In today’s armed conflicts, hospitals are increasingly being attacked or misused for military purposes, undermining one of international humanitarian law’s most fundamental protections. These strikes have devastating consequences for the people who rely on hospitals for life-saving care, from patients and medical staff to entire communities. When hospitals are damaged or forced to shut down, critical services like paediatric care or intensive care treatment vanish, often with fatal results. Despite clear legal safeguards granting protection to hospitals, cases indicate that hospitals are at times misused for military purposes and attacks regularly ensue. In many cases, core IHL principles are either deliberately ignored or applied in a permissive manner, threatening the very idea that hospitals must be specifically protected as neutral sanctuaries by all sides to a conflict.

In this post, ICRC Legal Advisers Supriya Rao and Alex Breitegger explore how IHL’s specific protection of hospitals is both robust and comprehensive, grounded in a presumption of neutrality that can only be lost in narrowly defined cases. Even when misuse occurs, parties are required to issue a warning and give time for it to stop, striking as a last resort only if the hospital meets the definition of a military objective – and even then, the rules of proportionality and precautions apply to limit the harm. Upholding this framework is essential to ensuring that the wounded and sick can access care, and that humanitarian principles endure, even amid the horror of war.