United Kingdom of Great Britain and Northern Ireland
Practice Relating to Rule 25. Medical Personnel
The UK Military Manual (1958) restates Articles 24–26 of the 1949 Geneva Convention I.
The manual specifies that the duty to respect and protect means that medical personnel
must not knowingly be attacked, fired upon, or unnecessarily prevented from discharging their proper functions. The pure accidental killing or wounding of protected personnel when in or near the area of combat is not a legitimate cause for complaint.
The manual also restates Article 20 of the 1949 Geneva Convention IV.
The UK LOAC Pamphlet (1981) states: “Medical personnel are those exclusively assigned to medical units. They are to be respected, protected and not attacked.”
The UK LOAC Manual (2004) states:
7.11. “Medical personnel” means “those persons assigned, by a Party to the conflict, exclusively to the medical purposes enumerated in paragraph 7.10 [relating to medical units] or to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary’.
7.11.1. The term embraces not only doctors and nurses but also a wide range of specialists, technicians, maintenance staff, drivers, cooks and administrators. It expressly includes military and civilian personnel and those assigned to civil defence organizations as well as medical personnel of national Red Cross or Red Crescent or other duly authorized and recognized national voluntary aid societies. Personnel of medical units and transports of neutral and other states not parties to the conflict, national aid societies of such states and impartial international humanitarian organizations are also included within the definition if made available to a party to the conflict for humanitarian purposes. While the expression includes dental personnel and chaplains in medical units and part-time medical personnel while engaged on medical duties, it excludes qualified medical and dental practitioners who are not assigned exclusively to medical purposes.
Identification of service medical personnel
7.26. Service medical personnel must be clearly identifiable as such so that they receive the protection and respect due to them. To achieve this, all service medical personnel must, in addition to normal service identity discs, wear on the left arm a water-resistant armlet (brassard) bearing the appropriate distinctive emblem. The armlet should be issued and stamped by the military authority. Service medical personnel must also carry a special identity card bearing the distinctive emblem. This card is embossed with the stamp of the military authority. These service identity cards must be uniform throughout the same armed forces and, as far as possible, of a similar type in the armed forces of all parties to Geneva Conventions I and II. Parties to a conflict must inform each other at the outbreak of hostilities which model identity card they are using. Identity cards should be made out, if possible, at least in duplicate, one copy being kept by the home country. In no circumstances may service medical personnel be deprived of their armlets (or the right to wear them) or of their identity cards. In the case of loss they are entitled to receive duplicates of the cards and to have the insignia replaced.
Status on capture of service medical personnel
7.27. In the event of capture, medical personnel do not become prisoners of war but are “retained personnel”.
Auxiliary medical personnel
7.28. Auxiliary medical personnel are members of the armed forces who are specifically trained for employment, when the need arises, as hospital orderlies, nurses or auxiliary stretcher-bearers in the search for or the collection, transport or treatment of the wounded and sick. Auxiliary medical personnel are issued with a special identity card. Auxiliary medical personnel become prisoners of war on capture. They may be required to exercise their medical functions in the interests of prisoners of war of their own state. In that case, they are exempt from any other work.
Civilian medical personnel
7.29. Civilian medical personnel are to be accorded the same protection as service medical personnel and, in occupied territory and areas where fighting is taking place or is likely to take place, they should be recognizable by the distinctive emblem and carry an identity card certifying their status. This card differs from that issued to service medical personnel. Civilian medical personnel who fall into the hands of the enemy should not be detained and should be allowed to continue their medical duties. If any security measures have to be taken, civilian medical personnel have all the protection of protected persons.
Furthermore, the manual prohibits attacks on medical and religious personnel in non-international armed conflict.
In 2009, in the MH and DS case
, the England and Wales Court of Appeal (Civil Division) was called upon to decide an appeal by MH, a Syrian Kurd, against a decision to exclude her from refugee protection on the basis of Article 1F of the 1951 Refugee Convention. The appellant had been affiliated with the Kurdistan Workers’ Party (PKK) and had inter alia
worked as an assistant nurse in a refugee camp set up for Turkish Kurds in Syria. Lord Justice Richards stated: “It is not in dispute that nurses and other medical personnel enjoy a special status and protection under international humanitarian law.”
A training video on IHL produced by the UK Ministry of Defence emphasizes the duty to respect, and not to attack, medical personnel.
According to the Report on UK Practice, there is no practice of incorporating medical staff in combat units in the UK armed forces.
The UK Military Manual (1958) lists among the conditions not depriving hospitals and mobile medical units of their protection the fact that “the personnel are armed, and use their arms for their own defence or for the defence of the wounded and sick”.
The UK LOAC Pamphlet (1981) provides: “Medical personnel may carry and use small arms for their self-defence and for the defence of the wounded and sick in their care.”
The UK LOAC Manual (2004) states:
7.15. Medical personnel may be equipped with “light individual weapons for their own defence or for that of the wounded and sick in their charge.”
7.15.1. Light individual weapons are those that can be handled and fired by one person and primarily intended for personnel targets. It follows that medical personnel may be armed with sub-machine guns, self-loading rifles and handguns. It should be stressed that the provision and use of these arms must be merely for defensive purposes as outlined above. Medical personnel (and chaplains) are non-combatants so they are not otherwise entitled to take part in hostilities. Medical personnel may use their weapons only if they, or those in their care, are attacked.
The UK LOAC Manual (2004), as amended in 2010, states: “Medical personnel do not forfeit their protection under Geneva Convention I 1949 by being armed with light individual weapons and by using those arms in their own defence or in the defence of the wounded and sick in their charge.”
The Report on UK Practice refers to a letter from an army lawyer who, after consultation with the medical-legal department, confirmed that medical personnel may carry a weapon for the purposes of self-defence and defence of their patients only. He also noted that, during the Gulf War, a certain commander of a field hospital would not allow any weapons at all within the hospital confines, even for self-defence.