/v1_rul_rule59

Ethical principles:

World Medical Association CODE OF CONDUCT: DUTIES OF PHYSICIANS WORKING IN ARMED CONFLICT AND OTHER SITUATIONS OF VIOLENCE – In fulfilling their duties and where they have the legal right, physicians and other health care professionals shall be identified and protected by internationally recognized symbols such as the Red Cross, Red Crescent or Red Crystal…. They must ‘Not take part in any act of hostility’. https://www.wma.net/policies-post/wma-regulations-in-times-of-armed-conflict-and-other-situations-of-violence/

Discussion:

Review of the question: this question covers the potential use of the Red Cross (or other symbol) to achieve military advantage. The principles arise from the exclusive and sole purpose of the Geneva emblems to protect the people and resources involved in the relief of the suffering from armed conflict. Recognising that there might be military advantage in the misuse of the Emblems, there are specific provisions to deter this behaviour. This scenario extends the discussion in Queen of Hearts about medical personnel to a discussion about medical units and medical transports.

Interpretation of the principles/policy from the references: the distinctive emblem should be displayed wherever practicable for the protection of healthcare personnel, transport and facilities. However, there may be occasions where it is not practicable/legal for the emblem to be displayed (e.g. the enemy are not respecting the protection afforded by the emblem, or the display of the Red Cross would reveal the location/employment of military facilities, or the display of the Red Cross to claim protection would be illegal because of the proximity of legitimate military targets). In these circumstances, it might be appropriate to conceal/not wear the Red Cross. However, medical units and transports are defined as a result of their function, not by their use of the Geneva Emblems. Therefore, it would be at least improper, if not war crime, if they were used for acts harmful to the enemy such as: the sheltering or movement of combatants, the storage or movement of munitions or war materiel, or the collection or transmission of military information or intelligence.

Framework for answering the scenario/question:

• Why is the Red Cross or other emblem used to protect medical units and transports?

• What are the implications of removing the Red Cross? Does that authorise the use of medical units or transports for other roles?

• Who has the authority to approve the display, concealment or removal of the Red Cross?

• What is the difference between moving combatants, munitions, other military equipment, other military supplies, and food or water? [none, if these have the purpose of sustaining military activity]

• Under what circumstances could food and water or other non-warlike stores be moved in medical transports? [e.g. sustainment of medical personnel and patients, equipment and consumables for exclusively humanitarian use]

Further discussion points:

• What is the difference between ‘improper use of the Geneva Emblems’ and ‘perfidy’

• List some other potential ‘improper uses’ of the Red Cross. [advertising, use by non-statutory organisations etc – see ‘Study on the Use of the Emblems: Operational and Commercial and Other Non-Operational Issues’].

• Should a medical facility be identified using the Red Cross if it is sited within a military logistics site such that it would be impossible for the enemy to discriminate between it and local military targets?

• Should a medical transport (ambulance, helicopter) display the Red Cross if it is escorted by military vehicles (tanks, armed helicopters)?

Author: Professor Martin Bricknell