Should enemy combatants receive medical assistance? – The science of yarn


A Ukrainian soldier walks as the Russian invasion continues in a destroyed village on the front line east of kyiv on March 21, 2022. Photo: Reuters/Gleb Garanich

  • If a military doctor encountered a wounded enemy soldier, he had a duty under the Geneva Convention to provide medical assistance if requested and feasible.
  • The Geneva Convention, which took shape at the end of the Second World War, established the principles of humanitarian and medical assistance in times of war.
  • Lt. Col. N. Mukundan, a retired Indian Army cardiac anesthetist, noted that during his tenure in Kashmir, enemy fighters would be treated for their injuries in a separate ward.

As a doctor in the Indian army, my father would sometimes tell me that it was his duty to treat Indian soldiers as well as enemy soldiers on the battlefield. Having grown up in military areas during the Pakistani and Chinese wars, I found his statements to be at odds with the prevailing general opinion.

In other conversations, it was very clear that the role of a medic in combat was different from that of other military personnel. If he encountered a wounded enemy soldier, he said he had a duty under the Geneva Convention to provide medical assistance if requested and feasible.

At the end of the Second World War, the Geneva Convention established the principles of humanitarian aid and health aid in times of war. Treaties provide protection for the wounded, sick and civilians in and around a war zone. The 1997 Convention on Human Rights and Biomedicine, also known as the “Oviedo Convention”, is an international and legally binding text which stipulates that the interests of human beings must come before the interests of science or society. The language of the text is designed to preserve human dignity, rights and freedoms through a series of principles and prohibitions.

While the central idea of ​​the convention was against the misuse of medical advances, it lays down the principle that everyone has the right to be treated, if they are sick, and that every doctor must treat everyone in need without moral judgment. While such principles may seem grand and pontificatory, they also raise some ethical questions.

Should enemy supply lines carrying medical aid and equipment be targeted? No, because the first Geneva Convention stipulates that there should be “no obstacle to humanitarian activities” and that the wounded and sick “shall be respected and protected in all circumstances”. Article 19, in particular, requires that hospitals and mobile medical facilities cannot be attacked under any circumstances..

the the rules protect the wounded soldier on and off the battlefield, as well as civilians in a country involved in war. The US Medical Neutrality Protection Act of 2011 calls for the creation of the position of United Nations Special Rapporteur on the “Protection and Promotion of Medical Neutrality” and for the Investigation of Medical Neutrality Violations. It also limits US military aid to countries that have violated medical neutrality and prohibits officials of their governments from obtaining US visas.

Violations of medical neutrality have occurred in many countries and war zones. Recent examples include attacks on Ukrainian hospitals by Russia, on Doctors Without Borders clinics in Gaza (by Israel) and Afghanistan (by the United States), on medical personnel in protest areas in Chile , Thailand and Myanmar, and guerrilla attacks on field hospitals in El Salvador. In India, Dr Binayak Sen, a doctor who advocated non-violent political engagement, was convicted of sedition by Indian courts for allegedly supporting outlaw Naxalites while working with the rural poor of Chhattisgarh .

Should health care sanctions be imposed on aggressor countries? No. This question arose in the Russian war against Ukraine, whether the international medical community should cut ties with Russia, thus preventing medical supplies and goods. The Geneva Convention protects civilians in a country at war, and cutting ties to the health system will worsen already unequal access to care on top of the shortage of lifesaving medicines created by economic sanctions.

What about the treatment of wounded terrorists? Doctors Without Borders Note that the term “terrorism” has political and ideological connotations that blur the line between terrorists and freedom fighters. The UN defines terrorism as “criminal acts, including against civilians, committed with intent to cause death or serious bodily harm, or the taking of hostages, with intent to induce a state of terror in public opinion or in a group of persons or certain persons, to intimidate a population or to compel a government or an international organization to perform or refrain from performing an act”.

Council of Europe Commissioner for Human Rights Note that:

“…although State action is necessary to effectively prevent and punish terrorist acts, not all means are justifiable. There is an imperative duty for States to protect the general interest of public security and the rule of law without jeopardizing the core of human rights, which are enshrined in particular in the European Convention on Human Rights. ‘man.

However, the operations carried out by several States in the so-called “war on terror” recent years have included “rendition programs”, the creation of “black sites” and mass surveillance. A wide range of human rights are potentially affected by these counter-terrorism measures, including the right to life, the prohibition of torture, inhuman or degrading treatment, the right to liberty, security and trial equity, as well as respect for private and family life.

The Terrorism Prevention Branch of the United Nations Office on Drugs and Crime believes that Fighting terrorism effectively while respecting human rights and fundamental freedoms is both possible and necessary. Their Terrorism Prevention Unit works with criminal justice officials involved in the investigation, prosecution and adjudication of terrorism cases to build their capacity to implement counterterrorism legislation.

Lt. Col. N. Mukundan, a retired cardiac anesthetist in the Indian Army, noted that during his tenure in Kashmir, enemy soldiers and terrorists would be treated for their injuries in a separate ward set up for that purpose. Examples of medical aid to enemy combatants in the mahabharata include the well-known provision of water by Arjuna to the dying Bhishma. During the Sikh-Mughal War of 1704, Bhai Kanhaiya was known to supply water to combatants on both sides. When asked, he said that he “saw neither Mughal nor Sikh on the battlefield. I only saw human beings who all have the same spirit of God.

The Hippocratic oath that all physicians take upon graduation states, “In honor of the knowledge I have received from my teachers, I swear to care for anyone who suffers, prince or slave.” In the fog of war, it is all too easy to forget such an oath, but the consequences of forgetting pose a serious threat to human rights and democracy.

V. Ramana Dhara is a doctor who explores the links between health and the environment. He is a former member of the International Medical Commission on Bhopal. He tweets at @RamanaDhara.


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