[Photo credit: Army Medicine, Flickr]
Dustin A. Lewis, Naz K. Modirzadeh, and Gabriella Blum, “Medical Care in Armed Conflict: International Humanitarian Law and State Responses to Terrorism,” Legal Briefing, Harvard Law School Program on International Law and Armed Conflict, September 2015
The surge in armed conflicts involving terrorism has brought to the fore the general question of medical care in armed conflict and the particular legal protections afforded to those providing such care to terrorists. Against this background, we evaluate international humanitarian law (IHL) protections for wartime medical assistance concerning terrorists. Through that lens, we expose gaps and weaknesses in IHL. We also examine tensions between IHL and state responses to terrorism more broadly.
Across recent and current armed conflicts, state responses to terrorism have cast a spotlight on the scope and implementation of IHL protections for medical care:
- During its internal armed conflict, Peru prosecuted physicians in part for providing medical assistance to members of Sendero Luminoso (the Shining Path);
- Colombia penalized a medical professional who managed the longer-term specialized care of members of the Fuerzas Armadas Revolucionarias de Colombia (the Revolutionary Armed Forces of Colombia);
- Syria detained physicians who gave medical care to wounded opposition fighters designated as terrorists, and it attacked health-care facilities in terrorist-controlled areas;
- The United States prosecuted an American physician for agreeing to be an “on call” doctor for wounded members of al-Qaeda the next time that doctor travelled to Saudi Arabia; it penalized a different American for seeking to travel to Iraq and Syria to provide medical care to wounded members of the Islamic State of Iraq and al-Sham (ISIS) and in hospitals in ISIS-held territory; and it prosecuted a Canadian in part for providing English lessons in an al-Qaeda clinic in Afghanistan to assist nurses in reading medicine labels; and
- Australia and the United Kingdom are evaluating whether to penalize, upon their return, medics who have reportedly provided medical care in ISIS-held territory—including, potentially, to members of ISIS.
Over the last quarter-century, terrorists and other non-state actors have controlled access to civilian populations in a variety of armed conflicts. Consider Afghanistan, Chechnya, Colombia, Gaza, Iraq, Lebanon, Mali, Nepal, Nigeria, Pakistan, Peru, the Philippines, Somalia, Syria, and Yemen (among others). The number and effects of terrorist attacks are reportedly increasing around the world. And states are designating more organized armed groups as terrorists. We therefore expect that these questions will become more salient and more urgent in a growing number of theaters.
We find that the global fight against terrorism has taken a turn that threatens to erode a foundational ethic of IHL: the protection of medical care for all wounded combatants, whether friend or foe. At the same time, aggressive state responses to terrorism illuminate how IHL medical-care protections, while extensive, are often fragmented and non-comprehensive. In short, contemporary counterterrorism policies contradict some of these IHL protections and expose the weakness of key others.
This PILAC initiative arose out of consultations with the Counterterrorism and Humanitarian Engagement Project’s Working Group — as well as the World Health Organization, Médecins Sans Frontières (Doctors Without Borders), the Norwegian Refugee Council, and the International Committee of the Red Cross.
—Timeline by Dustin A. Lewis, with assistance from Elizabeth Carthy, 2015. Made with Timeline.js.
This year, leading academics, practitioners and international experts will examine a number of legal challenges raised by the application of the Additional Protocols to the Geneva Conventions on the occasion of their 40th anniversary.
With the aim to advance international efforts, including those of the UN, to protect health care in conflict areas in follow-up to UNSC Resolution 2286, the Permanent Missions of Canada, the Netherlands, Spain, and the United Kingdom in collaboration with the Lancet-American University of Beirut Commission on Syria and Safeguarding Health in Conflict Coalition, are organizing a High-Level Side Event during the 72nd session of the UN General Assembly in New York. Image credit: swedennewyork, “The ECOSOC Council Chamber,” on Flickr; license: Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0).
In a special presentation for PHAP members and guests in Geneva and online, Dustin Lewis will present PILAC’s latest research on the intersections between counterterrorism laws and approaches and the protection of impartial wartime medical care in IHL. Image credit: UN Geneva, “Palais des Nations by night,” CC BY-NC-ND 2.0.
At this seminar, hosted by the Center on Terrorism and sponsored ARTIS, Dustin Lewis will present PILAC research on wartime medical care for terrorists, to be followed by a question-and-answer period. Photo credit: UN Photo/Kim Haughton [link].
The Stockton Center for the Study of International Law at the Naval War College will host the next iteration of its seminar series on January 22nd by hosting Dustin Lewis to discuss HLS PILAC research on medical care concerning terrorists in armed conflict. Photo credit: Number 10, “Prime Minister attends UN Security Council meeting,” Flickr, CC BY-NC-ND 2.0.
At this PHAP online expert IHL briefing, Dustin Lewis and Naz Modirzadeh, two of the authors of a recent report from the Harvard Law School Program on International Law and Armed Conflict (HLS PILAC), will present their research on IHL and medical care concerning terrorists in armed conflict. Photo credit: Marines, “No Marine Left Behind,” Flickr, CC BY-NC 2.0.