Practice Relating to Rule 28. Medical Units
The Military Manual (1993) of the Netherlands states:
Medical units must be respected and protected. They may not be attacked. Medical units may not be used under any circumstances to shield military objectives against attacks. The parties to the conflict must ensure, as far as possible, that medical units are located in such a way that attacks on military objectives do not endanger their safety.
The manual restates the rules on loss of protection of medical units found in Article 13 of the 1977 Additional Protocol I.
With respect to non-international armed conflicts in particular, the manual states: “medical units … must be respected and protected. They may not be attacked. … [Such protection] ceases when they are used, outside their humanitarian function, to commit hostile acts. But even then a warning must be given.”
The Military Handbook (1995) of the Netherlands provides: “Medical units (medical establishments, hospitals and first-aid posts) may not be attacked.”
The Handbook further provides: “Medical units may not be used to commit acts, outside their humanitarian function, which can be detrimental for the enemy (for example housing healthy soldiers or regular units).”
The Military Manual (2005) of the Netherlands states:
0620. Medical units must be respected and protected. They may not be attacked. Medical units may in no circumstances be used to attempt to shield military objectives from attack. The parties to a conflict must ensure that the medical units are located, as far as possible, in places where attacks on military objectives do not imperil their safety …
0622. The protection of medical units ends if they are used to commit acts harmful to the enemy, outside their humanitarian function. Their protection may, however, cease only after a warning has been given, setting a reasonable time limit, and after such warning has gone unheeded. The following do not constitute grounds for the ending of protection:
- if the personnel of the medical unit are equipped with personal small arms for their own defence or for that of the wounded and sick in their charge, and for the preservation of order and calm within the unit;
- if the unit is guarded by sentries or similar guards;
- if small arms and ammunition, taken from the wounded and sick and not yet handed in, are found in the units.
0623. The equipment of medical units which fall into enemy hands must remain in service for the treatment of the wounded and sick. Buildings, equipment and stocks of medical units may be used for other purposes only in exceptional situations. In a case of compelling military necessity, commanding officers may use such medical equipment and stocks if they have first taken the necessary steps to supply the wounded and sick in care. Buildings, equipment and stocks of medical units may not be deliberately destroyed.
In its chapter on neutrality, the manual states:
0939. Medical units and medical aircraft
A neutral State may offer its medical units to a party in the conflict. This is not viewed as involvement in the conflict. The personnel of such units cannot be held if captured: they must be allowed to return to their country or to the territory of the party to the conflict with which they were serving.
In its chapter on non-international armed conflict, the manual states:
Medical units and means of transport must be respected and protected. They may not be attacked. Their protection ends only when they are used to carry out hostile acts outside the scope of their humanitarian task. Even then, a warning must first be given.
In its chapter on peace operations, the manual states: “Attacks on medical facilities or transports are strictly prohibited.”
The Definition of War Crimes Decree (1946) of the Netherlands qualifies the “deliberate bombardment of hospitals” as a war crime.
Under the International Crimes Act (2003) of the Netherlands, “intentionally directing attacks against … hospitals and places where the sick and wounded are collected, provided they are not military objectives” is a crime, whether committed in an international or a non-international armed conflict.