Rule 110. The wounded, sick and shipwrecked must receive, to the fullest extent practicable and with the least possible delay, the medical care and attention required by their condition. No distinction may be made among them founded on any grounds other than medical ones.
State practice establishes this rule as a norm of customary international law applicable in both international and non-international armed conflicts.
The duty to care for wounded and sick combatants without distinction is a long-standing rule of customary international law already recognized in the Lieber Code and codified in the 1864 Geneva Convention.
This subject is dealt with in more detail by the 1949 Geneva Conventions.
It is now codified in Article 10 of Additional Protocol I.
The numerous military manuals which contain this rule are phrased in general terms covering all wounded, sick and shipwrecked.
Sweden’s IHL Manual, in particular, identifies Article 10 of Additional Protocol I as a codification of customary international law.
To deny medical care to the wounded, sick and shipwrecked is an offence under the legislation of many States.
In the context of a non-international armed conflict, this rule is based on common Article 3 of the Geneva Conventions, which provides that “the wounded and sick shall be collected and cared for”.
It is codified in a more detailed manner in Additional Protocol II.
In addition, it is set forth in a number of other instruments pertaining also to non-international armed conflicts.
The duty to care for wounded and sick combatants without distinction is set forth in a number of military manuals which are applicable in or have been applied in non-international armed conflicts.
Under the legislation of many States, it is an offence to deny medical care to the wounded, sick and shipwrecked.
Respect for this rule was required by Argentina’s National Court of Appeals in the Military Junta case
Furthermore, there are official statements and other practice supporting this rule in the context of non-international armed conflicts.
No official contrary practice was found with respect to either international or non-international armed conflicts. States and international organizations have generally condemned violations of this rule.
The ICRC has called on parties to both international and non-international armed conflicts to respect this rule.
The obligation to protect and care for the wounded, sick and shipwrecked is an obligation of means. Each party to the conflict must use its best efforts to provide protection and care for the wounded, sick and shipwrecked, including permitting humanitarian organizations to provide for their protection and care. Practice shows that humanitarian organizations, including the ICRC, have engaged in the protection and care of the wounded, sick and shipwrecked. It is clear that in practice these organizations need permission from the party in control of a certain area to provide protection and care, but such permission must not be denied arbitrarily (see also commentary to Rule 55).
In addition, the possibility of calling on the civilian population to assist in the care of the wounded, sick and shipwrecked is recognized in practice. Aid offered by the civilian population is recognized by the 1864 Geneva Convention, the First Geneva Convention and Additional Protocols I and II.
This possibility is also recognized in a number of military manuals.
The rule that no distinction may be made among the wounded, sick and shipwrecked except on medical grounds is often expressed in international humanitarian law as a prohibition of “adverse distinction” (see also Rule 88). This means that a distinction may be made which is beneficial, in particular by treating persons requiring urgent medical attention first, without this being discriminatory treatment between those treated first and those treated afterwards. This principle is set forth in many military manuals.
It is also supported by the requirement of respect for medical ethics, as set forth in Additional Protocols I and II (see also Rule 26), to the effect that medical personnel may not be required to give priority to any person, except on medical grounds.