Practice Relating to Rule 29. Medical Transports
Section B. Respect for and protection of medical aircraft
New Zealand’s Military Manual (1992) states: “Medical aircraft, correctly identified and exclusively used as such, are for the main part immune from attack.”
The manual further states: “Medical aircraft must be respected and protected at all times and must not be attacked. Their immunity ceases once they are used for purposes hostile to the adverse Party and outside their humanitarian purposes.”
The manual restates the rules governing medical aircraft found in Articles 25–28 of the 1977 Additional Protocol I.
In addition, the manual specifies that:
Aircraft used exclusively for the removal of wounded and sick civilians, the infirm and maternity cases, or for the transport of medical personnel and equipment must not be attacked when flying at heights, times and on routes specifically agreed upon between all the belligerents concerned … In the absence of agreement to the contrary, flights over enemy or enemy-occupied territory are prohibited. Such aircraft must obey every order to land, but, after landing and examination, may continue their flight.
According to the manual, “attacking a properly marked … medical aircraft” constitutes a war crime recognized by the customary law of armed conflict.