Medical Care in Armed Conflict: IHL and State Responses to Terrorism

The last fifteen years have witnessed a surge in armed conflicts involving designated terrorists. State responses to terrorism raise complex issues concerning international humanitarian law (IHL). Experts have debated legal and policy frameworks pertaining to the use of lethal force in counterterrorism operations, as well as the legal grounds to detain alleged wartime terrorists. Yet so far one vitally important area has evaded the same level of focus: how state responses to terrorism threaten to erode the foundational ethic of IHL entailed in impartial wartime medical care for all wounded and sick fighters hors de combat, friend and foe alike.

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) presented their research on IHL and medical care concerning terrorists in armed conflict. The presenters discussed and answered questions relating to:

• The intersections between IHL medical-care protections and the framework of global counterterrorism obligations imposed by the U.N. Security Council;
• Prosecutions—in Peru, Colombia, and the United States—based on various forms of medical assistance to terrorists in armed conflicts;
• The technical legal definitions of key concepts, such as the so-called special protections under IHL for “medical personnel,” “medical units,” and “medical transports”;
• Gaps between treaty-based medical-care protections applicable in international armed conflicts versus those applicable in non-international armed conflicts;
• Gaps between treaty-based medical-care obligations imposed on states party to the Additional Protocols of 1977 versus states not party to those conventions; and
• Whether customary IHL may fill some or all of those gaps.