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

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

Specific Topic(s):

• This question concerns the use of the Geneva Emblems. It links to the discussion at King Clubs.

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 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 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 use of the Red Cross (or other symbol) for the protection of healthcare personnel. The principles also apply to the use of the Red Cross to protect medical facilities. It is linked, but separate from, the legal and ethical obligations of healthcare workers to be solely employed for ‘humanitarian purposes’.

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 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 personnel still may not commit acts harmful to the enemy as they remain ‘protected persons’ and ethically and professionally remain obliged to refrain from any hostile act.

Framework for answering the scenario/question:

• Why is the Red Cross or other emblem worn by healthcare personnel?

• What are the implications of removing the Red Cross?

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

• How does this differ from restrictions on the employment of protected personnel?

Further discussion points:

• This question concerns the wearing of the Red Cross by medical personnel. How do these principles compare to the displaying of the Red Cross by medical units?

• Give some examples of misuse of the Geneva Emblems. What would be the consequences?

• Give some examples of the lack of respect towards the Geneva Emblems by armed actors. What would be the consequences? [review the Healthcare in Danger website]

Author: Professor Martin Bricknell