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This booklet contains practical advice for assessing public health and its determinants in laces of detention throughout the world. It draws heavily on the ICRC’s extensive experience in this field. The booklet will be of great assistance to health authorities, prison authorities and all those responsible for the provision of health care in prisons who seek to maintain or improve the health of people deprived of their freedom.
Source : CICR
When a hospital in Kodok, South Sudan was caught in the crossfire between the conflict’s two warring parties, doctors were forced to evacuate. Two people died as a direct result of fighting, but 11 patients died afterward because of the sudden lack of medical staff. It’s another example of how war imperils health care. The ICRC field delegate, who had just returned to Juba after being evacuated from Kodok, describes what happened and the consequences for the people in dire need of health care in the area.
Source : ICRC
Speech given by Peter Maurer, President of the ICRC, at the launch of the « Ethical Principles of Health Care in Times of Armed Conflict and Other Emergencies. »
The nature of humanitarian work often has me deliver speeches with words of warning and caution, and with descriptions of the particularly distressing situations in which victims of violence find themselves. I am glad to deviate from such patterns today, at the launch of our « Ethical principles of health care in times of armed conflict and other emergencies ».
Agreeing on these principles is indeed a substantive achievement and I would like to thank the World Medical Association (WMA), the International Committee of Military Medicine (ICMM), the International Council of Nurses (ICN) and the International Pharmaceutical Federation (FIP) for their participation and commitment to this process under the auspices of the ICRC.
The ethical principles we are launching today are a ground-breaking document because now, for the first time, our global associations have a common and concise set of shared principles. They will apply to more than 30 million professionals, civilian and military, who may face ethical dilemmas in times of armed conflict and other emergencies.
As we all know, modern international humanitarian law (IHL) originated from the idea that enhancing the protection of the medical mission – personnel, transports and units alike – was an essential step to better assist and protect victims of armed conflict.
This idea was at the core of the international consensus, which led to the first Geneva Convention of 1864. Today, this consensus seems to be becoming more elusive by the day.
Armed conflicts and emergencies are too often characterized by scores of people in urgent need of medical care as well as widespread destruction of health infrastructure and massive displacements of health personnel. In consequence, the pressure on the few remaining in the midst of combats and emergencies becomes all the more important.
During armed conflict and other emergencies, assaults on health facilities, health workers, and the patients they serve, are all too common. Aside from the immediate human toll they take, such attacks result in obstructed access to health services, they compromise the ability to deliver care to populations in great need, they weaken the presence of skilled health workers, they affect health systems overall and hamper efforts to reconstruct such systems and health infrastructure after war.
In 2011, the ICRC, together with other partners of the International Red Cross and Red Crescent Movement, began the Health Care in Danger project. The latest report on violent incident against health care, released in April 2015, analysed 2,398 incidents collected in 11 countries from January 2012 to December 2014. The report concludes that over 50% of the attacks took place against, inside or nearby health care facilities and that at least 598 health care personnel lost their lives or were wounded during an attack. In addition, over 700 medical transports were directly or indirectly affected. In most incidents, local health care workers were affected most seriously. As a consequence of such violence, health care facilities were forced to suspend operations fully or completely, and health care personnel and victims in need of medical treatment avoided going back to health care facilities, fearing arrest, intimidation, harassment, assault, or death.
Every day, more and more detailed information is coming to light, confirming such findings: according to the organization Physicians for Human Rights, in Syria in 2014 alone, on average one medical worker was killed every other day and a hospital was attacked every four days.
Indeed, delivering health services to victims of conflict without distinction or discrimination is an increasingly complex challenge in contemporary conflicts.
This is why the ethical principles of health care in times of armed conflict and other emergencies we are launching together today is so uniquely important. Be it in Yemen, in Mali or in Syria, doctors and nurses are exposed to threats and violence aimed at thwarting their medical duties every day. And within the constraints of armed conflict, they too often find themselves confronted with acute ethical dilemmas and – until now – without much guidance.
Existing norms are no longer sufficient and the general consensus that the medical mission has to be respected in all circumstances has slipped into the background while abuses have increased from sporadic to systematic.
That is why we call on governments to help improve the situation and put an end to these violations of international humanitarian law. The ICRC is raising the issue in multilateral fora, both regional and global, not only to increase awareness but to get States to take concrete action. Now that all major professional organisations have come together, we expect States and international organisations to offer political support to our efforts and to use all means available to facilitate their implementation.
As co-authors, we will not stop our efforts now that the principles have been agreed upon. Beyond reaching out to States and authorities, we will remain committed to engaging professionals and experts in their fields, to use the principles in the real dilemmas they face every day.
Traditionally, the ICRC addresses humanitarian challenges through assisting and protecting affected populations as directly as possible. But this is not sufficient given the complexities of the challenges we face. We have a collective responsibility to prevent the re-occurrence of abuses by developing normative instruments and promoting the compliance with norms and standards. Beyond relief work, and beyond engagement with States, the practical cooperation with professional networks is of critical importance. By pooling experience, knowledge, and expertise of professionals, we create standards that hold up to the challenges of practice.
In the past, this approach has proven productive when we devised a manual on war surgery which is now used across the world by surgeons operating on victims of conflict. Similarly, the creation of Professional Standards for Protection Work, launched by the ICRC in 2009, after substantial consultations with humanitarian and human rights organizations, paved the way to more coherent, more comprehensive humanitarian protection work. In turn, the set of principles we launch today will help to demonstrate that the 5th century BC Hippocratic oath remains as important and valid as ever – whether friend or foe, all human beings have the right to medical care, and medical professionals have the right to provide it.
This set of principles is a great achievement and demonstrates the capacity of a single sector to produce far-reaching ethical standards. The process through which we achieved this result is a perfect example of what I like to describe as principled pragmatism – where professional experience meets normative frameworks. Practical solutions will have to come from those confronted with real-life challenges while we will need stronger political commitment to reinforce these solutions and to create conditions in which the principles can be applied.
The endorsement of the ethical principles also demonstrates the outstanding commitment of health care professionals to preserve the integrity of health care staff and their resolve to lead without waiting for a governmental process – while it is critically relevant, it may take some more years to materialize.
Indeed, professional ethics transcend borders and political interests. The principles can therefore be seen as an articulation by individuals and civil society of what is acceptable and what is unacceptable behavior. Our common purpose today is to discuss how we are going to disseminate these rules and give them more leverage with different stakeholders.
We hope that you will use your own power, influence and your different networks to encourage the establishment of robust national legislations and accountability mechanisms.
Ladies and gentlemen, dear colleagues,
More than one hundred years ago, Florence Nightingale wrote that:
« Suffering lifts its victim above normal values. While suffering endures there is neither good nor bad, valuable nor invaluable, enemy nor friends. The victim has passed to a region beyond human classification or moral judgments and his suffering is a sufficient claim. »
Although we observe the sobering picture of a general deterioration of the protection of the medical mission, there is no reason to be fatalistic – the principles should rather become a source of hope.
A survey of 600 US military physicians engaged in « Operation Desert Storm » has shown that two-thirds of respondents said that medical needs should be the only criterion for triage, and a mere 22% stated that wounded enemy soldiers, no matter how severe their wounds, should be treated only after all allied forces have been treated. The ICRC study « Our world – Views from the field » is enlightening in this respect as well. About 4,200 persons living in eight countries affected by armed conflicts were interviewed in 2009, notably about their views regarding health care for the victims of the conflict. Ninety-six per cent agreed that « everyone wounded or sick during an armed conflict should have the right to health care ». Eighty-nine per cent replied that « Health workers should treat wounded and sick civilians from all sides of a conflict », and 89% that « Health workers must be protected when they are treating wounded or sick enemy combatants, especially when treating enemy civilians ».
After a long evolution in the practice and principles of military medicine, international humanitarian law over the past 150 years has imposed an unequivocal duty on all parties to armed conflict to provide impartial care for wounded and sick combatants. As shown by the history of military medicine, the humanitarian principles set out by international humanitarian law were shaped by humanitarian need and by medical practice on the battlefield. The shock and horror experienced by those witnessing the fate of severely wounded and dying men abandoned to their fate were at the origin of the indignation of people like Francisco de Goya and Henry Dunant. It is not human to abandon them; it is our human duty to provide them with relief and care.
In conclusion I would like to stress that the respect for health care and health personnel who carry out their mission in difficult circumstances is at the core of the principle of humanity. Health systems are usually the first line of defence in many armed conflicts and other emergencies. Undermining their response capacity means jeopardizing the survival of entire populations. Likewise, weak or vulnerable health systems are usually unable to absorb the shocks of major pandemics like Ebola or Polio.
The impartial access to health care and the protection of medical personnel in times of conflict is at the origin of IHL and represents the essence of the laws of war. It may remind us of the prophetic « Tutti Fratelli » clamour uttered by the women of Castiglione delle Stiviere, while they were treating the wounded on all sides in the aftermath of the battle of Solferino.
The set of principles we are presenting today may help health personnel in challenging situations to solve the numerous dilemmas they face in addition to the responsibility of caring for patients. This is why the ICRC is putting its full institutional weight behind this initiative.
Source : Peter Maurer, President of the ICRC : ICRC.org
Le CICR est heureux de présenter son module de formation en ligne sur le cadre juridique applicable aux soins de santé dans les conflits armés et d’autres situations d’urgence.
Fondé sur une approche pratique et interactive, ce module emploie toute une panoplie d’outils pédagogiques. Sa plateforme conviviale permet à des utilisateurs d’horizons différents – juristes ou novices en la matière – d’accéder facilement aux contenus proposés.
À travers des études de cas interactives, des activités pratiques et diverses animations, le module vous familiarisera avec les grands principes juridiques et les dilemmes auxquels le personnel médical se heurte fréquemment.
Ana, un jeune médecin exerçant dans un pays fictif, sera votre guide tout au long du module. Souhaitez-vous faire sa connaissance et vous lancer dans l’aventure ?
The law of war is of fundamental importance to the Armed Forces of the United States.
The law of war is part of who we are. George Washington, as Commander in Chief of the Continental Army, agreed with his British adversary that the Revolutionary War would be “carried on agreeable to the rules which humanity formed” and “to prevent or punish every breach of the rules of war within the sphere of our respective commands.” During the Civil War, President Lincoln approved a set of “Instructions for the Government of the Armies of the United States in the Field,” which inspired other countries to adopt similar codes for their armed forces, and which served as a template for international codifications of the law of war.
After World War II, U.S. military lawyers, trying thousands of defendants before military commissions did, in the words of Justice Robert Jackson, “stay the hand of vengeance and voluntarily submit their captive enemies to the judgment of law” in “one of the most significant tributes that Power has ever paid to Reason.” Reflecting on this distinctive history, one Chairman of the Joint Chiefs of Staff observed that “[t]he laws of war have a peculiarly American cast.” And it is al so true that the laws of war have shaped the U.S. Armed Forces as much as they have shaped any other armed force in the world.
The law of war is a part of our military heritage, and obeying it is the right thing to do. But we also know that the law of war poses no obstacle to fighting well and prevailing. Nations have developed the law of war to be fundamentally consistent with the military doctrines that are the basis for effective combat operations. For example, the self-control needed to refrain from violations of the law of war under the stresses of combat is the same good order and discipline necessary to operate cohesively and victoriously in battle. Similarly, the law of war’s prohibitions on torture and unnecessary destruction are consistent with the practical insight that such actions ultimately frustrate rather than accomplish the mission.
This manual reflects many years of labor and expertise, on the part of civilian and military lawyers from every Military Service. It reflects the experience of this Department in applying the law of war in actual military operations, and it will help us remember the hard-learned lessons from the past. Understanding our duties imposed by the law of war and our rights under it is essential to our service in the nation’s defense.
Stephen W. Preston – General Counsel of the Department of Defense
Originally posted on Dommages civils:
La question de la participation des civils aux hostilités est peut-être l’une des plus controversées en droit international humanitaire (DIH). Elle rend compte de la réalité selon laquelle des civils choisissent de prendre les armes contre les forces ennemies. Pour autant, si cette règle entraîne une perte d’immunité, elle n’aboutit pas à un changement de statut. En effet, un civil ne devient pas un combattant en raison de son choix de participer aux hostilités ; il ne se verra pas accorder le privilège du combattant. Ainsi, il se lance dans une « belligérance risquée » puisqu’il ne bénéficie plus de l’immunité contre les attaques ; il ne bénéficie pas du statut de prisonnier de guerre et peut faire l’objet de poursuite judiciaire pour cette participation aux hostilités en cas d’arrestation. Cette règle est au cœur de la rationalisation de la violence opérée par le DIH. Elle cherche à la fois…
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La Présidente de la transition, Catherine Samba Panza, a promulgué le 3 juin 2015, une loi portant création, organisation et fonctionnement de la Cour Pénale Spéciale (CPS). Ce geste confirme la ferme volonté des autorités nationales, de la représentation nationale de transition, appuyés par la communauté internationale, d’instaurer une réelle lutte contre l’impunité et un processus de vérité, justice et réconciliation, comme l’a confirmé le Forum national de Bangui en mai 2015. Initiée en avril 2014 avec la création de la Cellule spéciale d’enquête et d’instruction puis poursuivie en août 2014 avec l’accord entre le gouvernement de transition et les Nations Unies sur la création d’une telle Cour, la Cour pénale spéciale doit contribuer avec la justice centrafricaine et la Cour pénale internationale (CPI) à mettre un terme à l’impunité qui prévaut en RCA.
La FIDH, aux côtés de 23 organisations de défense des droits humains centrafricaines et internationales, a vigoureusement œuvré pour la création de la CPS.
La nouvelle cour sera compétente pour enquêter sur les crimes les plus graves et poursuivre les auteurs de crimes de guerre et de crimes contre l’humanité commis sur le territoire de la Centrafrique depuis le 1er janvier 2003.
La FIDH et ses organisations membres et partenaires appellent la communauté internationale à soutenir résolument les autorités centrafricaines pour la mise en place rapide et effective de la Cour pénale spéciale, notamment en nommant rapidement les magistrats, en lui trouvant des locaux et en assurant son financement.
Source : FIDH
The ICRC eLibrary is an application for Android and iOS tablets that lets you read and download selected ICRC publications.
Features: Publications in up to eight languages ; Support for PDF and HTML5 publications ; Global keyword search ; Smart recommendations based on documents you’ve read previously ; Downloading for offline reading ; Interface in English and French.
Originally posted on Dommages civils:
Du 13 au 17 avril, les membres délégués de la Convention sur l’interdiction ou la limitation de l’emploi de certaines armes classiques se sont à nouveau réunis pour discuter de la problématique des systèmes d’armes létaux autonomes (SALA). Ces derniers peuvent être définis comme des « systèmes d’arme robotique qui, une fois activés, peuvent sélectionner et engager des cibles sans l’intervention d’un opérateur humain. (…) Le robot dispose d’un choix autonome dans la sélection de l’objectif et l’usage de la force létale ».
Qualifiés de « robots tueurs » par leurs opposants, ces derniers font campagne depuis plusieurs années pour l’adoption d’un traité international visant l’interdiction préventive de cette technologie. En effet, ils estiment qu’elle est incapable de respecter le droit international humanitaire (DIH) en l’absence de la faculté de…
Voir l'original 2 977 mots de plus