The war between Israel and Hamas has seen various attacks on ambulances and medical personnel. On October 7, 2023, among the other atrocities committed by Hamas terrorists, they attacked and took control of Israeli ambulances, killing or seriously injuring paramedics during their assault.
In November, the Israel Defense Force (“IDF”) carried out an airstrike on an ambulance in northern Gaza following information that Hamas was using the ambulance to transfer terror operatives and weapons. What does law of armed conflict have to say about these two events and why are they different?
It is well-established, both under the provisions of international law and the collective consensus of civilized society, that medical care providers should be entitled to special protections during times of war, given their aim of helping preserve life. As a starting point, it is important to understand who exactly qualifies as “medical personnel.” Article 24 of the Geneva Convention (I) on Wounded and Sick in Armed Forces in the Field defines medical personnel to be those who are:
“exclusively engaged in the search for, or the collection, transport or treatment of the wounded or sick, or in the prevention of disease, staff exclusively engaged in the administration of medical units and establishments, as well as chaplains attached to the armed forces, shall be respected and protected in all circumstances.”
This definition accordingly makes clear that a medical provider is not defined by the status of the individual as a nurse, doctor, or other medical professional but rather by the conduct that person engages in. When a medic engages in behavior outside of caring for the sick and injured, then they forfeit their special protected status. It is important to know that the protection of medical objects and the criteria to lose such protection is widely regarded as customary international law, and as such, it is applicable in both non-international and international armed conflicts.
This is best illustrated by Israel’s decision to target an ambulance. The Palestinian ambulance, which in the ordinary course of transporting injured civilians would not have been a valid target, subsequently lost this status when it was being used to transport weapons and Hamas combatants. This shift in purpose from “exclusively” providing medical services to aiding in hostile acts destroyed the protections afforded to both the ambulance itself and the medical personnel within.
This attack by Israel diverges greatly from Hamas’ attack on the Israeli ambulance. In the latter, Hamas terrorists indiscriminately and intentionally attacked an ambulance and its medical personnel who were clearly engaged in providing medical services. Humanitarian law is clear that intentional attacks against medical services is considered a war crime subject to the jurisdiction of the International Criminal Court.
1 https://www.timesofisrael.com/aharon-haimov-25-ambulance-driver-killed-on-way-to-treat-victims/ ; https://www.timesofisrael.com/liveblog_entry/paramedic-among-those-killed-hamas-has-control-of-2-israeli-ambulances-magen-david-adom/
2 https://treaties.un.org/pages/showDetails.aspx?objid=080000028015847c (emphasis added).
3 Customary International Humanitarian Law, Volume II, Chapter 7, Section A, pp. 79 – 104, Cambridge University Press (2005).
4 International Criminal Court, Elements of Crime, Arts. 8.2.b.xxiv and 8.2.e.ii.
