Treaties, States Parties and Commentaries
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Commentary of 2016 
Article 41 : Identification of auxiliary personnel
Text of the provision*
(1) The personnel designated in Article 25 shall wear, but only while carrying out medical duties, a white armlet bearing in its centre the distinctive sign in miniature; the armlet shall be issued and stamped by the military authority.
(2) Military identity documents to be carried by this type of personnel shall specify what special training they have received, the temporary character of the duties they are engaged upon, and their authority for wearing the armlet.
* Paragraph numbers have been added for ease of reference.
Reservations or declarations

A. Introduction
2612  Under the First Convention, a distinction is made between permanent medical personnel (Article 24) and auxiliary or temporary medical personnel (Article 25) in relation to both their identification on the battlefield and their treatment if they fall into enemy hands.[1] Article 41 stipulates that the emblem on the white armlet worn by auxiliary medical personnel should be ‘in miniature’. The rationale for this requirement was to preserve the significance of the armlet of permanent medical personnel and to avoid abuses of the emblem in the area of hostilities. This concern has now been overridden by the need to ensure that all medical personnel, be they permanent or temporary, are identifiable as such when they are exclusively employed on their duties close to hostilities. In those circumstances, auxiliary medical personnel enjoy the same immunity from attack as permanent medical personnel and must therefore display their status in the same way.
2613  In enemy hands, however, auxiliary medical personnel are not entitled to the same treatment as permanent medical personnel, that is, they are not covered by the retention regime (see Article 28). Instead, like combatants, they become prisoners of war (see Article 29). However, according to Article 29, auxiliary medical personnel who are detained as prisoners of war must be employed on medical duties when necessary. In this regard, it is important for them to carry identity documents certifying their status as auxiliary or temporary medical personnel.
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B. Historical background
2614  The protection accorded to auxiliary or temporary medical personnel under the Geneva Conventions has fluctuated over time. In the 1864 and 1906 Conventions, no protection was accorded to such personnel. In the 1929 Geneva Convention on the Wounded and Sick, auxiliary medical personnel who had fallen into enemy hands were entitled to the same treatment under the retention regime as permanent medical personnel but were not authorized to wear the emblem identifying them as temporary medical personnel during hostilities, even when they were exclusively employed on medical duties.[2] In practice, however, it proved difficult to establish what auxiliary medical personnel were doing at the time they fell into enemy hands. With this in mind, the 1949 Convention essentially reversed the provisions of the 1929 Convention, allowing auxiliary medical personnel to wear the emblem but not to benefit from the retention regime.
2615  The 1929 Diplomatic Conference had not granted auxiliary medical personnel the right to wear the emblem on the battlefield because abuses were feared. Delegates to the Conference refused to entertain the idea of the armlet being put on or taken off according to whether the person was acting in a combatant or a medical capacity. In other words, they did not wish to make the emblem ‘removable’.[3] The drafters of the 1949 Convention felt that protection could be accorded to auxiliary personnel while they were actually carrying out their medical duties on the battlefield. However, they, too, felt that there was a risk of abuse if such personnel were authorized to use the same armlet as permanent medical personnel.[4] Following a discussion of possible ways to indicate the difference, including by using initials to represent auxiliary medical functions such as ‘stretcher bearer’, the Diplomatic Conference settled on the same emblem but in a smaller size.[5]
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C. Paragraph 1: The armlet
2616  Article 41 sets out the identification measures to be applied by auxiliary or temporary medical personnel as defined in Article 25 of the First Convention.[6]
2617  Under the system set up in the First Convention, auxiliary or temporary medical personnel may be authorized to wear an armlet bearing the emblem in miniature when they are exclusively engaged in medical activities. However, for States party to Additional Protocol I, Article 18(1) provides that ‘[e]ach Party to the conflict shall endeavour to ensure that medical and religious personnel and medical units and transports are identifiable’ and does not specify a difference in the size of the emblem, whether worn by permanent or auxiliary medical personnel.
2618  There is good reason to consider that the requirement set down in Article 41 for the emblem displayed on the armlets of auxiliary medical personnel to be ‘in miniature’ is obsolete.[7] The fear that medical personnel might abuse the protection symbolized by the emblem by putting on and taking off the armlet at will, which could lead to a lessening of respect for the emblem, has abated. The primary concern today is to promote the visibility of medical personnel in all circumstances where it will facilitate their protection.
2619  The view that the emblem on the armlet worn by auxiliary medical personnel need not be restricted in size is supported by instruments providing further guidance on the use of the protective emblem. The Regulations concerning identification in Annex I of Additional Protocol I state (in relation to Article 18) that ‘[t]he distinctive emblem shall, whenever possible, be displayed on a flat surface, on flags or in any other way appropriate to the lay of the land, so that it is visible from as many directions and from as far away as possible, and in particular from the air’.[8] It also states that ‘[m]edical and religious personnel carrying out their duties in the battle area shall, as far as possible, wear headgear and clothing bearing the distinctive emblem’.[9] Studies have shown that even the normal-sized emblem on an armlet is often insufficiently visible on the battlefield, prompting the adoption of the more flexible regulations in the Protocol.[10] Requiring auxiliary medical personnel to use an even smaller emblem would only compound the problem. This interpretation is affirmed in academic writing.[11]
2620  While some States may wish nevertheless to continue to use the emblem in miniature on armlets worn by their auxiliary medical personnel,[12] they are not bound to do so.
2621  In view of this development, it is of the utmost importance that auxiliary or temporary medical personnel are not seen to be switching too frequently between the roles of combatant and medic. Indeed, no time limit has been fixed on the duration of the assignment to exclusively medical duties, but common sense dictates that, to the greatest possible extent, there should be no change in the assignment of medical personnel – or, for that matter, medical objects – during a given military operation. If the temporary assignment is too short and changes too often, it could generate mistrust towards the medical personnel and undermine their protection.[13] Moreover, auxiliary medical personnel must comply scrupulously with the conditions under which they are authorized to wear the emblem: they must be specially trained for medical duties and they must only wear the emblem when they are actually engaged in such activities.
2622  The armlet must be issued and stamped by the competent military authority, just as for permanent medical personnel under Article 40.
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D. Paragraph 2: Identity documents
2623  Article 41 sets out the specific details to be included on the military identity documents carried by auxiliary or temporary medical personnel. These identity cards should be the same as those required by Article 17(3) of the Third Convention, but include a special entry indicating that the bearer is authorized to wear the armlet.[14] The documents are thus distinct from those carried by permanent medical personnel, underscoring the different regimes that apply to the personnel once they fall into enemy hands. The identity cards of auxiliary medical personnel must specify the temporary nature of their activities so as to clarify that they are liable to be held as prisoners of war rather than returned to their own forces or retained as medical personnel. At the same time, the cards must indicate the bearers’ authority for wearing the armlet and the special training they have received in this respect. The latter may facilitate their employment on medical duties if detained as prisoners of war (see Article 29).
2624  Possession of an identity card is not a sine qua non for proving one’s authority to wear the protective emblem in every case, especially since documents can be lost or taken; in the absence of such documents, the status of auxiliary medical personnel can be proven by other means when they fall into enemy hands.[15] That said, as the system is based on trust, auxiliary medical personnel would be well advised to carry an identity card demonstrating their authority for wearing the armlet.
2625  The requirement for auxiliary medical personnel to be issued with identity cards in general is set down in Article 17(3) of the Third Convention, as States must provide such documents to any person liable to become a prisoner of war. Article 40(4) of the First Convention prohibits depriving permanent medical personnel of their identity cards and insignia; while Article 41 is silent on the matter, the last sentence of Article 17(3) of the Third Convention clearly establishes the same prohibition in respect of identity cards of prisoners of war, including those of auxiliary medical and religious personnel.
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Select bibliography
Bouvier, Antoine A., ‘The Use of the Emblem’, in Andrew Clapham, Paola Gaeta and Marco Sassòli (eds), The 1949 Geneva Conventions: A Commentary, Oxford University Press, 2015, pp. 855–886.
Cauderay, Gérald C., ‘Visibility of the distinctive emblem on medical establishments, units, and transports’, International Review of the Red Cross, Vol. 30, No. 277, August 1990, pp. 295–321.
De Waard, Peter and Tarrant, John, ‘Protection of Military Medical Personnel in Armed Conflicts’, University of Western Australia Law Review, Vol. 35, No. 1, 2010, pp. 157–183.
ICRC, Study on the Use of the Emblems: Operational and Commercial and Other Non-Operational Issues, ICRC, Geneva, 2011, pp. 47–51.
Kleffner, Jann, K. ‘Protection of the Wounded, Sick, and Shipwrecked’, in Dieter Fleck (ed.), The Handbook of International Humanitarian Law, 3rd edition, Oxford University Press, 2013, pp. 321–357.

1 - The persons covered by Article 25 are commonly referred to as ‘auxiliary personnel’. Since the adoption of Additional Protocol I, the term ‘temporary (medical) personnel’ is used more frequently to describe this category of medical personnel. For a full definition of temporary medical personnel, see Additional Protocol I, Article 8(k).
2 - Geneva Convention on the Wounded and Sick (1929), Article 9(2). Under the retention regime, medical personnel may not be held until the end of active hostilities on the same basis as prisoners of war; unless they are needed to care for the wounded and sick, they must be sent back to their own armed forces. See, Articles 28, 30 and 31 of the First Convention.
3 - Des Gouttes, Commentaire de la Convention de Genève de 1929 sur les blessés et malades, ICRC, 1930, pp. 154–155; Proceedings of the Geneva Diplomatic Conference of 1929, pp. 168–177 and 184–191.
4 - Minutes of the Diplomatic Conference of Geneva of 1949, pp. 20–22.
5 - Final Record of the Diplomatic Conference of Geneva of 1949, Vol. II-A, pp. 116–118 and 198.
6 - Article 8(c) and (k) of Additional Protocol I provides a further definition of temporary medical personnel, which is broader than Article 25 as it encompasses civilian medical personnel who are not members of the armed forces.
7 - Sandoz/Swinarski/Zimmermann (eds), Commentary on the Additional Protocols, ICRC, 1987, para. 759, which emphasizes that ‘the indications of the Conventions regarding restrictive use of the emblem (armlets) and particularly those imposing on temporary personnel the obligation to wear an emblem smaller in size, must be considered to be obsolete’. Note also that the ICRC’s Model Law on the Emblems does not include a provision relating to the use of an armlet with an emblem in miniature. See also ICRC, Study on the Use of the Emblems, pp. 47–51.
8 - Additional Protocol I, Annex I, Regulations concerning identification (amended 30 November 1993), Article 5, para. 1.
9 - Ibid. para. 4.
10 - Cauderay, pp. 305–308.
11 - De Waard/Tarrant, p. 167. See also Kleffner, pp. 352–355, and Bouvier, pp. 864–865, who make no mention of a difference in the size of the protective emblem.
12 - See e.g. Belgium, Law of Armed Conflict Training Manual, 2009, Course V, p. 10; Netherlands, Military Manual, 2005, p. 80; and United States, Law of War Manual, 2015, p. 438.
13 - Sandoz/Swinarski/Zimmermann (eds), Commentary on the Additional Protocols, ICRC, 1987, para. 395. See also De Waard/Tarrant, pp. 159 and 180–181.
14 - Final Record of the Diplomatic Conference of Geneva of 1949, Vol. II-A, p. 198; see also the commentary on Article 17(3) of the Third Convention.
15 - For a view that the requirement is more stringent, see De Waard/Tarrant, p. 167, who assert: ‘This is a critical requirement. If a combatant wearing a distinctive protective armlet or brassard does so without the appropriate documentation, they could be liable for misuse of the protective emblem.’