Ensuring respect for, and protection of, the wounded and sick and delivery of health care to them were at the origin of the Red Cross and Red Crescent Movement, as well as the development of international humanitarian law (IHL). In today's armed conflicts and other emergencies, the problem is not the lack of existing international rules but the implementation of relevant IHL and international human rights law (IHRL) which form a complementary framework governing this issue. Against the backdrop of the different manifestations of violence observed by the ICRC in the field and expert consultations held in the framework of the Health Care in Danger Project, this article identifies commonalities between the two legal regimes, including with respect to obligations to provide and facilitate impartial health care; prohibitions of attacks against wounded and sick and health-care providers; prohibitions to arbitrarily obstruct access to health care; prohibitions to harass health-care personnel, in violation of medical ethics; or positive obligations to ensure essential medical supplies and health-care infrastructure and protect health-care providers against violent interferences by others. The article concludes by indicating certain areas where implementation of existing IHL and IHRL is needed, including in domestic normative frameworks, military doctrine and practice, as well as training of health-care personnel on these international legal frameworks and medical ethics.

This article provides a first attempt at analysing the complex set of issues around remote management practices in insecure environments and their increased use. It looks at definitions and reviews existing published and grey literature on remote management and related practices. It tries to situate remote management in the evolving context of post-Cold War strategies of dealing with conflict and crisis. On the basis of interviews with a cross-section of aid workers, senior headquarters managerial and policy staff, donors, and research institutions, it provides an assessment of current remote management practices, with a particular focus on Afghanistan and Somalia, and their implications for the future of humanitarian action.

In this contribution, I will identify the main issues relevant for the applicability and application of international humanitarian law (IHL) in military operations under the command of the European Union (EU) and I will briefly describe the EU's practice and policy in this respect.1

Armed conflicts have numerous adverse health consequences for the affected populations, many of which occur in the long-term. This article analyses in detail how international humanitarian law (IHL) and the right to health complement each other in obliging states to mitigate the direct and indirect health consequences of non-international armed conflicts. With its historical origin and purpose of protecting wounded and sick combatants of standing governmental armies, IHL focuses on the protection of the wounded and sick suffering from the direct health consequences of armed conflicts, such as injuries resulting from ongoing hostilities. The right to health is more expansive: it obliges states to prioritise the provision of primary health care through creating and maintaining an accessible basic health system. This focus enables it to highlight and address the indirect health consequences of armed conflicts, such as the spreading of epidemic and endemic diseases and rising child and maternal mortality and morbidity.

In his article ‘Challenges to international humanitarian law: Israel's occupation policy’, the president of the International Committee of the Red Cross (ICRC), Mr Peter Maurer, addresses the challenges that the application of international humanitarian law (IHL) faces in the Middle East in general and in the context of the Israeli–Palestinian conflict in particular. Mr Maurer focuses on three main issues in relation to Israel's military occupation of the Palestinian territory: East Jerusalem, settlements and the Annexation Wall. Furthermore, he touches on the ICRC's confidentiality policy and suggests that the ICRC engage in public dialogue with parties to the conflict, especially when confidential dialogue fails to improve the lives of the affected people.

Attacks on and interference with health care services, providers, facilities, transports, and patients in situations of armed conflict, civil disturbance, and state repression pose enormous challenges to health care delivery in circumstances where it is most needed. In times of armed conflict, international humanitarian law (IHL) provides robust protection to health care services, but it also contains gaps. Moreover, IHL does not cover situations where an armed conflict does not exist. This paper focuses on the importance of a human rights approach to addressing these challenges, relying on the highest attainable standard of health as well as to civil and political rights. In particular we take the Committee on Economic, Social and Cultural Rights General Comment No. 14 (on Article 12 of the International Covenant on Economic, Social and Cultural Rights) as a normative framework from which states' obligations to respect, protect and fulfil the right to health across all conflict settings can be further developed.

The applicability of international humanitarian law (IHL) to United Nations (UN) forces has long generated discussion. When peacekeepers have become engaged in hostilities of such a nature as to trigger the application of IHL (either via acts in self-defence, or in the course of carrying out a mandate as authorised by the UN Security Council under Chapter VII of the Charter of the United Nations), questions have arisen as to whether they should be equally subject to the rules of IHL. Such questions arise as UN peacekeeping forces act on behalf of the international community and thus have a ‘just cause’, so to speak, to use force. Despite these questions, however, it now appears well settled that the distinction between jus ad bellum (the right to use force under public international law) and jus in bello (the law governing the conduct of hostilities) should be maintained, and that IHL applies in respect of UN peacekeeping operations whenever the conditions for its application are met. That said, questions regarding the conditions for the application of IHL, as well as its scope of application, continue to be relevant, particularly at a time when the Security Council is tasking UN operations with increasingly robust mandates.

Health-care workers face ethical dilemmas in their decision-making in every clinical intervention they make. In times of armed conflict the decisions may be different, and the circumstances can combine to raise ethical tensions. This article looks at the tensions in peacetime and in times of armed conflict and examines the types of cases that doctors and other health-care workers will face. It also discusses the common ethical decision-making framework and the role of communication within both clinical care and ethical analysis.

Questions of the applicability and application of international humanitarian law (IHL) to multinational forces are of central interest to the North Atlantic Treaty Organisation (NATO, also referred to as ‘the Alliance’ or ‘the Organisation’). Far from being incidental, multinational military coordination is the Organisation's raison d’être and the driving concept behind its methods, history and operations. Since the end of the Cold War, it has conducted a series of major multinational military operations – in and around the Balkans, Afghanistan, Libya and elsewhere – in which questions of the application of IHL have inevitably arisen.

The ‘debate’ section of the Review aims at contributing to the reflection on current ethical, legal, or practical controversies around humanitarian issues.

In this issue of the Review, we invited two experts in international humanitarian law (IHL) and multinational peace operations – Professor Eric David and Professor Ola Engdahl – to debate on the way in which the involvement of a multinational force may affect the classification of a situation. This question is particularly relevant to establishing whether the situation amounts to an armed conflict or not and, if so, whether the conflict is international or non-international in nature. This in turn will determine the rights and obligations of each party, especially in a context in which multinational forces are increasingly likely to participate in the hostilities.

Military medical personnel and objects, as well as wounded and sick combatants, are protected against direct attack under the principle of distinction in international humanitarian law. However, some authors argue that they are not covered by the principles of proportionality and precautions. This opinion note explains that military medical objects constitute civilian objects under the rules governing the conduct of hostilities. It also demonstrates that, in view of the object and purpose of the First Additional Protocol to the Geneva Conventions, expected incidental casualties of military medical personnel and wounded and sick combatants must be included among the relevant incidental casualties under the principles of proportionality and precautions. This stems in particular from the interpretation of the obligation ‘to respect and protect’ as the overarching obligation of the special protection afforded to all medical personnel and wounded and sick. Support for this conclusion can be found in a number of military manuals and in the Additional Protocol's preparatory work and Commentaries. This conclusion also reflects customary law.

This article describes some of the challenges raised by multinational operations for the application of international humanitarian law. Such challenges are the result of different levels of ratification of treaties, divergent interpretations of shared obligations, and the fact that there is no central authority that determines who is a party to an armed conflict. The article discusses methods that have been developed to ensure ‘legal interoperability’. Some of these methods attempt to avoid situations where such interoperability is required. Where this is not possible, a ‘maximalist’ or a ‘minimalist’ approach can be taken, and in practice these are usually combined.

This paper discusses three main areas of controversy relating to detention in the context of multinational operations: the relationship between international humanitarian law and human rights law; the principle of legality in the context of relying on United Nations Security Council resolutions as a justification for taking detainees; and the transfer of detainees where there is, for example, a substantial risk of torture or cruel, inhuman or degrading treatment or punishment. The paper then considers how the Copenhagen Principles address these issues.

The article aims to examine, in light of the codification work of the International Law Commission and of the most recent practice, some issues concerning the allocation of responsibility between an organisation and its troop-contributing states for the conduct taken in the course of a multinational operation (with a specific focus on UN operations). After explaining the general rule of attribution of conduct based on the status of the multinational force as an organ or an agent of the organisation, this article will examine the validity of special rules of attribution of conduct based on the notions of ‘effective control’ or ‘ultimate control’ over the acts of the multinational force. Finally, I will discuss the possibility of dual responsibility of both the organisation and the troop-contributing state concerned.