Opposing the erosion of medical neutrality: Why attacking hospitals violates international law and endangers civilians

The increasing frequency of attacks on hospitals represents a dangerous erosion of a cornerstone of international law. Medical neutrality—the principle that the sick and wounded must be cared for regardless of affiliation—is essential for preserving humanity in war. When hospitals are attacked, even if they are allegedly used for military purposes, the consequences are catastrophic and often disproportionate. The killing of doctors and destruction of medical supplies leaves entire populations without care, especially the most vulnerable: children, the elderly, and the wounded. In Gaza, the destruction of Al-Shifa hospital and others has led to preventable deaths and the spread of disease. In Ukraine, attacks on maternity wards and cancer centres have caused outrage. In Sudan, the looting and shelling of hospitals has collapsed the health system in Darfur and Khartoum. International humanitarian law is clear: any attack on a medical facility must consider the potential harm to civilians, and if the military advantage is outweighed by the civilian cost, the attack is illegal. In practice, most attacks on hospitals are indiscriminate or disproportionate, often because the military intelligence is flawed or the precautions are insufficient. Moreover, the repeated targeting of hospitals breeds distrust in medical neutrality, making it harder for aid organisations to operate and for civilians to seek care. The trend must be reversed through accountability—prosecuting those who order such strikes—and through reaffirming the absolute protection of medical facilities. Any use of hospitals for military purposes should be addressed by other means, not by bombing.