Medical neutrality
Medical neutrality refers to a principle of noninterference with medical services in times of armed conflict and civil unrest: physicians must be allowed to care for the sick and wounded, and soldiers must receive care regardless of their political affiliations; all parties must refrain from attacking and misusing medical facilities, transport, and personnel. Concepts comprising the principles of medical neutrality derive from international human rights law, medical ethics and humanitarian law. Medical neutrality may be thought of as a kind of social contract that obligates societies to protect medical personnel in both times of war and peace, and obligates medical personnel to treat all individuals regardless of religion, race, ethnicity, or political affiliation. Violations of medical neutrality constitute crimes outlined in the Geneva Conventions.
Historical background
The principle of medical neutrality has roots in many social traditions.- The Hippocratic Oath, which requires physicians to practice medicine ethically, dates back to the fifth century.
- The idea of 'do no harm' has histories in "Jewish and Islamic, as well as Chinese and Indian medicine"
- Geneva Conventions :
- *The First Geneva Convention was written by Henri Dunant in response to seeing such the difficulty of treating wounded soldiers at the Battle of Solferino.
- *The first and the following Geneva Conventions created the Red Cross, outlined the protections of medical personnel in times of war, and codified the protections of citizens, soldiers, medical personnel, etc.
- *The First Geneva Convention stated that there should be no "obstacle to the humanitarian activities" and that wounded and sick "shall be respected and protected in all circumstances."
- *Article 18 demanded that medical units, i.e. hospitals and mobile medical facilities, may in no circumstances be attacked.
- *The Declaration of Geneva was created as an amendment to the Hippocratic Oath in 1948, a response to the human experimentation on Nazi prisoners.
Violations of neutrality
- Attacks on hospitals
- Attacks on patients
- Attacks on medical personnel
- Attacks on medical transport
- Misuse of medical facilities
- Breaches of medical ethics by medical personnel
- Using the hospital/medical facilities to attack, fire/ fire rockets e.j., to civilians from the medical facilities
- Using the medical facilities to house weapons or soldiers
- Using the medical facilities for purposes other than medical assistance and/or aid to the public.
Recorded violations of medical neutrality
Gaza (2023-)
On 4 November 2023, an Israeli air strike hit an ambulance outside Al-Shifa Hospital, where 15 people were killed and 60 others wounded. The Israel Defense Forces stated the attack targeted Hamas militants and that the ambulances were used to transport operatives and weapons. Hamas official Izzat El-Reshiq denied these claims, and the Gaza Health Ministry claimed Israel had targeted a convoy of ambulances.On 30 January 2024, Israeli special forces performed a raid on Ibn Sina hospital in Jenin dressed as civilians and medical personnel, killing three alleged Palestinian militants. Footage from the scene shows at least ten armed members carrying assault rifles, assumed to be Israeli forces, dressed in civilian attire including as nurses wearing blue scrubs, a doctor in a white overcoat, and women in hijabs. The raid is said to have killed three men, with the IDF claiming the targeted men were Hamas member Mohammed Jalamneh, and Islamic Jihad members Mohammed and Basel Al-Ghazawi. The hospital alleges the three men were sleeping at the time and Al-Ghazawi was at the hospital undergoing medical treatment. Legal experts have suggested that Israeli actions could have violated international law by disguising themselves as civilians and medical staff, and by killing sick and wounded personnel.
Ukraine (2022)
As of 12 March 2022 at least nine medical facilities, including Mariupol maternity hospital, most being located to the north and the south-east of Ukraine, were attacked by Russian military forces. The deadliest one happening on 24 February 2022, at the Central City Hospital in Vuhledar when a Russian ballistic missile full of cluster munitions fell just outside of the hospital, killing four and injuring ten. The Russian Ministry of Defense claimed that some of hospitals were used for military purposes and denied attacking Mariupol maternity hospital alleging it was a "staged provocation".Between 24 February and 21 March 2022, sixty-four medical facilities and their personnel were targeted by Russian forces in Ukraine, the World Health Organization reported. The facilities were being hit at rate of two to three a day, inflicting 15 deaths and 37 injuries. All sixty-four attacks were verified and said to be violations of international law breaching medical neutrality. It was reported that some of hospitals were converted into military strongholds and that most of damages inflicted were caused by heavy weaponry. By 8 April 2022, WHO had confirmed 91 attacks.
Gaza Strip (2021)
During the Israeli bombing of Gaza in May 2021, parts of a Médecins Sans Frontières trauma and burns care clinic were destroyed in a series of airstrikes. The strikes destroyed a sterilization room and damaged a waiting area, there were no resulting direct casualties suffered. The airstrikes also destroyed the road that lead to the clinic, thereby preventing access to it. The clinic was subsequently forced to close.Further airstrikes also lead to death of two prominent doctors in the Gaza Strip. Dr. Ayman Abu al-Ouf, the head of internal medicine at Al-Shifa hospital, was killed along with 12 members of his extended family after an airstrike on his home on 16 May 2021. Dr. Mooein Ahmad al-Aloul, a 66-year-old psychiatric neurologist, was also killed in his home during the al-Wehda attacks.