Practice Relating to Rule 29. Medical Transports
Section A. Respect for and protection of medical transports
Israel’s Manual on the Rules of Warfare (2006) states that “ambulances and similar facilities” must not be used as military targets.
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 the Physicians for Human Rights v Commander of IDF Forces in the Gaza Strip case in 2004, Israel’s High Court of Justice stated:
22. As for the shooting upon an ambulance, Col. Mordechai stressed that it was not intentional. There are clear instructions that shooting on ambulances is prohibited. “Ambulances are out of bounds” – so stated Col. Mordechai before us. Col. Mordechai informed us that tens of ambulances passed with no harm done to them. It is to be regretted if a single exception occurred …
23. There is no disagreement regarding the normative framework … In HCJ 2117/02 Physicians for Human Rights v. Commander of IDF Forces in the West Bank, Justice Dorner stated:
[I]nternational law provides protection for medical stations and personnel against attack by combat forces … [It is forbidden], under all circumstances, [to] attack 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 …. However, the “Medical Service” has the right to full protection only when it is exclusively engaged in the search, collection, transport and treatment of the wounded or sick …. [P]rotection of medical establishments shall cease if they are being “used to commit, outside their humanitarian duties, acts harmful to the enemy,” on condition that “a due warning has been given, naming, in all appropriate cases, a reasonable time limit and after such warning has remained unheeded.”
It appears to us that the passage of ambulances to and from Rafah proceeded properly. This was made possible, among other means, by the contact between the IDF [Israel Defense Forces] – via officers of the DCO [District Coordination Offices] – and the ambulances. This contact was proper, and it was put into effect properly. In addition, ambulances move freely to and from the area … The single instance of shooting on an ambulance was an exception. We have been convinced that the instructions forbidding such activity are clear and unequivocal.
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:
[T]he Supreme Court emphasized in Physicians for Human Rights v. IDF Commander in West Bank
, at p. 29, that the abuse that is sometimes made of … ambulances requires the IDF [Israel Defense Forces] to act in order to prevent such activity, but it does not in itself permit a sweeping violation of the principles of humanitarian law, and that “this position is required not only by international law, on which the petitioners rely, but also by the values of the State of Israel as a Jewish and democratic state.”
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 operational order confirmed that medical … vehicles should be provided absolute protection from attack, unless they were being used by the enemy for military activities.”
The report further stated:
[The] IDF [Israel Defense Forces] trains forces at all levels to exercise extra caution to avoid harming medical crews and facilities. In the Gaza Operation, the IDF reinforced those instructions. In many cases IDF forces suspended their operations against legitimate military objectives when a medical vehicle … [was] in the vicinity. In some of these instances, the IDF refrained from attacking medical vehicles even in cases where Hamas and other terrorist organisations were using them for military purposes. Such restraint was not required under the Law of Armed Conflict, under which protection to medical vehicles may cease if the vehicles are being “used to commit, outside their humanitarian function, acts harmful to the enemy.”