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Medical impartiality

medical camp in conflict zone

Medical impartiality is a fundamental ethical principle in medicine.

We believe a doctor’s right to safely practice medicine in humanitarian settings must be protected.

Doctors must be able to provide treatment to those in need irrespective of their political affiliation. All health professionals have a right to practice medicine without fear of reprisal or attack. Global conflicts in recent years, particularly in the Middle East and North Africa (MENA), have seriously undermined medical impartiality. Health infrastructure, and medical personnel have been targeted by both governments and non-state actors. Elsewhere, doctors have been subject to reprisals for treating the sick and injured.

International bodies, such as the United Nations, continue to document ongoing human rights violations - including the continued widespread and systematic targeting of healthcare facilities and medical personnel. Read our case studies outlining breaches below. 

 

The principle of medical impartiality

Defenders for Medical Impartiality (DMI) define medical impartiality as:

“The international principle that no person or group shall interfere with the access to or delivery of medical services in times of conflict and civil unrests, and that medical personnel shall not discriminate or refuse care to anyone injured or sick during times of conflict and civil unrest.”

 

BMA action to protect medical impartiality

The British Medical Association has signed the Colombo Declaration, which condemns attacks on medical personnel and facilities in conflict situations, and in February 2019 we joined the Royal College of Emergency Medicine and fourteen additional medical Royal Colleges in writing to the Foreign Secretary to request that the UK Government also signal its support for the Declaration.

Adding his support to the letter, Dr John Chisholm, chair of the BMA’s medical ethics committee said: “We condemn in the strongest possible terms the practice of intentionally targeting medical personnel and facilities in areas of conflict. Access to health care is a fundamental human right and it is essential that healthcare workers are at liberty to provide assistance in conflict zones without fear of being targeted.”

The Colombo Declaration – drafted in Sri Lanka in 2016 - condemns the targeting of medical facilities, patients and clinicians in areas of conflict and calls on United Nations member states to support the enforcement of UN Security Council Resolution 2286. This resolution demands that member states uphold and comply with the 1949 Geneva Conventions which criminalise targeted attacks on medical personnel and facilities under International Humanitarian Law.

Further reading

Read the letter to the Foreign Secretary Jeremy Hunt MP

Get involved

Sign the Colombo Declaration, or join the MSF #NotATarget campaign, a social media act of solidarity to stand up for the protection of civilians and civilian infrastructure, patients, medical staff and hospitals in conflicts.

Add your voice

 

  • Nicaragua

    Persecution of physicians for providing care to certain groups

    In November 2018, we learned that physicians in Nicaragua had been dismissed and, in some cases, criminalised for providing medical care to persons involved in anti-government protest activities. Further, that healthcare workers had been forced to prioritise care for certain groups based on their political affiliations.

    We wrote to the Nicaraguan Ambassador to raise our concerns, and to demand respect for the rights of the injured and wounded to appropriate medical treatment.

    Further reading

    Read our letter to the Nicaraguan Ambassador, Guisell Morales-Echaverry - November 2018

  • Sudan

    Attack on Omdurman Hospital

    In January 2019, Sudanese security forces attacked Omdurman Hospital. Reports of the attack state that security forces opened fire inside the hospital whilst looking for individuals who had been injured whilst participating in protests earlier in the day.

    The intentional targeting of health professionals, including hospitals and medical facilities, is a clear breach of the Geneva Conventions of 1949 and of International Humanitarian Law, as well as accepted international human rights norms. Health professionals provide a necessary service, and it is essential that they are at liberty to provide that service, wherever they may be, without fear of being targeted.

     

    Further reading

    Read our letter to the Sudanese Ambassador, Mohammed Abdalla Ali Eltom - February 2019

    Read our letter to the Foreign Secretary, Jeremy Hunt MP – February 2019

  • Afghanistan

    Coalition bombing of MSF hospital in Afghanistan

    On 2 November 2015, the BMA wrote to Foreign Office minister Tobias Ellwood MP to seek the support of the UK government in calling on President Obama to agree to an independent investigation into the sustained bombing by coalition forces of the Médecins Sans Frontières (MSF) trauma facility in Kunduz, Afghanistan on 3 October.

    Twelve hospital staff members and at least 10 patients, including three children were killed on that night, with a further two members of staff presumed dead. In addition, 37 people, including 19 staff members were injured. All parties to the conflict were given the accurate GPS co-ordinates of the hospital and yet it was precisely hit several times by coalition bombing. 

    Read our letter to Foreign Office Minister Tobias Ellwood MP - November 2015

    Read our blog: Remembering Kunduz: The week leading to the attack

     

    Survivors of the Kunduz bombing

    Kunduz: 6 months later

  • Syria

    Doctors' deaths in Syrian custody

    We are deeply concerned by the Syrian government's continued flouting of international human rights standards, including rights to a fair trial, and its complete disregard for medical neutrality. 

    We have written to the Syrian authorities expressing our profound sadness and deep concern over the death of Dr Abbas Khan and Dr Osama Baroudi in Syrian custody.

    Both doctors had been imprisoned after being unlawfully arrested for peacefully attempting to provide medical treatment to injured civilians during the conflict in Syria.

    We have also expressed extreme alarm at reports that Dr Khan and Dr Baroudi had been tortured in prison.

    Read our news coverage of Dr Khan's death

    Read our letter to Syrian president Bashar al-Assad - December 2013

    Read our letter to Syrian ambassador Bashar Ja'afari - December 2013

     

    Read our news coverage of Dr Baroudi's death

    Read our letter to Syrian president Bashar al-Assad - December 2013

    Read our letter to Syrian ambassador Bashar Ja'afari - December 2013

     

  • Bahrain

    Breaches of medical neutrality in Bahrain

    Physicians for Human Rights has highlighted ongoing violations of medical neutrality in Bahrain in the wake of popular unrest that began in early 2011.

    The lobbying group has documented attacks by the Bahraini security forces on medical institutions, including arrests and detention of medical workers providing care to protesters.

    More than two years after the start of the protests, the Bahraini government has not yet properly addressed medical neutrality violations. Those who were abducted, detained, abused and tortured have not received any reparation from the government, or even acknowledgement of wrongdoing. Some remain in prison. Others, released from prison, continue to face harassment or intimidation from state officials.

    Find out more and hear from Bahraini doctors at Physicians for Human Rights

    Read the BMA News article on the arrest of a Bahraini doctor for his use of social media

  • Gaza

    Shelling of medical facilities in Gaza

    On 6 August 2014, Dr Mark Porter wrote to Israel's Prime Minister Benjamin Netanyahu expressing the BMA's grave concerns about the impact of recent hostilities on medical facilities and health personnel in Gaza.

    Dr Porter said the principle of medical neutrality was fundamental in international humanitarian law and called upon Israeli authorities to ensure that medical infrastructure was protected.

    Read Dr Porter's letter to Israel's Prime Minister, Benjamin Netanyahu - August 2014

  • Turkey

    Breaches of medical neutrality in Turkey

    The BMA has written to the Turkish Prime Minister expressing grave concern at the reported breaches of medical neutrality there.

    In 2013, doctors and nurses were arrested and threatened with the loss of their medical licenses after treating protesters who were injured during public demonstrations. The Turkish Government later attempted to enact legislation which criminalised the provision of emergency healthcare in Turkey.

    The BMA has written a series of letters to raise these issues with the appropriate authorities, which are provided below.

    Further reading

    Read our letters to the Turkish Prime Minister and the Turkish Health Minister between 2013 and 2014

    Read a BMJ editorial on attacks on medics in Turkey