The protection of hospitals during armed conflicts

Subject: IR

Section :International Convention

What the law says:

According to International humanitarian law (IHL), health establishments and units, including hospitals, should not be attacked.
This protection extends to the wounded and sick as well as to medical staff and means of transport. The rule has few exceptions.

What kind of specific protection do the wounded and sick enjoy in times of armed conflict:

In times of armed conflict, international humanitarian law (IHL) mandates protection and care for the wounded and sick, regardless of their affiliation.
Rights include respect, protection from attacks, and medical assistance without discrimination.
IHL requires searching for, collecting, and providing care to the wounded, with efforts made, even under limited resources.
State and non-State parties must ensure the best possible care and permit impartial humanitarian organizations to assist.
Specific protections extend to medical personnel, units, and establishments, safeguarding them from attacks and undue interference during medical functions in conflict zones.

In which circumstances can medical establishments and units lose their protection granted by IHL:

Under international humanitarian law (IHL), medical establishments and units, including hospitals, are generally entitled to specific protection.
This protection continues unless they are used to commit acts harmful to the enemy outside their humanitarian functions.
In case of doubt, the presumption is that medical units or establishments are not used for harmful purposes.
While IHL does not define “act harmful to the enemy,” certain acts are explicitly recognized as not falling under this category.
The loss of protection occurs when medical facilities interfere directly or indirectly in military operations, causing harm to the enemy, such as being used for launching attacks, as observation posts, weapons depots, centers for military liaison, or shelters for combatants.

What can be considered as an “act harmful to the enemy”:

Engaging in acts harmful to the enemy may expose a medical establishment or unit to potential attack, endanger the wounded and sick in its care, and undermine trust in the work of medical facilities, diminishing the protective value of international humanitarian law (IHL).
Depending on circumstances, such acts could violate precautionary obligations to protect the wounded and sick, health-care personnel, and objects against attacks.
For instance, placing a medical facility near a military objective to shield it from enemy operations may violate these obligations.
Additionally, such conduct may lead to other IHL violations or war crimes, especially if it involves improper use of distinctive emblems like the Red Cross, Red Crescent, or Red Crystal, or if done as an act of perfidy to harm enemy combatants.

Does the law set for additional legal requirements to attack a medical unit or establishment used to commit an act harmful to the enemy:

Before attacking a medical establishment or unit that has lost its protected status, a warning should be issued, including a time limit if appropriate, to allow cessation of harmful acts or the safe evacuation of non-responsible wounded and sick individuals.
If the warning goes unheeded, the enemy is no longer obliged to refrain from interference, but humanitarian considerations for the safety of patients must be maintained.
The attacking party is bound by principles of proportionality and must weigh the military advantage against humanitarian consequences.
Precautions in attack, including minimizing harm to patients and medical personnel, should be taken, and measures to address disruption and re-establish health-care services must be prepared.
Interrupting the attack if the facility no longer meets criteria for loss of protected status and facilitating
After the attack, measures for the rapid restoration of health-care services (e.g. provide military medical support for the civilian medical facility) are done.