United States of America
Practice Relating to Rule 29. Medical Transports
Section A. Respect for and protection of medical transports
The US Field Manual (1956) restates Article 35 of the 1949 Geneva Convention I and Article 21 of the 1949 Geneva Convention IV.
The US Air Force Commander’s Handbook (1980) provides that ambulances … “should not be deliberately attacked, fired upon, or unnecessarily prevented from performing their medical duties”.
The Handbook further stresses that medical transports lose their special immunity if they are used to commit “acts harmful to the enemy outside their humanitarian functions”. In this respect, the manual gives the example of “firing at the enemy from an ambulance”.
The US Naval Handbook (1995) states: “medical vehicles … may not be deliberately bombarded. Belligerents are required to ensure that such medical facilities are, as far as possible, situated in such manner that attacks against military targets in the vicinity do not imperil their safety.”
The manual qualifies “deliberate attack upon … medical vehicles” as a war crime.
The US Naval Handbook (2007) states that “medical vehicles … may not be deliberately bombarded. Belligerents are required to ensure that such medical facilities are, as far as possible, situated in such a manner that attacks against military targets in the vicinity do not imperil their safety.”
The Handbook also states that examples of war crimes that could be considered as grave breaches of the 1949 Geneva Conventions include: “Deliberate attacks upon … medical vehicles.”
Upon signature of the 1977 Additional Protocols I and II, the United States declared:
It is the understanding of the United States of America that the terms used in Part III of [the 1977 Additional Protocol II] which are the same as the terms defined in Article 8 [of the 1977 Additional Protocol I] shall so far as relevant be construed in the same sense as those definitions.
In 1987, in submitting the 1977 Additional Protocol II to the US Senate for advice and consent to ratification, the US President expressed the view that the obligations in the Protocol were “no more than a restatement of the rules of conduct with which US military forces would almost certainly comply as a matter of national policy, constitutional and legal protections, and common decency”.