(1) (u) “Medical aircraft” means any aircraft permanently or temporarily assigned — by the competent authorities of a Belligerent Party — exclusively to aerial transportation or treatment of wounded, sick, or shipwrecked persons, and/or the transport of medical personnel and medical equipment or supplies.
- Rule 1 (u) is based on the first paragraph of Art. 39 of GC/II and on Arts. 8 (f), (g) and (j) of AP/I.
- A medical aircraft is defined by its function, i.e. the aerial transport of wounded, sick, or shipwrecked persons, and/or the aerial transport of medical personnel and medical equipment or medical supplies. The definition ought to be interpreted as also including the transportation of religious personnel.
- In contrast to AP/I, this definition foresees the provision of medical treatment in a medical aircraft. The rationale behind this enlarged definition stems from an enhanced capacity to conduct such activities: armed forces are today often equipped with air ambulances providing not only the efficient evacuation of sick and wounded from the battlefield but which are also able to provide medical care en route (Medivac).
- Any aircraft may become a medical aircraft, depending on its assignment. Hence, a military aircraft (see Rule 1 (x)) may become a medical aircraft, in which case it no longer constitutes a lawful target (unless engaged in acts harmful to the enemy) (see Rule 26 and Section L).
- Search-and-rescue aircraft do not qualify as a medical aircraft nor must they be used to search for the wounded, sick and shipwrecked within areas of combat operations, unless pursuant to prior consent of the enemy (for details, see Rule 86).
- The terms “wounded”, “sick”, “shipwrecked” and “medical personnel” need to be interpreted in accordance with the 1949 Geneva Conventions and Art. 8 of AP/I 1977. On the definition of wounded, sick and shipwrecked, see the Commentary on Rule 16. For further explanation on the definition of medical and religious personnel, see the Commentary on Rule 71.
- A medical aircraft needs to be “exclusively” assigned to one of the tasks mentioned. It must therefore only contain categories of persons, medical equipment or medical supplies that fall under its definition as long as it is assigned to this purpose. For example, an aircraft carrying only medical and religious personnel or an air transportable hospital would qualify as a medical aircraft. If the aircraft, in addition, carries able combatants and/or items which do not qualify as medical equipment or supplies, it does not fall under the definition of medical aircraft.
- The assignment of an aircraft to exclusive medical purposes has to be done by a competent authority of the Belligerent Party. Following the assignment, the aircraft becomes a medical aircraft, subject to specific protection as defined in Section L. Art. 8 (g) of AP/I insists not only on assignment to the function of a medical aircraft, but also on control by the Belligerent Party. If the aircraft is either a military aircraft or any other State aircraft, full control by the Belligerent Party is implicit both at the time of the assignment and during its operation as a medical aircraft thereafter. If the medical aircraft is a civilian aircraft, the Belligerent Party incurs full responsibility to ensure that the aircraft will operate in keeping with the law of international armed conflict and in particular will not be abused, e.g., with regard to the display of the protective emblem (see Rule 72).
- A medical aircraft may either be “permanently” or “temporarily” assigned to medical transportation or treatment. To be considered “permanent”, medical aircraft must be (Art. 8 (k) of AP/I) “assigned exclusively to medical purposes for an indeterminate period”, whereas “temporary” medical aircraft are defined based on their assignment or use during a limited period of time. A medical aircraft’s mission ends when it has been given a new assignment or use not related to medical purposes. Occasionally, the same aircraft is used as a matter of routine flying wounded and sick on one segment of its flight, and armed personnel and equipment on another segment. During that segment of the flight in which the aircraft is carrying wounded and sick, it is considered a medical aircraft notwithstanding the temporary nature of the assignment.
- First paragraph of Art. 39 of GC/II: “Medical aircraft, that is to say, aircraft exclusively employed for the removal of the wounded, sick and shipwrecked, and for the transport of medical personnel and equipment, may not be the object of attack, but shall be respected by the Parties to the conflict, while flying at heights, at times and on routes specifically agreed upon between the Parties to the conflict concerned.”
- Art. 8 of AP/I: “(f) “‘medical transportation’ means the conveyance by land, water or air of the wounded, sick, shipwrecked, medical personnel, religious personnel, medical equipment or medical supplies protected by the Conventions and by this Protocol; (g) “medical transports” means any means of transportation, whether military or civilian, permanent or temporary, assigned exclusively to medical transportation and under the control of a competent authority of a Party to the conflict; (j) “medical aircraft” means any medical transports by air.”
- See fns. 229–230, 394.
- See fn. 73.
- Art. 8 (k) of AP/I: “‘permanent medical personnel’, ‘permanent medical units’ and ‘permanent medical transports’ mean those assigned exclusively to medical purposes for an indeterminate period. ‘Temporary medical personnel’, ‘temporary medical units’ and ‘temporary medical transports’ mean those devoted exclusively to medical purposes for limited periods during the whole of such periods. Unless otherwise specified, the terms ‘medical personnel’, ‘medical units’ and ‘medical transports’ cover both permanent and temporary categories.”