Protection and Care of Military Casualties and EPW 

Wounded or sick members of any armed force must be respected and protected at all times. It is unlawful to attack or mistreat any friendly or enemy casualty. Wounded or sick enemy personnel must receive medical attention equal to that given friendly casualties. The only method of assigning treatment priority among friendly and enemy casualties is medical urgency. If casualties must be abandoned, they must be left, as far as military conditions permit, with medical personnel and supplies to provide for their care. 

EPW casualties are entitled to equal protection and care. It is incumbent upon medical personnel to plan for the medical support of large numbers of EPW. An Army field hospital is an excellent type of unit to be used to provide for their care. 

Combatants are required to search for and collect casualties from the battlefield. The extent of this effort is left to the discretion of the tactical commander. Combatants may ask civilians to collect and care for casualties, however this does not relieve military authorities of the responsibility to provide care. 

Care Provided Civilians 

Civilian casualties are not entitled to the same degree of care and protection as are combatants. Civilian casualty care is the responsibility of civilian authorities. However, if a military force begins providing treatment to civilians, it is then required to provide them with the same degree of care and protection it is required to provide military casualties. 

An occupying force must cooperate with the civilian authorities to ensure a civilian medical system is maintained. Civilian medical facilities may not be used by an occupying force unless the needs of the civilian population have been met. 

Medical supplies may not be taken from civilian sources unless the civilian requirements have already been met. If civilians in an occupied territory require medical supplies, the occupying force must provide them. 

An occupying force must provide medical care to detained an interned persons. 

Identification and Protection of Military Medical Personnel 

Medical personnel who are exclusively engaged in medical duties or medial administration are entitled to special protection. While it is not a violation of the conventions for medical personnel to perform non-medical duties, they lose their protection by doing so. Once protected status has been lost, it cannot be regained. Medical personnel are provided the following protection. 

• Medical personnel are protected from intentional attack, provided they are readily recognizable as medical personnel by the enemy while in a combat environment. This condition is met by the wearing of a white brassard bearing a red cross or red crescent.
• Medical personnel will receive the designation of "retained person" should they fall under enemy control. Although they are entitled to the same protections as EPW, retained persons "shall be retained only in so far as the state of health . . . and the number of prisoners of war require." However, the convention continues to state that retained persons may be required to perform non-medical labor and may be held until a general repatriation of EPW is conducted.

Identification and Protections of Medical Units, Facilities, Materiel, and Transports 

Medical units, facilities , materiel, and transport are protected from intentional attack if they are clearly identifiable by the enemy in a combat environment. This can be accomplished by using large white and red flags, emblems, or panels. To be afforded this protection, medical units may not be positioned so that attacks against military objectives imperil their safety. Medical evacuation vehicles that also carry unwounded, non-medical personnel are not entitled to protection. Medical evacuation aircraft are only entitled to protection while flying on prearranged routes at prearranged times and heights. If there are no prearrangements, medical evacuation aircraft fly at their own risk. 

Should medical materiel be captured by the enemy, it is to be used first to treat patients of the captured force. If there are no patients of the captured force, it may be used to treat other sick or wounded persons. Therefore, medical materiel is not to be destroyed to prevent it from being captured by the enemy. Captured medical facilities should continue to be used as medical facilities. Captured medical transports may be used for non-medical purposes if their distinctive markings are removed. A medical aircraft must obey an enemy summons to land; if examination reveals it is not engaged in harmful acts, it will be released to continue its medical mission. 

Guidelines from the Geneva conventions grant medical units protected status, however to maintain protection they must identify themselves with very distinct and obvious markings. There are three symbols used to identify medical units: a red cross, a red crescent, or a red lion. These red emblems must be displayed on a white background to qualify as an obvious marking. Although the red Star of David is not officially recognized as a distinct medical symbol, it has been afforded protection in past conflicts. 

Although the articles of the Geneva conventions state that the medical emblems "shall be displayed on the flags, armlets, and on all equipment employed in the Medical Service," it is generally accepted that there is no obligation for belligerents to mark units with the emblems. A commander, usually no lower than the grade of O6 in the U.S. forces, may order medical units and transports to be camouflaged to conceal the presence or strength of a force. Camouflaging a medical asset does not automatically result in its losing protected status. Protection is only lost if camouflaging the unit or transport prevents the enemy for recognizing its medical function. There is no such thing as a camouflaged red cross. When medical units and transports are camouflaged, their red cross emblems should be covered up or taken down. A black cross on an olive drab background is meaningless. 

Loss of Protection by Medical Units and Facilities 

Medical assets may lose their protection by engaging in acts harmful to the enemy. If a force suspects its enemy is using medical units to commit harmful acts, it must first warn the enemy to stop within a given period time period. Only after the time period has expired and the harmful acts have not ceased may the force open fire or attack. Examples of harmful acts include using a hospital to shelter combatants, siting a medical unit to impede an enemy attack, or mounting a crew-served weapon on an ambulance. Use of smoke and obscurants, like camouflage, is not considered a harmful act. 

Conditions that Do Not Deprive Medical Assets of Protection 

• Medical personnel may be armed and may use arms in self-defense or in defense of their patients.
• Medical personnel may perform guard duties for their own unit if non-medical personnel are not available.
• Small arms and ammunition taken from casualties may be stored in medical facilities until they can be turned in to proper authorities.
• Veterinary personnel and materiel may be collocated with medical personnel and materiel.

Medical personnel may care for civilian casualties.

Wounded, Sick, and Shipwrecked at Sea 

Military personnel who are at sea and are wounded, sick, or shipwrecked, by whatever cause, are entitled to respect and protection. Should fighting occur on board a warship, the sick bay shall be respected and spared from fighting if possible. Sick bays lose their protected status if they are used to commit acts harmful to the enemy. 

Hospital Ships 

Hospital ships may not be attacked or captured, provided their names and descriptions have been provided to the enemy at least ten days before they are deployed. Hospital ships lose protection if they are used for any military purpose or commit acts harmful to the enemy. Possession of secret codes for radios or other means of communication by a hospital ship is considered an act harmful to the enemy.