2023年7月18日乌克兰的军队：如何拯救他们更多的士兵

![](/media/202412//1733453434.239352.png)武装部队的战斗医务人员

乌克兰的军队：如何拯救他们 更多的士兵

2023年7月18日

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![](/media/202412//1733453434.2480721.jpeg)*战斗医生在拯救伤员的生命方面发挥着关键作用*

*战*场。这些专业人士在2017年出现在乌克兰军队中，但是 战斗医务人员的法律地位仍有争议。国际的

人道主义法（IHL）将他们定义为医务人员，而大多数人

指挥官们主要把他们当作战斗人员来对待。这样的法律不确定性 阻止将战斗医务人员从囚禁中释放出来，因为他们属于a

根据各日内瓦公约，受保护的类别。这个 分析论文旨在提供理解为什么这种发生和 就如何处理这个问题提出建议。

根据国际人道主义法（IHL），人员 专门从事提供医疗援助的，即在搜索，或收集、运输、诊断或治疗（包括急救）的伤员或病人，被认为是 医务人员，不管他们是否属于成员

是否有武装部队(公约（一）第24条和第二十八条 武装伤人员状况的改善

外地部队（1949年8月12日），《议定书》第8条和第43条 截至1977年6月8日签订的各日内瓦公约的附加条款)。

这些人不被承认为战斗人员，也可能不是

被攻击并作为战俘关押(除了需要 为受伤的囚犯提供援助)。

关于保护和尊重医务人员的规定

战争时期是一项得到所有国家都承认的普遍权利 以及他们在所有武装冲突中都必须尊重的世界。

违反这些规定的行为，特别是对医疗机构进行有针对性的攻击 人员、疏散车辆、医疗机构、干扰

医务人员的工作，构成了严重违反法律的行为和战争的习俗，是一种战争罪。第85条第2条。2的

《日内瓦附加议定书》第43条、第8条 截至1977年6月8日签订的公约)。

另一方面，为了保护医务人员得到保护因此，他们应该避免直接参与敌对行动(除了在 自卫和保护伤员)，并必须坚持医疗规定伦理学和中立性原则。这些人员只被允许进入携带轻型武器，他们可以用于自卫和保护 受伤的。

医务人员与战斗人员

根据北约的标准，两个新的职位出现在了北约

2017年乌克兰武装部队：排战斗医生和高级军官

战斗医生（一个公司、炮台或类似单位）。

根据目前版本的武装职位名单

乌克兰部队的这些职位属于军事职业性职位

专业（MOS）878，即初级医务人员和是

在第9.4节中规定。MOS列表-“医学专业 ”。

新职位的同时引入

战术医学训练中心作为武装部队的一部分 乌克兰这是中心主任，中校

奥莱 ·沃兹纽克谈到该设施时说： “我们的中心管理着一名战斗医生 课程完成它的军人将成为排的战斗

医务人员。他们将负责在其单位提供紧急情况

护理、疏散伤员和培训的人员 和他们一起服务。

战斗医生和战斗医生的教育和资格描述 训练中心批准了高级战斗医疗中心学员。

根据描述，这些专业人员被划分为初级专业人员

未接受过医学教育的医务人员，应拥有 知识和技能，包括纯粹的医疗组成部分。

与此同时，乌克兰国防部的命令

介绍战斗医生和高级战斗医生的职位，

没有阐明在军队中使用这些专家的原则。

![](/media/202412//1733453434.2608066.jpeg)根据国际人道主义法，战斗医疗人员是 被列为医务人员

此外，他们的地位、权利和义务没有任何规定

适用于乌克兰武装部队的监管文件 将军

在实践中，它们有时，但不总是，按顺序描述

旅和营的级别。有时战斗医务人员是

分配了通常由其他相关专家执行的职责 如卫生指导员或战术医学指导员等职位， 并由《武装部队内务宪章》规定

乌克兰军队。但即使在这种情况下，这些职责的清单也包括在内

仅有医疗功能：及时识别病人，提供医疗服务 在军事人员受伤(受伤、

中毒)、卫生、卫生和防疫措施 公司（电池）等。

然而，在大多数情况下，战斗医护人员并不清楚 明确的权利和义务，并履行他们的职责

根据指挥官的特别命令。而且，战斗医生也是如此 没有适当的医疗证明。

所有这些都导致了人们对这些专家的错误看法

军队，主要是由司令部指挥的。一个关键的讨论是围绕着

是否将战斗医务人员视为具有特定医疗条件的战斗医务人员 技能或他们是否应该执行专门的医疗任务

在战场上享受所有相关的特权和限制 与此状态。

受伤后的第一分钟：不要浪费的时间

现代战争使得人们无法在附近找到外科护理中心 部队的前沿阵地。在最有利的条件下，

疏散伤员，并将伤员运送到他们接受治疗的地方

手术护理可能需要几十分钟到几个小时，甚至几天甚至几天

![](/media/202412//1733453434.2740662.jpeg)就战术医学而言，在被杀之后的头几分钟 受伤者通常决定了a的生存和恢复的前景 士兵

在这种情况下，即使士兵的生命得救了，他们的机会 全面恢复和恢复岗位急剧下降。例如，让我们取一个 用止血带进行止血的肢体严重受伤

流血如果止血带的使用时间超过6个小时，则应使用 截肢的概率几乎是百分之百的。在……之后

这样，服务人员很可能会被转移到保护区

乌克兰军队将失去一名士兵，政府将被迫投降 来支持他的生活。

但当伤员接受专业治疗时，情况就不同了

和及时。然后，他们很有可能会恢复健康并返回工作岗位。

然而，必须有有人来提供这样的帮助。和 这是一个战斗医生。

就战术医学而言，前几分钟后 受伤通常决定了生存的前景

恢复士兵。

如果在这段时间内提供的护理是在一个很高的专业人员和

质量水平升高，生存概率增加，生存持续时间延长 与伤害相关的残疾被减少了。

为了在这一级提供援助，这是不够的

组织战术医学方面的一般军事训练，因为它没有 包括练习，例如，在移除或更换止血带时

有更安全的控制出血的方法。然而，与医疗人员作战 有这样的技能。当他们被卷入战场上时

为了医疗目的，它会直接影响到生命的数量 拯救

战斗或野战医务人员

国际人道主义法保障了高水平的保护

适用于医务人员，其关键功能是搜索、救援和

撤离伤员。与此同时，我们的情况是

战斗医生的状态不在公开的资料中确定 武装部队的规章制度。

正因为如此，这些专业人员往往使用效率低下， 分配他们战斗人员的责任，从而浪费

资源投资于他们作为医务人员的培训和减少

拯救士兵的生命和健康的潜力。但最重要的

重要的问题是，如果指挥官使用战斗人员作为 战斗人员，他们不再受到IHL的保护。

我们认为，这种方法背后的原因之一在于

战斗医疗人员帖子本身的名字。也许指挥官 在前线，他们主要专注于持有或

占领阵地，认为第一个字-战斗-是一个关键

在战斗医生这个短语中的词。在这种情况下，用， 比如说，“字段 ”将使它能够摆脱a的正式符号 为这些服务人员服务的战斗人员。

确定一场战斗的法律地位还有另一个原因

医学是重要的。在武装冲突的情况下，时间 对服务人员的专业培训减少到1个月。这是

然而，这足以确保高质量的专业培训， 知识的巩固需要实践和不断的学习

战术医学技能的提高。因此，战斗媒介 是否提高专业水平的困境

医疗或战斗技能。如果这个人会充当战斗人员，也就是说， 没有特殊的IHL保护，并将由指挥官使用

和其他战斗人员一样，他们的优先级很可能是 打磨战斗技能，而不是获得深入的医疗知识

见识因此，院前护理的质量

可能会受到负面影响，从而会增加伤亡人数 以及那些在受伤后不愿返回军队的人。

保护免受监禁和惩罚犯罪

医务人员

战斗（野战）医生作为医疗人员的正式地位

工作人员不太可能保护这些服务人员不受敌人的伤害 在战斗中攻击。相反，在他们遇到的情况下

敌人的控制和有一个日内瓦公约一。D.专用卡

他们会自动为他们提供保护。持有此类服务人员 国际法禁止他们被囚禁起来。

目前，俄罗斯及其武装部队不遵守IHL的规定。他们

袭击乌克兰的医务人员并俘虏他们。然而 记录和调查战争罪行的过程

继续下去，战犯就会是

被绳之以法，特别是针对危害医疗的罪行

人员然后是缺乏战斗医生的官方身份 乌克兰将使罪犯很难甚至不可能带到

正义，因为如果一个医生是作为一个战斗人员，这就允许 对方将这些医生囚禁直到结束

战争

此外，即使是现在也有战斗医务人员

很可能是在执行纯粹的医疗功能

战场。在成功地利用了国际法律机制

释放这些人，特别是通过联合国机构，要视情况而定

主要是关于乌克兰如何定义战斗医务人员的职能和地位。

结论和建议

![](/media/202412//1733453434.2832189.png)我们必须承认，使用战斗医疗人员的概念在

乌克兰的武装部队尚未正式确定。然而，有 事实上是一种不进行功能分离的既定做法

战斗人员的战斗医务人员。

![](/media/202412//1733453434.2977839.png)在我们看来，使用战斗医务人员作为 战斗人员违背了IHL的精神和利益

国家，这不仅在于维持战斗能力

军事人员，也在返回伤员 普通的平民生活。

这可能会导致一个服务人员，面临着典型的任务 战斗人员和意识到缺乏特殊的法律保护，将会

不感兴趣获得高水平的资格

战斗医务人员。他们的首要任务可能是一般的军事训练， 处理武器和弹药，而不是寻找，

帮助和疏散伤员。也就是医学

战斗医疗职业的组成部分将逐渐淡出 背景

![](/media/202412//1733453434.3065948.png)我们认为，在战斗中并没有出现显著的增加

由于军队的能力参与战斗医务人员的作为

额外的战士。相反，使用战斗医务人员作为 战斗人员减少了提高战前战质量的趋势

在医院照顾伤员。

![](/media/202412//1733453434.3153143.png)我们相信，在IHL和战略利益方面

在这个国家里，一个战斗医生应该被视为一个成员

医务人员这样的专家应该重点关注战术问题

医学方面，完成高质量的专业培训，知道如何去做 给药，使用必要的复杂设备来节省

军队，其目标是返回尽可能多的受伤士兵 可能的义务。

![](/media/202412//1733453434.3250685.png)为此目的，乌克兰国防部和乌克兰

我们认为，乌克兰武装部队的指挥权应该如此 制定和实施概念框架的作用

在军队里的医疗人员，明确他们的权利和义务，

按照下列规定向他们颁发医务人员证书 IHL，并尽一切努力提高其资格水平

战斗的医疗。

弗拉迪斯拉夫·鲁登科，伞形律师事务所合伙人，讲师 乌克兰武装部队战术医学训练中心

![](/media/202412//1733453434.3347046.png)

安德里伊·雅科夫利耶夫，MIHR伞形律师事务所的管理合伙人 专家

斯坦尼斯拉夫·米罗什尼琴科，美国国务院信息部部长 米尔

![](/media/202412//1733453434.3474264.jpeg)

М е д i и н а i н i ц i а т и в а з а п р а в а л ю д и н и , MIHR

原文网址 <https://mipl.org>.武装部队的战斗医务人员 乌克兰的，如何拯救的，甚至更多的士兵/

![](/media/202412//1733453444.2577846.png)

![](/media/202412//1733453444.2714381.png)Combat Medics of the Armed Forces of Ukraine: How to Save Even More Soldiers

• 18 July 2023

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2064

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![](/media/202412//1733453444.2805634.png)

*The combat medic occupies a key role in saving lives of the wounded on the battlefield. Such professionals appeared in the Ukrainian army in 2017, but*

*the legal status of combat medics is still debatable. International*

*humanitarian law (IHL) defines them as medical personnel, while most commanders primarily treat them as combatants. Such legal uncertainty prevents freeing combat medics from captivity, because they belong to a protected category in accordance with the Geneva Conventions. This*

*analytical paper aims to provide understanding of why this happens and give recommendations on what to do about this issue.*

According to the international humanitarian law (IHL), persons

exclusively engaged in provision of medical assistance, that is in the search for, or the collection, transport, diagnosing or treatment

(including first aid) of the wounded or sick, are considered to be

medical personnel regardless of whether they are members of the

![](/media/202412//1733453444.2921863.png)armed forces or not (Articles 24 and 28 of Convention (I) for the

Amelioration of the Condition of the Wounded and Sick in Armed

Forces in the Field (August 12, 1949), Articles 8 and 43 of the Protocol Additional to the Geneva Conventions dated as of June 08, 1977).

**Such persons are not recognized as combatants, may not be attacked and held as prisoners of war (except for the need to provide assistance to wounded prisoners).**

The provisions about protection of and respect for medical personnel in time of war are a universal right that is recognized by all countries of

the world and which they are obliged to respect in all armed conflicts. Violation of these provisions, in particular, a targeted attack on medical personnel, evacuation vehicles, medical institutions, interference with the work of medical personnel, constitutes a grave breach of the laws

and customs of war and is a war crime (par. 2 of Article 85,par. 2 of Article 43, Article 8 of the Protocol Additional to the Geneva

Conventions dated as of June 08, 1977).

On the other hand, in order for medical personnel to be protected under IHL, they should refrain from directly engaging in hostilities (except in self-defense and protecting the wounded) and must adhere to medical ethics and the neutrality principle. Such personnel are only allowed to carry light weapons, which they can use for self-defense and protection of the wounded.

**Medical personnel vs combatants**

![](/media/202412//1733453444.3039646.png)Inline with the NATO standards, two new positions appeared in the [Armed Forces of Ukraine in 2017: platoon combat medic and senior combat medic (of a company, battery or similar unit).](https://zakon.rada.gov.ua/laws/show/z1384-17#n2)

According to the current version of the list of positions of the Armed Forces of Ukraine these positions belong to Military Occupational

Specialty (MOS) 878, which means junior medical personnel and is specified in Section 9.4. [List of MOS – “Medical Specialties”](https://zakon.rada.gov.ua/laws/show/z0927-20#Text) .

New positions were introduced simultaneously with the creation of the Tactical Medicine Training Center as part of the Armed Forces of

![](/media/202412//1733453444.3136551.png)[Ukraine. Here is what the **Head of the Center**, **Lieutenant Colonel**](https://armyinform.com.ua/2020/10/16/speczpryznachenczi-vid-taktychnoyi-medyczyny/)

[**Oleh Vozniuk**, says about the facility: “Our center runs a combat medic](https://armyinform.com.ua/2020/10/16/speczpryznachenczi-vid-taktychnoyi-medyczyny/) course. Service persons who complete it become platoon combat

medics. They will be responsible in their units for providing emergency care, evacuation of the wounded and training of the personnel who

serve together with them.

The education and qualification descriptions of a combat medic and

senior combat medic were approved for cadets of the Training Center. According to the descriptions these professionals are classified as junior medical personnel without medical education and should possess

knowledge and skills, including purely medical components.

At the same time, the order of the Ministry of Defense of Ukraine, which introduces the positions of combat medic and senior combat medic,

articulates no principles for using of these specialists in the army.

![](/media/202412//1733453444.3283703.jpeg)

According to the International Humanitarian Law, combat medics are categorized as medical personnel

Moreover, their status, rights and obligations are not specified by any regulatory document applicable to the Armed Forces of Ukraine in

general.

In practice, they are sometimes, but not always, described in orders at the level of brigades and battalions. Sometimes combat medics are

![](/media/202412//1733453444.3419926.png)assigned the duties typically performed by specialists of other related positions, such as sanitary instructors or tactical medicine instructors, [and provided for by the Charter of the Internal Service of the Armed](https://zakon.rada.gov.ua/laws/show/548-14#Text)

[Forces of Ukraine. But even in this case, the list of these duties includes](https://zakon.rada.gov.ua/laws/show/548-14#Text) only medical functions: timely identification of patients, provision of

medical assistance to military personnel in case of injury (wounds, poisoning), sanitary, hygienic and anti-epidemic measures in a

company (battery), etc.

**However, in most cases, combat medics do not have clearly**

**defined rights and obligations at all, and they perform their duties based on ad hoc orders of commanders. Also, combat medics do**

**not have appropriate medical certificates.**

All this contributes to an erroneous perception of these specialists in the army, primarily by the command. A key discussion revolves around whether to treat combat medics as combatants having specific medical skills or whether they should perform an exclusively medical mission on the battlefield enjoying all privileges and restrictions associated

with this status.

**First minutes after injury: time not to be wasted**

Modern warfare makes it impossible to locate surgical care centers near the forward positions of troops. Under the most favorable conditions, evacuation and delivery of the wounded to the place where they receive surgical care can take from tens of minutes to hours, and days and even weeks in some cases.

![](/media/202412//1733453444.3573892.jpeg)

As far as tactical medicine is concerned, the first minutes after being

wounded usually determine the prospects for survival and recovery of a soldier

In such situation, even if the soldier’s life is saved, the chances of their full recovery and return to duty drop sharply. For example, let us take a

serious injury to a limb to which a tourniquet has been applied to stop bleeding. If the tourniquet is used for more than six hours, the

probability of limb amputation is almost one hundred percent. After this, the service person is likely to be transferred to the reserve, the Ukrainian army will lose a soldier, and the government will be obliged to support him for life.

But it is a different story when the wounded are treated professionally and timely. Then they will most likely recover and return to duty.

However, there must be someone who will provide such assistance. And this is a combat medic.

**As far as tactical medicine is concerned, the first minutes after being wounded usually determine the prospects for survival and recovery of a soldier.**

If within this time period care is provided at a high professional and quality level, the probability of survival increases and the duration of injury-related disability is reduced.

In order to provide assistance at this level, it is not sufficient to

organize general military training in tactical medicine, as it does not

include practicing, for example, in removing or replacing a tourniquet with safer means of controlling bleeding. **However, combat medics**

**have such skills. And when they are involved on the battlefield for medical purposes, it has a direct impact on the number of lives**

**saved.**

**Combat or field medic**

International humanitarian law guarantees a high level of protection for medical personnel whose key function is to search, rescue and

evacuate the wounded. At the same time, we have a situation where the status of a combat medicis not determined in the publicly available

rules and regulations of the Armed Forces.

Because of this, such professionals are often used inefficiently,

assigning them the responsibilities of combatants and thereby wasting resources invested in their training as medical personnel and reducing the potential to save the lives and health of soldiers. But the most

important problem is that if commanders use combat medics as combatants, they are no longer under IHL protection.

We believe that one of the reasons behind this approach lies in the

name of the combat medic post itself. **Perhaps commanders on the**

**frontline,who are primarily focused on the task of holding or**

**occupying positions, consider the first word – combat – to be a key word in the phrase combat medic. In such a case, replacing it with, say, “field” would make it possible to get rid of the formal sign of a combatant for such service persons.**

There is another reason why determining the legal status of a combat medicis important. In the conditions of an armed conflict, the time of professional training of service persons was reduced to 1 month. This is enough to ensure high-quality professional training, however,

consolidation of knowledge requires practice and constant

improvement of skills in tactical medicine. Therefore, the combat medic is faced with the dilemma about whether to enhance professional

medical or combat skills. If such person will act as a combatant, that is, without special IHL protection, and will be used by the commander in the same manner as other combatants, their priority will most likely be polishing combat skills rather than acquiring in-depth medical

knowledge and experience. As a result, the quality of pre-hospital care maybe negatively affected, which will increase the number of casualties and those who will not return to the army after being wounded.

**Protection from captivity and punishment for crimes against medical personnel**

The official status of a combat (field) medic as a member of medical

personnel is unlikely to safeguard such service person from an enemy attack during combat. Instead, in a situation where they come under

enemy control and have a Geneva Convention I.D. Card, special

protection is automatically afforded them. Holding such service persons in captivity is prohibited by international law.

At present, Russia and its armed forces do not comply with IHL. They attack Ukrainian medical personnel and hold them captive. **However, the process of documenting and investigating war crimes**

**continues,and the time will come when war criminals will be brought to justice, particularly for crimes against medical**

**personnel.** And then the lack of an official status of a combat medic in

Ukraine will make it difficult or even impossible to bring criminals to justice, because if a medicis engaged as a combatant, this allows the opposing side to keep such medic in captivity until the end of

hostilities.

In addition, even now there are combat medics held by the enemy in captivity who, quite likely, performed purely medical functions on the battlefield. The success in using international legal mechanisms for

releasing these persons, in particular through UN bodies, depends

largely on how Ukraine defines functions and status of combat medics.

· We must admit that the concept of using combat medics in the

**Conclusions and recommendations**

Armed Forces of Ukraine has not been formalized. However, there is de facto an established practice of not functionally separating

combat medics from combatants.

· In our opinion, **the practice of using combat medics as**

**combatants goes against the spirit of IHL and the interests of**

**the state**, which lie not only in maintaining the combat capability of military personnel, but also in returning of the wounded to an

ordinary civilian life.

· This can result in that a service person, faced with tasks typical for combatants and realizing the lack of special legal protection, will not be interested in acquiring a high level of qualification as a

combat medic. **Their priority maybe general military training, handling weapons and ammunition, rather than searching for, helping and evacuating the wounded. That is, the medical**

**component of a combat medic profession will fade into the background.**

· We believe that there is no significant increase in the combat

capability of the army due to the involvement of combat medics as additional fighters. Instead, **the use of combat medics as**

**combatants reduces the tendency to improve the quality of pre- hospital care for the wounded.**

· We are convinced that **in terms of IHL and strategic interests of the state, a combat medic should be treated as a member of**

**medical personnel.** Such specialist should focus on tactical

medicine,complete high-quality professional training, knowhow to administer medicines, use complex equipment necessary to save the military, and be aimed at returning as many wounded soldiers as

possible to duty.

· For this purpose, the Ministry of Defense of Ukraine and the

command of the Armed Forces of Ukraine, in our opinion, **should**

**develop and implement conceptual framework for the role of**

**combat medics in the army, specify their rights and obligations, issue them medical personnel certificates in accordance with**

**IHL, and make every effort to improve the qualification level of combat medics.**

*Vladyslav Rudenko, Partner in the Umbrella Law Firm, instructor at the Tactical Medicine Training Center of the Armed Forces of Ukraine*

*Andrii Yakovliev, Managing Partner in the Umbrella Law Firm,MIHR expert*

*Stanislav Miroshnychenko, Head of the Information Department of the MIHR*

![](/media/202412//1733453444.381773.jpeg)

[Медійна ініціатива за права людини, MIHR](https://mipl.org.ua/team/medijna-inicziatyva-za-prava-lyudyny/)

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2023年7月18日乌克兰的军队：如何拯救他们 更多的士兵

2023年7月18日乌克兰的军队：如何拯救他们更多的士兵