Practice Relating to Rule 25. Medical Personnel
Section A. Respect for and protection of medical personnel
Israel’s Manual on the Laws of War (1998) states:
It is prohibited to interfere with the administration of medical aid … In fact, this prohibition also covers the attack on medical personnel, paramedics and doctors in the battlefield itself. According to the Geneva Convention, medical teams are not part of the armed conflict. They are marked with distinctive identification signs, they do not carry arms, they do not cause injury and it is forbidden to harm them. It is prohibited to shoot a paramedic in the battlefield or to take him prisoner. The medical team is also restricted in that it does not take part in the hostilities, does not carry any weapons and is committed to administering medical aid also to the enemy’s wounded. In actuality, this provision is not observed in the wars and confrontations waged in the Middle East, at least not in regard to medical teams in the field. They are not immune to harm, they are not identified by special identification symbols, they bear arms and take part in the fighting. This situation also exists in many other armies around the world, including the American army.
Israel’s Manual on the Rules of Warfare (2006) states:
It is absolutely forbidden to attack the medical facilities of the enemy including military medical facilities and it is forbidden to attack the enemy’s wounded. This ban also applies to attacks on medical personnel, paramedics and doctors in the battlefield. According to the Geneva Convention medical teams are not part of the fighting force, they are marked with recognised insignia and do not carry arms. They do not attack and it is forbidden to attack them. It is forbidden to open fire on a medic on the battlefield and he/she must not be taken into captivity, providing the medical team is not participating directly in the war and does not carry arms. … In wars and confrontations in the Middle East, the medical teams have not worn special insignia; they participate in the fighting, consequently they are not protected from being attacked.
The Manual on the Rules of Warfare (2006) is a second edition of the Manual on the Laws of War (1998).
In its judgment in Physicians for Human Rights v. IDF Commander in the West Bank in 2002, the Supreme Court of Israel stated:
[I]nternational law provides protection for medical stations and personnel against attack by combat forces. Article 19 of the Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, of Aug. 12, 1949 … forbids, under all circumstances, attack of stations and mobile medical units of the “Medical Service,” that is to say, hospitals, medical warehouses, evacuation points for the wounded and sick, and ambulances.
In its judgment in Physicians for Human Rights v. Prime Minister of Israel in 2009, concerning the humanitarian situation in the Gaza Strip consequent to the start of Israeli military operations (“Cast Lead”) there in December 2008, Israel’s High Court of Justice stated:
17. … Everyone agrees that the rules of customary international law – which grant protection to medical personnel … – apply to the combat operations that are being carried out in the “Cast Lead” operation and bind the actions of the IDF [Israel Defense Forces].
18. The provisions of international humanitarian law grant protection to medical … personnel from being attacked. Thus … arts. 24–25 of the First Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field, 1949, prohibit any attack upon medical personnel, if they are exclusively or currently engaged in medical activities; art. 26 of the Fourth Geneva Convention extends this protection to members of the Red Cross or other international organizations that fulfil similar functions (see also art. 20 of the Fourth Geneva Convention). A detailed definition of what constitutes protected medical personnel is laid down in art. 8(c) of the First Protocol [1977 Additional Protocol I] and detailed provisions with regard to the protections that are given to medical personnel are laid down in arts. 12–16 of the First Protocol.
According to the Report on the Practice of Israel, the Israel Defense Forces (IDF) do not have a policy of targeting the medical personnel of its adversaries. The report adds that the implementation of this policy is subject to such personnel being clearly recognizable and not participating in hostile activities. It further states:
The IDF … has chosen to incorporate its front-line medical staff in its combat units. As a result, when participating in combat missions, front-line Israeli military medical personnel would not carry distinguishing marks and do not expect to be granted protected status in combat situations.
In 2009, in a report on Israeli operations in Gaza between 27 December 2008 and 18 January 2009 (the “Gaza Operation”, also known as “Operation Cast Lead”), Israel’s Ministry of Foreign Affairs stated: “[The] IDF [Israel Defense Forces] trains forces at all levels to exercise extra caution to avoid harming medical crews … In the Gaza Operation, the IDF reinforced those instructions. In many cases IDF forces suspended their operations against legitimate military objectives when … medical staff were in the vicinity.”