Practice Relating to Rule 26. Medical Activities

Geneva Convention I
Article 18, third paragraph, of the 1949 Geneva Convention I provides: “No one may ever be molested or convicted for having nursed the wounded or sick.” 
Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, Geneva, 12 August 1949, Article 18, para. 3.
Additional Protocol I
Article 16 of the 1977 Additional Protocol I provides:
1. Under no circumstances shall any person be punished for carrying out medical activities compatible with medical ethics, regardless of the person benefiting therefrom.
2. Persons engaged in medical activities shall not be compelled to perform acts or to carry out work contrary to medical ethics or to other medical rules designed for the benefit of the wounded and sick or to the provisions of the Conventions or of this Protocol, or to refrain from performing acts or carrying out work required by those rules and provisions. 
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. 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:
1. Under no circumstances shall any person be punished for having carried out medical activities compatible with medical ethics, regardless of the person benefiting therefrom.
2. Persons engaged in medical activities shall neither be compelled to perform acts or to carry out work contrary to, nor be compelled to refrain from acts required by, the rules of medical ethics or other rules designed for the benefit of the wounded and sick, or this Protocol. 
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. Article 10 was adopted by consensus. CDDH, Official Records, Vol. VII, CDDH/SR.51, 3 June 1977, p. 112.
No data.
Argentina
Argentina’s Law of War Manual (1989) provides with respect to non-international armed conflicts in particular:
No one shall be punished for having carried out a medical activity in conformity with medical ethics, whatever the circumstances or beneficiaries of this activity. No one shall be compelled to perform acts contrary to medical ethics or to refrain from acts required by medical ethics. 
Argentina, Leyes de Guerra, PC-08-01, Público, Edición 1989, Estado Mayor Conjunto de las Fuerzas Armadas, aprobado por Resolución No. 489/89 del Ministerio de Defensa, 23 April 1990, § 7.06.
Australia
Australia’s Defence Force Manual (1994) provides:
Medical personnel, military or civilian, cannot be compelled to give preferential treatment to any sick or wounded person, except on medical grounds, nor may they be compelled to carry out any act incompatible with their humanitarian mission or medical ethics. No person may be punished for carrying out medical activities in accordance with medical ethics, regardless of the nationality or status of the person treated. 
Australia, Manual on Law of Armed Conflict, Australian Defence Force Publication, Operations Series, ADFP 37 – Interim Edition, 1994, § 967.
Australia
Australia’s LOAC Manual (2006) states:
Medical personnel, military or civilian, cannot be compelled to give preferential treatment to any sick or wounded person, except on medical grounds, nor may they be compelled to carry out any act incompatible with their humanitarian mission or medical ethics. No person may be punished for carrying out medical activities in accordance with medical ethics, regardless of the nationality or status of the person treated. 
Australia, The Manual of the Law of Armed Conflict, Australian Defence Doctrine Publication 06.4, Australian Defence Headquarters, 11 May 2006, § 9.72.
The LOAC Manual (2006) replaces both the Defence Force Manual (1994) and the Commanders’ Guide (1994).
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
The Occupying Power cannot instruct the medical personnel irrespective of for whom they are carrying out their mission, except for medical reasons (it is thus unlawful for the Occupying Power to instruct the civilian medical personnel to give priority in their care to its wounded and sick to the detriment of the wounded and sick of the occupied territory).
Lastly, the Occupying Power must not force the civilian medical personnel to carry out tasks incompatible with its humanitarian mission. 
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.
The manual also states: “In the domain of medical activities, only reasons of medical urgency authorize a priority in the order of care.” 
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. 93, § 352.20.
Canada
Canada’s LOAC Manual (1999) states:
Medical personnel cannot be required to provide preferential treatment to any sick or wounded person except on medical grounds. They may not be compelled to carry out any act incompatible with their humanitarian mission or medical ethics. Furthermore, no one may be punished for carrying out their medical activities in accordance with medical ethics, regardless of the nationality or status of the person treated”. 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 9-3, § 29.
With respect to non-international armed conflict in particular, the manual states:
34. In accordance with general medical practice, medical personnel may not be required to give priority to any person except for medical reasons… . [They] may not be compelled to perform any action incompatible with their humanitarian mission.
35. Medical aid is to be offered to all without distinction. Persons may not be punished for carrying out any medical activities compatible with their own medical ethics. Medical personnel may not be compelled to perform acts contrary to, or refrain from acts required by, their medical ethics or other rules for the protection of the sick, wounded or shipwrecked. 
Canada, The Law of Armed Conflict at the Operational and Tactical Level, Office of the Judge Advocate General, 1999, p. 17-4, §§ 34–35.
Canada
Canada’s LOAC Manual (2001) states in its chapter on the treatment of the wounded, sick and shipwrecked:
Medical personnel cannot be required to provide preferential treatment to any sick or wounded person except on medical grounds. They may not be compelled to carry out any act incompatible with their humanitarian mission or medical ethics. Furthermore, no one may be punished for carrying out their medical activities in accordance with medical ethics, regardless of the nationality or status of the person treated. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 914.3.
In its chapter on non-international armed conflicts, the manual states:
2. In accordance with general medical practice, medical personnel may not be required to give priority to any person except for medical reasons … [They] may not be compelled to perform any action incompatible with their humanitarian mission …
3. Medical aid is to be offered to all without distinction. Persons may not be punished for carrying out any medical activities compatible with their own medical ethics. Medical personnel may not be compelled to perform acts contrary to, or refrain from acts, required by their medical ethics or other rules for the protection of the sick, wounded or shipwrecked. 
Canada, The Law of Armed Conflict at the Operational and Tactical Levels, Office of the Judge Advocate General, 13 August 2001, § 1719.2.
Chad
Chad’s Instructor’s Manual (2006) states that “persons carrying out a medical activity may not be compelled to carry out acts or work that are contrary to professional ethics”. 
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.
France
France’s LOAC Manual (2001), under the heading “Red Cross and Red Crescent (rules of protection)”, provides:
The protection is linked to the medical purposes of the actions undertaken and finds its expression in the limitation of detention, in the granting of facilities when that personnel carries out its activity, and in the assurance not to be punished for any medical activity compatible with medical ethics. 
France, Manuel de droit des conflits armés, Ministère de la Défense, Direction des Affaires Juridiques, Sous-Direction du droit international humanitaire et du droit européen, Bureau du droit des conflits armés, 2001, p. 46.
Israel
Israel’s Manual on the Rules of Warfare (2006) forbids “interference with the provision of medical assistance”. 
Israel, Rules of Warfare on the Battlefield, Military Advocate-General’s Corps Command, IDF School of Military Law, Second Edition, 2006, p. 24.
The Manual on the Rules of Warfare (2006) is a second edition of the Manual on the Laws of War (1998).
Mexico
Mexico’s Army and Air Force Manual (2009), in a section on the 1977 Additional Protocol I, states that medical personnel “must not be compelled to carry out medical activities that are not consistent with medical ethics.” 
Mexico, Manual de Derecho Internacional Humanitario para el Ejército y la Fuerza Área Mexicanos, Ministry of National Defence, June 2009, § 273.
Netherlands
The Military Manual (1993) of the Netherlands restates the prohibition to violate medical ethics found in Article 16 of the 1977 Additional Protocol I. 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, p. VI-4.
With respect to non-international armed conflicts in particular, the manual states:
[Medical personnel] may not be compelled to perform tasks which are incompatible with their humanitarian mission. Medical personnel may not be required to give priority to any person, except on medical grounds. Nobody may be punished for having carried out medical acts which are compatible with medical ethics, regardless of the persons who benefited from those acts. 
Netherlands, Toepassing Humanitair Oorlogsrecht, Voorschift No. 27-412/1, Koninklijke Landmacht, Ministerie van Defensie, 1993, p. XI-6.
Netherlands
The Military Manual (2005) of the Netherlands states:
No one may be punished for carrying out medical treatment compatible with medical ethics, regardless of who benefits from such actions. Persons who do medical work may not be ordered to engage in activities incompatible with the rules of medical ethics or with the requirements of the humanitarian law of war, neither may they be forced to refrain from activities prescribed by medical rules or requirements. 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 0617.
In its chapter on non-international armed conflict, the manual states:
Medical and religious personnel must be respected, protected and helped in fulfilling their duties. They may not be forced to carry out tasks incompatible with their humanitarian mission. Medical personnel may not be required to give priority to a person, save on medical grounds, while carrying out their duties. No one may be punished for carrying out medical actions which are compatible with medical ethics, no matter who benefited from the treatment. 
Netherlands, Humanitair Oorlogsrecht: Handleiding, Voorschift No. 27-412, Koninklijke Landmacht, Militair Juridische Dienst, 2005, § 1057.
New Zealand
New Zealand’s Military Manual (1992) provides:
Medical personnel, military or civilian, cannot be required to afford preferential treatment to any sick or wounded person, except on medical grounds; nor may they be compelled to carry out any act incompatible with their humanitarian mission or medical ethics. No person may be punished for carrying out his medical activities in accordance with medical ethics, regardless of the nationality or status of the person treated. 
New Zealand, Interim Law of Armed Conflict Manual, DM 112, New Zealand Defence Force, Headquarters, Directorate of Legal Services, Wellington, November 1992, § 1005(2).
With respect to non-international armed conflicts in particular, the manual states:
In accordance with general medical practice, medical personnel may not be required to give priority to any person except for medical reasons … They may not be compelled to perform any action incompatible with their humanitarian mission. 
New Zealand, Interim Law of Armed Conflict Manual, DM 112, New Zealand Defence Force, Headquarters, Directorate of Legal Services, Wellington, November 1992, § 1818(2).
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:
(1) practise their profession with conscience and dignity;
(2) make the health of the patient their first consideration. 
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.(1) and (2).
The manual further states:
c. Medical personnel must not be punished for carrying out medical activities compatible with the principles of medical ethics.
This means that medical activities must not, under any circumstances, give rise to violence, threats, reprisals, prosecution or criminal or administrative punishment, if they are performed in keeping with the principles of medical ethics, regardless of the circumstances and the person benefiting from their assistance (no distinction must be made between friend and foe).
d. Medical personnel must not be compelled to act contrary to the rules of medical ethics.
Medical personnel must never be compelled to perform acts or to carry out work contrary to the rules of medical ethics, other medical rules designed for the benefit of the wounded and sick or the provisions of the Geneva Conventions and their Protocols. 
Peru, Manual de Derecho Internacional Humanitario para las Fuerzas Armadas, Resolución Ministerial Nº 1394-2004-DE/CCFFAA/CDIH-FFAA, Lima, 1 December 2004, § 93.c and d.
Peru
Peru’s IHL and Human Rights Manual (2010) states:
c. Medical personnel must not be punished or interrupted for carrying out medical activities compatible with the principles of medical ethics.
This means that medical activities must not, under any circumstances, give rise to violence, threats, prosecution or punishment (criminal or administrative sanctions), if they are performed in accordance with the principles of medical ethics, regardless of the circumstances and the person benefiting from their assistance (no distinction must be made between the wounded and sick based on whether they are friend or foe).
d. Medical personnel must not be compelled to act contrary to the rules of medical ethics.
Medical personnel must never be compelled to perform acts or to carry out acts or work incompatible with their humanitarian obligations and contrary to the principles of medical ethics or other medical … rules designed for the benefit of the wounded and sick or contrary to the provisions of the [1949 Geneva] Conventions and their [1977 Additional] Protocols. 
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(c)–(d), 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 in peacetime. They must behave in the following way:
(1) practise their profession with conscience and dignity;
(2) make the health of the patient their first consideration. 
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)(1)–(2), p. 273.
Senegal
Senegal’s IHL Manual (1999) states:
No one shall be punished for having carried out a humanitarian act in conformity with medical ethics.
Persons engaged in medical activities shall not be compelled:
1. to perform acts or to carry out work contrary to medical ethics; or
2. to refrain from performing acts or from carrying out work required by medical ethics. 
Senegal, Le DIH adapté au contexte des opérations de maintien de l’ordre, République du Sénégal, Ministère des Forces Armées, Haut Commandement de la Gendarmerie et Direction de la Justice Militaire, Cabinet, 1999, p. 17.
Spain
Spain’s LOAC Manual (1996) provides, with reference to Article 16 of the 1977 Additional Protocol I and Article 10 of the 1977 Additional Protocol II, that IHL imposes a duty on medical personnel “to respect the principles of medical ethics”. 
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 that IHL imposes a duty on medical personnel to “respect the principles of medical ethics”. 
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).(a).
The manual further states:
Medical personnel must not be punished for carrying out medical activities in keeping with medical ethics. Therefore, medical activities must not give rise to reprisals, threats, violence, prosecution or criminal or administrative punishment.
Persons engaged in medical activities must not be compelled to perform acts or carry out work contrary to the rules of medical ethics. 
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); see also § 9.6.b.(2).
Switzerland
Switzerland’s Regulation on Legal Bases for Conduct during an Engagement (2005) states:
13 Protected persons
13.1 Behaviour with regard to the wounded, sick and shipwrecked and medical and religious personnel
174 In combat, the disarmament, rescue of and the provision of first aid to the wounded, sick and shipwrecked begins as soon as the situation allows. For security reasons this usually does not happen spontaneously. The superiors make the necessary arrangements. No distinction may be made between friend and enemy or between civilian and military personnel. Purely medical criteria determine the priority in medical treatment. No one may be punished for having cared for the wounded or sick.
176 Medical personnel, equipment and means of transport as well as localities used by the military service must be spared and must not be hindered in the fulfilment of their mission.
177 … Civilian and military medical personnel must be enabled to carry out their duties at all times. 
Switzerland, Bases légales du comportement à l’engagement (BCE), Règlement 51.007/IVf, Swiss Army, issued based on Article 10 of the Ordinance on the Organization of the Federal Department for Defence, Civil Protection and Sports of 7 March 2003, entry into force on 1 July 2005, §§ 174 and 176–177.
United Kingdom of Great Britain and Northern Ireland
The UK LOAC Manual (2004) states:
7.14. It is forbidden to punish anyone who carries out “medical activities compatible with medical ethics regardless of the person benefiting therefrom.”
7.14.1. This covers not only “medical personnel” as defined above but all persons engaged in medical activities, including not only civilian medical and dental practitioners and their ancillary staff but also unqualified persons who administer first aid. Similarly those “engaged in medical activities shall not be compelled to perform acts or to carry out work contrary to the rules of medical ethics or to other medical rules”. 
United Kingdom, The Manual of the Law of Armed Conflict, Ministry of Defence, 1 July 2004, §§ 7.14–7.14.1.
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.
a. Persons engaged in medical activities shall neither be compelled to perform acts or to carry out work contrary to, nor be compelled to refrain from acts required by, the rules of medical ethics or other rules designed for the benefit of the wounded and sick, or the Protocol. 
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) states:
No person may be punished for the performance of any medical duty compatible with medical ethics, regardless of the person benefiting therefrom. Medical personnel shall not be compelled to perform acts contrary to medical ethics or to refrain from performing acts dictated by medical ethics. 
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.
Bangladesh
Bangladesh’s International Crimes (Tribunal) Act (1973) states that the “violation of any humanitarian rules applicable in armed conflicts laid down in the Geneva Conventions of 1949” is a crime. 
Bangladesh, International Crimes (Tribunal) Act, 1973, Section 3(2)(e).
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).
Ethiopia
Ethiopia’s Criminal Code (2004) states:
Article 271.- War Crimes against Wounded, Sick or Shipwrecked Persons or Medical Services.
(1) Whoever, in the circumstances defined above [i.e., in time of war, armed conflict or occupation … and in violation of the rules of public international law and of international humanitarian conventions] organizes, orders or engages in:
(c) compelling persons engaged in medical … activities to perform acts or to carry out work contrary to or to refrain from acts required by their … professional rules and ethics or other rules designed for the benefit of the wounded, sick or civilian population,
is punishable in accordance with [rigorous imprisonment from five years to twenty-five years, or, in more serious cases, with life imprisonment or death]. 
Ethiopia, Criminal Code, 2004, Article 271(1)(c).
Ireland
Ireland’s Geneva Conventions Act (1962), as amended in 1998, provides that any “minor breach” of the 1949 Geneva Conventions, including violations of Article 18 of the Geneva Convention I, and of the 1977 Additional Protocol I, including violations of Article 16, 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 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 Geneva Conventions of 12 August 1949 … [and in] the two additional protocols to these Conventions … is liable to imprisonment. 
Norway, Military Penal Code, 1902, as amended in 1981, § 108.
Sri Lanka
Sri Lanka’s Prisons Ordinance (1878), as amended to 2005, states:
DUTIES OF OFFICERS
MEDICAL OFFICER
20. (1) It shall be the duty of the medical officer to keep under close observation every prisoner whose health is or is likely to be injuriously affected by any inability or failure to take food or sufficient food, and to subject every such prisoner to any medical treatment that may be necessary at the earliest possible stage after his condition is discovered.
(2) The medical officer may, whenever he considers it to be necessary or advisable, adopt any device or means which may appear to him to be suitable –
(a) for the compulsory feeding of any prisoner who, in the opinion of the medical officer, feigns inability to take food or willfully refuses food with intent to procure a discharge from prison or any exemption from labour or for any other reason; or
(b) for the artificial feeding of any prisoner who has become unconscious or otherwise unable to feed himself.
(3) The medical officer shall personally carry out the compulsory or artificial feeding required in any case referred to in subsection (2), and shall, in every such case, take all due precautions to ensure that no greater force is used than may be reasonably necessary for the purposes of such feeding.
(4) The medical officer shall report to the Superintendent for the information of the Commissioner-General, and to the Director-General of Health Services, full particulars of every case of compulsory or artificial feeding carried out by him.
(5) No criminal prosecution or civil action shall be instituted or maintained against the medical officer in respect of any injury caused or alleged to have been caused to any prisoner by any act of the medical officer in the course of any compulsory or artificial feeding carried out by him or by the omission of the medical officer in the exercise of his discretion to adopt any measures for the compulsory or artificial feeding of the prisoner. 
Sri Lanka, Prisons Ordinance, 1878, as amended to 2005, Article 20.
This article applies to persons deprived of their liberty under Sri Lanka’s Emergency Regulations (2005) pursuant to section 19 of these regulations.
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.
United States of America
In the Levy case in 1968, the US Army Board of Review held that medical ethics could not excuse disobedience to the orders of a superior. An army doctor had pleaded that the order to train Green Berets paramedics was contrary to medical ethics, which forbade training unqualified personnel to perform treatment which should be done by a physician. 
United States, United States Army Board of Review, Levy case, Judgment, 29 August 1968.
United Kingdom of Great Britain and Northern Ireland
The Report on UK Practice refers to a letter from an army lawyer in which it is stated that any interference with medical ethics by military authorities would be very unlikely. Medical personnel are members of their relevant professional bodies, and there would be a strong response if the Ministry of Defence or a commander were seeking to override medical ethics. 
Report on UK Practice, 1997, Letter from an army lawyer, 24 February 1998, Chapter 2.7.
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 preclude the possibility that it might affect the administration of discipline of US military personnel. 
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.
United States of America
In its Country Report on Human Rights Practices for 1996, the US Department of State noted, in the section on Turkey and under the heading “Use of Excessive Force and Violations of Humanitarian Law in Internal Conflicts”, that the provisions of the Turkish Penal Code and Anti-Terror Law prohibiting assistance to illegal organizations or armed groups were used extensively to prosecute health professionals who provided care to individuals suspected of being members of terrorist organizations. 
United States, Department of State, Country Reports on Human Rights Practices for 1996: Turkey, United States Government Printing Office, Washington, D.C., 1997, p. 1163.
Commenting on this, the Report on US Practice states the principle that: “During internal armed conflict, medical personnel should not be punished solely for treating the wounded.” 
Report on US Practice, 1997, Chapter 5.7.
UN General Assembly
In a resolution adopted in 1989 on the situation of human rights in El Salvador, the UN General Assembly considered that under the 1977 Additional Protocol II “no one may be punished for carrying out medical activities compatible with medical ethics, regardless of the circumstances and the beneficiaries of such activities” and requested that “medical and health personnel shall under no circumstances be penalized for carrying out their activities”. 
UN General Assembly, Res. 44/165, 15 December 1989, preamble and § 5, adopted without a vote.
UN Commission on Human Rights
In a resolution adopted in 1990 on the situation of human rights in El Salvador, the UN Commission on Human Rights requested the parties to the conflict “in no circumstances to penalize medical and health personnel for carrying out their activities”. 
UN Commission on Human Rights, Res. 1990/77, 7 March 1990, § 10, adopted without a vote.
UN Commission on Human Rights
In a resolution adopted in 2003 on torture and other cruel, inhuman or degrading treatment or punishment, the UN Commission on Human Rights urged governments to “protect medical and other personnel for their role in documenting torture or any other form of cruel, inhuman or degrading treatment or punishment and in treating victims of such acts”. 
UN Commission on Human Rights, Res. 2003/32, 23 April 2003, § 11, adopted without a vote.
UN Commission on Human Rights
In a resolution adopted in 2004 on torture and other cruel, inhuman or degrading treatment or punishment, the UN Commission on Human Rights urged governments “to protect medical and other personnel for their role in documenting torture or any other form of cruel, inhuman or degrading treatment or punishment and in treating victims of such acts”. 
UN Commission on Human Rights, Res. 2004/41, 19 April 2004, § 11, adopted without a vote.
UN Commission on Human Rights
In a resolution adopted in 2005 on torture and other cruel, inhuman or degrading treatment or punishment, the UN Commission on Human Rights urged governments “to protect medical and other personnel for their role in documenting torture or any other form of cruel, inhuman or degrading treatment or punishment and in treating victims of such acts”. 
UN Commission on Human Rights, Res. 2005/39, 19 April 2005, § 13, adopted without a vote.
UN Sub-Commission on Human Rights
In a resolution adopted in 1989, the UN Sub-Commission on Human Rights reminded the Government of El Salvador that “under no circumstances may it punish the health personnel for carrying out their medical activities”. 
UN Sub-Commission on Human Rights, Res. 1989/9, 31 August 1989, § 4.
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: “[Medical personnel] may not be punished or molested for having engaged in medical activity, whoever the beneficiaries of such care may be.” The Assembly also expressed the wish that the UN draw up a charter for the protection of medical missions. The proposed charter would include, inter alia, the following provisions: medical personnel may not be punished for having engaged in medical activity; medical personnel must scrupulously respect the rules of medical ethics and may not refrain from performing acts required by these rules; and the assistance must be based purely on medical criteria of a humanitarian kind. 
Council of Europe, Parliamentary Assembly, Res. 904, 30 June 1988, Appendix.
No data.
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 shall be punished for performing medical activities compatible with medical ethics.
Persons engaged in medical activities shall not be compelled:
a) to perform acts or to carry out work contrary to medical ethics; or
b) to refrain from performing acts or from carrying out work required by medical ethics. 
Frédéric de Mulinen, Handbook on the Law of War for Armed Forces, ICRC, Geneva, 1987, § 217.
World Medical Association
Pursuant to the World Medical Association’s Rules Governing the Care of the Sick and Wounded, Particularly in Time of Conflict, established in 1983, “the fulfilment of medical duties and responsibilities shall in no circumstance be considered an offence”. 
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.
Instituto de Derechos Humanos de la Universidad Centroamericano
In 1990, in a report on the offensive by the Farabundo Martí Front for National Liberation (FMLN) in El Salvador in November 1989, the Instituto de Derechos Humanos de la Universidad Centroamericano stated:
Twelve members of the Lutheran Church, the majority of whom worked in medical assistance, were arrested and accused, among others, of providing medical assistance to the FMLN. Five workers of a clinic of the parish of Saint Francis of Assisi in Mejicanos were arrested by soldiers from the first infantry brigade; one of them is still disappeared. These facts constitute serious violations of Article 10 [of the 1977 Additional Protocol II] which guarantees respect for medical personnel. 
Instituto de Derechos Humanos de la Universidad Centroamericana, “Los derechos humanos y la ofensiva del 11 de noviembre de 1989”, Estudios Centroamericanos, Universidad Centroamericana José Simeón Cañas, Vol. XLV, Nos. 495–496, January–February 1990, p. 65; see also José Simeón Cañas, Los Derechos Humanos en El Salvador en 1990, San Salvador, 1991, pp. 68–69.
Turku Declaration of Minimum Humanitarian Standards
The Turku Declaration of Minimum Humanitarian Standards, adopted by an expert meeting convened by the Institute for Human Rights of Åbo Akademi University in Turku/Åbo, Finland in 1990, states:
Medical and religious personnel … shall not be compelled to carry out tasks which are not compatible with their humanitarian missions. Under no circumstances shall any person be punished for having carried out medical activities compatible with the principles of medical ethics, regardless of the person benefiting there from. 
Turku Declaration of Minimum Humanitarian Standards, adopted by an expert meeting convened by the Institute for Human Rights, Åbo Akademi University, Turku/Åbo, 30 November–2 December 1990, Article 14, IRRC, No. 282, 1991, p. 335.
Peruvian Medical Federation for Human Rights
In 1994, in a report on medical practice in the context of internal armed conflict, the Peruvian Medical Federation for Human Rights detailed several instances in which doctors had been punished for providing medical assistance to members of the Sendero Luminoso (Shining Path) or to the Movimiento Revolucionario Tupac Amaru (MRTA). The report stated:
A review of the opinions and judgments handed down in cases where charges of terrorism against physicians were based solely on the performance of a medical act reveals that the legal reasoning used by judges and public prosecutors is based on interpretation of the medical act as an act of collaboration with the terrorist organisation.
The report concluded:
We must be firm in our position: the medical act, i.e. care given by the physician to the wounded or sick without distinction whatsoever, in observance of his professional principles and duties to protect human life, can in no way be considered an act of collaboration with subversives. 
Peruvian Medical Federation for Human Rights, Medical Practice in the Context of Internal Armed Conflict, August 1994, quoted in Marco Sassòli and Antoine A. Bouvier (eds.), How Does Law Protect in War?, ICRC, Geneva, 1999, pp. 1376–1382.
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.
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.