Practice Relating to Rule 26. Medical Activities

Additional Protocol I
Article 16(3) of the 1977 Additional Protocol I provides:
No person engaged in medical activities shall be compelled to give to anyone belonging either to an adverse Party, or to his own Party except as required by the law of the latter Party, any information concerning the wounded and sick who are, or who have been, under his care, if such information would, in his opinion, prove harmful to the patients concerned or to their families. Regulations for the compulsory notification of communicable diseases shall, however, be respected. 
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), Geneva, 8 June 1977, Article 16(3). Article 16 was adopted by consensus. CDDH, Official Records, Vol. VI, CDDH/SR.37, 24 May 1977, p. 70.
Additional Protocol II
Article 10 of the 1977 Additional Protocol II provides:
3. The professional obligations of persons engaged in medical activities regarding information which they may acquire concerning the wounded and sick under their care shall, subject to national law, be respected.
4. Subject to national law, no person engaged in medical activities may be penalized in any way for refusing or failing to give information concerning the wounded and sick who are, or who have been, under his care. 
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of Non-International Armed Conflicts (Protocol II), Geneva, 8 June 1977, Article 10(3) and (4). Article 10 was adopted by consensus. CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 112.
No data.
Cameroon
Cameroon’s Instructor’s Manual (2006) states:
Protection of Non-Combatants in Combat Zones
Medical and religious personnel must fulfil their tasks under the special protection of the belligerents; amongst other things, they must provide assistance in the various combat zones and when circumstances require.
1. Medical Personnel
It is … prohibited to compel the medical personnel to give information regarding the wounded and sick whom they care for: information regarding the activity, relations, location or existence of the wounded. 
Cameroon, Droit des conflits armés et droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces de défense, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 229, § 541.
Canada
Canada’s LOAC Manual (1999) states, with respect to non-international armed conflict in particular: “The professional obligations of medical personnel regarding information they acquire concerning the wounded and sick under their care must be respected, subject to the requirements of national law.” 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 17-4, § 36.
Canada
Canada’s LOAC Manual (2001) states in its chapter on non-international armed conflicts: “The professional obligations of medical personnel must be respected with regard to information concerning those under their care. This is subject to the requirements of national law.” 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 1719.4.
Chad
Chad’s Instructor’s Manual (2006) states that “persons carrying out a medical activity may not be compelled to … give information about the wounded if that information may be prejudicial to the wounded persons concerned”. 
Chad, Droit international humanitaire, Manuel de l’instructeur en vigueur dans les forces armées et de sécurité, Ministère de la Défense, Présidence de la République, Etat-major des Armées, 2006, p. 93.
Guinea
Guinea’s Code of Medical Ethics (1996) states:
Article 4. – Professional secrecy established in the interest of patients is required for all Physicians within the conditions laid down by the law. The secrecy covers everything that has come to the knowledge of the Physician in the exercise of his profession; that is to say not only what has been confided in him, but also what he has seen, heard or understood.
Article 44. – For each patient, the Physician shall keep a personal medical record; this record is confidential and contains regularly updated information required for decisions of diagnostic and therapeutic character. In all cases, these documents are kept under the responsibility of the Physician.
Article 71. – The Physician must protect medical documents concerning the people he has treated or examined against any indiscretion, whatever is the documents’ content and form. 
Guinea, Code of Medical Ethics, 1996, Articles 4, 44 and 71.
Mexico
Mexico’s Army and Air Force Manual (2009), in a section on the 1977 Additional Protocol I, states that medical personnel “are not required to provide information on the people they treat.” 
Mexico, Manual de Derecho Internacional Humanitario para el Ejército y la Fuerza Área Mexicanos, Ministry of National Defence, June 2009, § 273.
Peru
Peru’s IHL Manual (2004) states:
Medical personnel providing medical services in armed conflicts have a duty to respect the principles of medical ethics as in peacetime. They must behave in the following way:
(3) respect the secrets confided in them. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 84.a.(3).
The manual further states:
Medical personnel must not be compelled to give information concerning the wounded and sick in their care.
This refers to information that would, in their opinion, prove harmful to the patients concerned or to their families. This right implies a confidential relationship between patients and those treating them.
There are, however, exceptions to this rule. Regulations for the compulsory notification of communicable diseases must be respected, taking into account the general interest. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 93.e.
Peru
Peru’s IHL and Human Rights Manual (2010) states:
Medical personnel must not be compelled to give information concerning the wounded and sick in their care.
This principle refers to information that would, in their opinion, prove harmful to the wounded and sick or to their families. This right implies a confidential relationship between patients and those tasked with treating them.
There are, however, exceptions to this rule. Regulations for the compulsory notification of communicable diseases must be respected, taking into account the general interest. 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 84(e), p. 286.
The manual also states:
Medical personnel providing medical services in armed conflicts have a duty to respect the principles of medical ethics as they would in peacetime. They must behave in the following way:
(3) Respect the secrets confided in them. 
Peru, Manual de Derecho Internacional Humanitario y Derechos Humanos para las Fuerzas Armadas, Resolución Ministerial No. 049-2010/DE/VPD, Lima, 21 May 2010, § 75(a)(3), p. 273.
Russian Federation
With regard to internal armed conflicts, the Russian Federation’s Regulations on the Application of IHL (2001) states:
Medical personnel may give information concerning the wounded and sick which constitutes a medical secret only in cases provided for by the laws of the Russian Federation concerning the citizens’ health protection. 
Russian Federation, Regulations on the Application of International Humanitarian Law by the Armed Forces of the Russian Federation, Ministry of Defence of the Russian Federation, Moscow, 8 August 2001, § 83.
Spain
Spain’s LOAC Manual (1996) states, with reference to Article 16 of the 1977 Additional Protocol I and Article 10 of the 1977 Additional Protocol II, that medical personnel have the following right:
Prohibition on being compelled to provide information concerning the wounded and sick in their care. This rule is absolute with respect to the relationship between medical personnel and enemy wounded or sick, but when the wounded or the sick are of their own side, they are subject to national law. A general exception is related to the compulsory provision of information regarding communicable diseases. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Publicación OR7-004, 2 Tomos, aprobado por el Estado Mayor del Ejército, División de Operaciones, 18 March 1996, Vol. I, § 9.2.a.(2); see also § 9.6.b.(2).
Spain
Spain’s LOAC Manual (2007) states:
Persons engaged in medical activities must not be compelled to give information concerning the wounded and sick under their care. This rule is absolute in the case of medical personnel treating enemy wounded and sick. Medical personnel treating their own wounded and sick must, however, comply with domestic legislation. A general exception to this rule is the compulsory notification of communicable diseases. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 9.2.a.(2).(c).
The manual further states with regard to the status of the medical personnel of an occupied State:
- They are not required to provide information to the occupying army.
- They are not required to provide information to their own party, except:
- as required under domestic legislation
- in the case of communicable diseases. 
Spain, Orientaciones. El Derecho de los Conflictos Armados, Tomo 1, Publicación OR7–004, (Edición Segunda), Mando de Adiestramiento y Doctrina, Dirección de Doctrina, Orgánica y Materiales, 2 November 2007, § 9.6.b.(2).
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Manual (2004) states:
[A] a person engaged in medical activities [may not] be compelled “to give to anyone belonging either to an adverse Party, or to his own Party except as required by the law of the latter Party, any information concerning the wounded and sick who are, or who have been, under his care, if such information would, in his opinion, prove harmful to the patients concerned or to their families.” However, regulations for the compulsory notification of communicable diseases must be respected. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, § 7.14.1.
With regard to non-international armed conflicts in which the 1977 Additional Protocol II is applicable, the manual states:
“Under no circumstances shall any person be punished for having carried out medical activities compatible with medical ethics, regardless of the person benefiting therefrom.” This general principle is expanded in three areas.
b. The professional obligations of persons engaged in medical activities regarding information which they may acquire concerning the wounded and sick under their care, shall, subject to national law, be respected.
c. Subject to national law, no person engaged in medical activities may be penalized in any way for refusing or failing to give information concerning the wounded and sick who are, or have been, under his care. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, § 15.46.
Yugoslavia, Socialist Federal Republic of
The Socialist Federal Republic of Yugoslavia’s Military Manual (1988) notes: “Yugoslav regulations establish an obligation for medical personnel to provide to competent authorities data on wounded, sick and shipwrecked to whom they have provided assistance.” 
Yugoslavia, Socialist Federal Republic of, Propisi o Primeri Pravila Medjunarodnog Ratnog Prava u Oruzanim Snagama SFRJ, PrU-2, Savezni Sekretarijat za Narodnu Odbranu (Pravna Uprava), 1988, § 197.
Denmark
Denmark’s Military Criminal Code (1973), as amended in 1978, provides:
Any person who uses war instruments or procedures the application of which violates an international agreement entered into by Denmark or the general rules of international law, shall be liable to the same penalty [i.e. a fine, lenient imprisonment or up to 12 years’ imprisonment]. 
Denmark, Military Criminal Code, 1973, as amended in 1978, § 25(1).
Denmark’s Military Criminal Code (2005) provides:
Any person who deliberately uses war means [“krigsmiddel”] or procedures the application of which violates an international agreement entered into by Denmark or international customary law, shall be liable to the same penalty [i.e. imprisonment up to life imprisonment]. 
Denmark, Military Criminal Code, 2005, § 36(2).
Ireland
Ireland’s Geneva Conventions Act (1962), as amended in 1998, provides that any “minor breach” of the 1977 Additional Protocol I, including violations of Article 16(3), as well as any “contravention” of the 1977 Additional Protocol II, including violations of Article 10, are punishable offences. 
Ireland, Geneva Conventions Act, 1962, as amended in 1998, Section 4(1) and (4).
Norway
Norway’s Military Penal Code (1902), as amended in 1981, provides:
Anyone who contravenes or is accessory to the contravention of provisions relating to the protection of persons or property laid down in … the two additional protocols to [the 1949 Geneva] Conventions … is liable to imprisonment. 
Norway, Military Penal Code, 1902, as amended in 1981, § 108(b).
Sri Lanka
Sri Lanka’s Prisons Ordinance (1878), as amended to 2005, states:
PART II
DUTIES OF OFFICERS
MEDICAL OFFICER
18. (1) It shall be lawful for the Minister after consulting the Minister charged with the subject and function of Health to make rules as to each of the following matters:–
(b) the records to be made respecting sick prisoners;
(2) The medical officer shall obey all rules made Medical under subsection (1).
PART VIII
HEALTH OF PRISONERS
67. All recommendations given by the medical officer in relation to any prisoner, with the exception of orders for the supply of medicines or directions relating to such matters as are carried into effect by the medical officer himself or under his superintendence, shall be entered day by day in his journal, which shall have a separate column, wherein entries shall be made by the Superintendent stating in respect of each recommendation the fact of its having been or not having been complied with, accompanied by such observations, if any, as the Superintendent thinks fit to make, and the date of the entry. 
Sri Lanka, Prisons Ordinance, 1878, as amended to 2005, Articles 18(1)(b), 18(2) and 67.
These articles apply to persons deprived of their liberty under Sri Lanka’s Emergency Regulations (2005) pursuant to section 19 of these regulations.
Sri Lanka
Sri Lanka’s Emergency Regulations (2005), as amended to 2008, states:
Any … [person] who renders any medical assistance to, or from whom medical assistance is sought by, an injured person who appears to have received such injury consequent to the use of a firearm, bomb, explosive or other lethal substance or device shall record the particulars of the identity of such injured person, the details of the injury and wherever possible the circumstances under which it had been caused and forthwith furnish such information to the nearest Police station. 
Sri Lanka, Emergency Regulations, 2005, as amended to 2008, Section 72.
Colombia
In 2007, in the Constitutional Case No. C-291/07, the Plenary Chamber of Colombia’s Constitutional Court stated that the obligation in the 1977 Additional Protocol II to respect medical duties “has attained customary status, mainly due to its impact on State practice and on conflicts in the last decades”. 
Colombia, Constitutional Court, Constitutional Case No. C-291/07, Judgment of 25 April 2007, p. 69.
South Africa
In 1987, in the Petane case, the Cape Provincial Division of South Africa’s Supreme Court dismissed the accused’s claim that the 1977 Additional Protocol I reflected customary international law. The Court stated:
The accused has been indicted before this Court on three counts of terrorism, that is to say, contraventions of s 54(1) of the Internal Security Act 74 of 1982. He has also been indicted on three counts of attempted murder.
The accused’s position is stated to be that this Court has no jurisdiction to try him.
… The point in its early formulation was this. By the terms of [the 1977 Additional] Protocol I to the [1949] Geneva Conventions the accused was entitled to be treated as a prisoner-of-war. A prisoner-of-war is entitled to have notice of an impending prosecution for an alleged offence given to the so-called “protecting power” appointed to watch over prisoners-of-war. Since, if such a notice were necessary, the trial could not proceed without it, Mr Donen suggested that the necessity or otherwise for giving such a notice should be determined before evidence was led. …
On 12 August 1949 there were concluded at Geneva in Switzerland four treaties known as the Geneva Conventions. …
South Africa was among the nations which concluded the treaties. … Except for the common art 3, which binds parties to observe a limited number of fundamental humanitarian principles in armed conflicts not of an international character, they apply to wars between States.
After the Second World War many conflicts arose which could not be characterised as international. It was therefore considered desirable by some States to extend and augment the provisions of the Geneva Conventions, so as to afford protection to victims of and combatants in conflicts which fell outside the ambit of these Conventions. The result of these endeavours was Protocol I and Protocol II to the Geneva Conventions, both of which came into force on 7 December 1978.
Protocol II relates to the protection of victims of non-international armed conflicts. Since the State of affairs which exists in South Africa has by Protocol I been characterised as an international armed conflict, Protocol II does not concern me at all.
The extension of the scope of art 2 of the Geneva Conventions was, at the time of its adoption, controversial. …
The article has remained controversial. More debate has raged about its field of operation than about any other articles in Protocol I. …
South Africa is one of the countries which has not acceded to Protocol I. Nevertheless, I am asked to decide, as I indicated earlier, as a preliminary point, whether Protocol I has become part of customary international law. If so, it is argued that it would have been incorporated into South African law. If it has been so incorporated it would have to be proved by one or other of the parties that the turmoil which existed at the time when the accused is alleged to have committed his offences was such that it could properly be described as an “armed conflict” conducted by “peoples” against a “ra[c]ist regime” in the exercise of their “right of self-determination”. Once all this has been shown it would have to be demonstrated to the Court that the accused conducted himself in such a manner as to become entitled to the benefits conferred by Protocol I on combatants, for example that, broadly speaking, he had, while he was launching an attack, distinguished himself from civilians and had not attacked civilian targets. …
… I am prepared to accept that where a rule of customary international law is recognised as such by international law it will be so recognised by our law.
To my way of thinking, the trouble with the first Protocol giving rise to State practice is that its terms have not been capable of being observed by all that many States. At the end of 1977 when the treaty first lay open for ratification there were few States which were involved in colonial domination or the occupation of other States and there were only two, South Africa and Israel, which were considered to fall within the third category of ra[c]ist regimes. Accordingly, the situation sought to be regulated by the first Protocol was one faced by few countries; too few countries in my view, to permit any general usage in dealing with armed conflicts of the kind envisaged by the Protocol to develop.
Mr Donen contended that the provisions of multilateral treaties can become customary international law under certain circumstances. I accept that this is so. There seems in principle to be no reason why treaty rules cannot acquire wider application than among the parties to the treaty.
Brownlie Principles of International Law 3rd ed at 13 agrees that non-parties to a treaty may by their conduct accept the provisions of a multilateral convention as representing general international law. …
I incline to the view that non-ratification of a treaty is strong evidence of non-acceptance.
It is interesting to note that the first Protocol makes extensive provision for the protection of civilians in armed conflict. …
In this sense, Protocol I may be described as an enlightened humanitarian document. If the strife in South Africa should deteriorate into an armed conflict we may all one day find it a cause for regret that the ideologically provocative tone of s 1(4) has made it impossible for the Government to accept its terms.
To my mind it can hardly be said that Protocol I has been greeted with acclaim by the States of the world. Their lack of enthusiasm must be due to the bizarre mixture of political and humanitarian objects sought to be realised by the Protocol. …
According to the International Review of the Red Cross (January/February 1987) No 256, as at December 1986, 66 States were parties to Protocol I and 60 to Protocol II, which, it will be remembered, deals with internal non-international armed conflicts. With the exception of France, which acceded only to Protocol II, not one of the world’s major powers has acceded to or ratified either of the Protocols. This position should be compared to the 165 States which are parties to the Geneva Conventions.
This approach of the world community to Protocol I is, on principle, far too half-hearted to justify an inference that its principles have been so widely accepted as to qualify them as rules of customary international law. The reasons for this are, I imagine, not far to seek. For those States which are contending with “peoples[’]” struggles for self-determination, adoption of the Protocol may prove awkward. For liberation movements who rely on strategies of urban terror for achieving their aims the terms of the Protocol, with its emphasis on the protection of civilians, may prove disastrously restrictive. I therefore do not find it altogether surprising that Mr Donen was unable to refer me to any statement in the published literature that Protocol I has attained the status o[f] customary international [law].
I have not been persuaded by the arguments which I have heard on behalf of the accused that the assessment of Professor Dugard, writing in the Annual Survey of South African Law (1983) at 66, that “it is argued with growing conviction that under contemporary international law members of SWAPO [South-West Africa People’s Organisation] and the ANC [African National Congress] are members of liberation movements entitled to prisoner-of-war status, in terms of a new customary rule spawned by the 1977 Protocols”, is correct. On what I have heard in argument I disagree with his assessment that there is growing support for the view that the Protocols reflect a new rule of customary international law. No writer has been cited who supports this proposition. Here and there someone says that it may one day come about. I am not sure that the provisions relating to the field of application of Protocol I are capable of ever becoming a rule of customary international law, but I need not decide that point today.
For the reasons which I have given I have concluded that the provisions of Protocol I have not been accepted in customary international law. They accordingly form no part of South African law.
This conclusion has made it unnecessary for me to give a decision on the question of whether rules of customary international law which conflict with the statutory or common law of this country will be enforced by its courts.
In the result, the preliminary point is dismissed. The trial must proceed. 
South Africa, Supreme Court, Petane case, Judgment, 3 November 1987, pp. 2–8.
South Africa
In 2010, in the Boeremag case, South Africa’s North Gauteng High Court stated:
In Petane, … Conradie J found that the provisions of [the 1977 Additional] Protocol I are not part of customary international law, and therefore are also not part of South African law.
Referring to the fact that in December 1986 only 66 of the 165 States party to the Geneva Conventions had ratified Protocol I, the Court [in Petane] stated:
This approach of the world community to Protocol I is, on principle, far too half-hearted to justify an inference that its principles have been so widely accepted as to qualify them as rules of customary international law. The reasons for this are, I imagine, not far to seek. For those States which are contending with “peoples[’]” struggles for self-determination, adoption of the Protocol may prove awkward. For liberation movements who rely on strategies of urban terror for achieving their aims the terms of the Protocol, with its emphasis on the protection of civilians, may prove disastrously restrictive. I therefore do not find it altogether surprising that Mr Donen was unable to refer me to any statement in the published literature that Protocol I has attained the status of customary international law.
Important changes with respect to certain aspects applicable at the time of Petane have taken place. The ANC [African National Congress] has become South Africa’s ruling party and in 1995 ratified Protocol I. The total number of States that have ratified it, is now … 162.
This last aspect forms the basis on which the First Respondent [the State] and the applicants agree that Protocol I forms part of customary international law as well as of South African law. As requested, this position is accepted for the purposes of the decision, without deciding on the matter.
Despite these changes, it remains debatable whether the provisions of Protocol I have become a part of South African law in this way.
The consensus of both parties to the conflict is required. See Petane … and Article 96 of Protocol I. …
Parliament’s failure to incorporate Protocol I into legislation in accordance with Article 231(4) of the Constitution in fact points to the contrary, and is indicative that the requirements of usus and/or opinio juris have not been met. See Petane. 
South Africa, North Gauteng High Court, Boeremag case, Judgment, 26 August 2010, pp. 21–22.
[footnotes in original omitted]
The Court also held:
If the [1977 Additional Protocol I] applies in South Africa as customary international law, the two requirements that form the basis of customary law must be met. It is arguable that the requirement of usus has been met by the vast number of States that have acceded or ratified it. By ratifying Protocol I the Republic of South Africa has indicated its intention to apply the Protocol, thereby fulfilling the requirement of opinio juris. 
South Africa, North Gauteng High Court, Boeremag case, Judgment, 26 August 2010, p. 66.
Cuba
At the CDDH, Cuba stated: “The performer of a medical action was free to decide whether or not to give information to a third party.” 
Cuba, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.16, 10 February 1975, p. 152, § 65.
Denmark
At the CDDH, Denmark stated: “The principle of non-denunciation of the wounded and sick had already been established in 1959 by the WMA [World Medical Association], the International Committee of Military Medicine and Pharmacy and the ICRC.” 
Denmark, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.39, 20 March 1975, p. 422, § 21.
Denmark
At the CDDH, Denmark supported the view of the Netherlands (see infra), stating: “The provision of information by medical personnel should not be made compulsory to the detriment of underground movements.” 
Denmark, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.16, 10 February 1975, p. 152, § 63.
France
At the CDDH, France stated: “Physicians, who were also citizens, were deeply distressed by the obligation to report wounds caused by firearms in time of war. That did not apply to the obligation to report communicable diseases.” 
France, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.16, 10 February 1975, p. 151, § 55.
Netherlands
In the discussion at the CDDH on a proposal by Brazil, which purported to add “wounds by firearms, or other evidence related to a criminal offence” as a further exception, the Netherlands stated: “Physicians should not be obliged to denounce a member of a resistance movement who had wounded a member of the occupying forces.” 
Netherlands, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.16, 10 February 1975, p. 152, § 59.
Norway
At the CDDH, Norway stated it “deeply regretted” the inclusion in Article 10 of the 1977 Additional Protocol II of the words “subject to national law” because it was unacceptable “that an international legal norm of the importance of [the 1977 Additional Protocol II] should be made subject to the national law of any country”. It added that “it was unlikely that Norway would be able to ratify [the 1977 Additional Protocol II] if the words ‘subject to national law’ were maintained”. 
Norway, Statement at the CDDH, Official Records, Vol. XI, CDDH/II/SR.46, 4 April 1975, p. 513, § 2
Notwithstanding this statement, Norway ratified the two Additional Protocols in 1981 without making any reservation or declaration.
Philippines
An Executive Order of the Philippines of 1987 provides that all medical practitioners must report to the authorities any person treated by them for wounds that are subject to the provisions of the Criminal Code relative to physical injuries, including those they suspect to belong to the insurgent forces. 
Philippines, Executive Order 212, 1987.
United States of America
In 1987, in submitting the 1977 Additional Protocol II to the US Senate for advice and consent to ratification, the US President recommended a reservation to Article 10 of the 1977 Additional Protocol II to make clear that military medical personnel could be required to disclose otherwise confidential information to appropriate authorities. 
United States, Message from the US President transmitting the 1977 Additional Protocol II to the US Senate for advice and consent to ratification, Treaty Doc. 100-2, 29 January 1987, Comment on Article 10.
No data.
Council of Europe Parliamentary Assembly
In a resolution adopted in 1988 on the protection of humanitarian medical missions, the Council of Europe Parliamentary Assembly stated: “No member of a medical staff may be compelled to provide information concerning the persons to whom he has given assistance with the exception of information concerning contagious diseases.” 
Council of Europe, Parliamentary Assembly, Res. 904 (1988), 30 June 1988, Appendix XVI, § 3.
Third International Congress on the Neutrality of Medicine
The Third International Congress on the Neutrality of Medicine in 1968 recommended that the principle of non-denunciation should be categorically recognized. 
Third International Congress on the Neutrality of Medicine, Medical-Legal Commission, Monaco, 17-20 April 1968, Annales de Droit international médical, No. 18, December 1968, pp. 74–76.
No data.
ICRC
To fulfil its task of disseminating IHL, the ICRC has delegates around the world teaching armed and security forces that:
No person engaged in medical activities (e.g. doctor, nurse) shall be compelled to give to anyone any information concerning the wounded and sick who are, or who have been, under his care, if such information would, in his opinion, prove harmful to the patients concerned or their families. However, information must be given when required:
a) by the law of the Party to which the person engaged in medical activities belongs;
b) by regulations for the compulsory notification of communicable diseases. 
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, § 218.
International Law Association
A report on Medical Secrecy during Armed Conflict prepared for the Fifty-third Conference of the International Law Association in 1968 recommended the following:
The Geneva Conventions should be complemented by a provision to the effect that the parties to the conflict must strictly respect medical secrecy and may not require medical and para-medical personnel, military or civilian, to denounce their patients – combatants from the adverse party.
The Conference endorsed this recommendation in a resolution adopted unanimously. 
International Law Association, Report of the Fifty-third Conference, Buenos Aires, 25–31 August, 1968, pp. 548 and 573.
World Medical Association
The World Medical Association’s Regulations in Time of Armed Conflict established in 1983 state: “Medical confidentiality must be preserved by the physician in the practice of his profession.” 
World Medical Association, Regulations in Time of Armed Conflicts, amended by the 35th World Medical Assembly, 1983, § 5, quoted in Yves Sandoz et al. (eds.), Commentary on the Additional Protocols, ICRC, Geneva, 1987, pp. 200–201, § 656, footnote 11.
World Medical Association
The World Medical Association’s Rules Governing the Care of the Sick and Wounded, Particularly in Time of Conflict state: “The fulfilment of medical duties and responsibilities shall in no circumstance be considered an offence. The physician must never be prosecuted for observing professional confidentiality.” 
World Medical Association, Rules Governing the Care of the Sick and Wounded, Particularly in Time of Conflict, amended by the 35th World Medical Assembly, 1983, § B(3), quoted in Yves Sandoz et al. (eds.), Commentary on the Additional Protocols, ICRC, Geneva, 1987, p. 201, § 656, footnote 12.
Medical Action Group (MAG)
In a report in 1989, MAG, a Philippine NGO, noted that a health worker was ordered to report all her treatment activities to the military or the vigilantes. 
Aurora A. Parong, Total War: A Threat to People’s Health and Lives, Medical Action Group (MAG), Philippines, 1989, p. 3, Point 3.