between individuals. Defensive war is not, on this view, another exception to our prohibition on the use of force, in addition to the exception that permits individual defence. Rather, war is the very same exception as individual defence.’ The second idea put forward by revisionists is that individuals are liable to be killed, not only as a result of their status of combatant (jus in bello), but also as a result of participating in an unjust cause (jus ad bellum). This enables a state acting in self-defense to make a distinction between just and unjust combatants. This theory is a major departure from the traditional Just War doctrine whereby (i) the jus ad bellum is a matter for states (not individuals) to be responsible, and (ii) combatants from all parties are morally equal. As McMahan puts it: ‘…the revisionist account of jus in bello is based on an asymmetrical understanding of the morality of defense. While just combatants are usually justified in attacking unjust combatants, unjust combatants are seldom justified in attacking just combatants.’28 A third element of controversy is the status of noncombatants or civilians. According to the traditional doctrine, noncombatants have the right not to be deliberate targets of attacks. The immunity of non-combatant also extends to combatants who have ceased to be contributors to the war effort, either by surrendering or by becoming incapacitated29. This idea is challenged by revisionists30, who generally argue that non-combatants or disabled combatants from the unjust side have a responsibility that comes in degrees. Therefore, harming or killing them is a matter of proportionality rather than discrimination31. In an extreme development of the argument (opposing ‘The Red Cross Objection’), Frowe suggests that ‘...members of the Red Cross act voluntarily- nobody is coerced into joining this sort of organization. It looks, then, as if Red Cross medics (and those performing similar roles in war) are morally responsible to defensive killing by just combatants.’32 These theories are evolving and they have not yet reached the status of an organised doctrine. The practical Table 2: Just war theories.
TRADITIONAL Universal doctrine State-based, collectivist Moral equality of combatants The distinction between combatants and civilians is absolute Non-combatants are immune to be killed VOL. 90/3 REVISIONIST Opportunistic theories Reductionist individualism Distinction between just and unjust combatants The distinction between unjust combatants and civilians is a matter of degree Non combatants are liable to be killed or incapacitated, to the extent that they partake in an unjust cause
implications are real though, for example in Israel where a team of philosophers has defined ‘The Just War Doctrine of Fighting Terror’33. Implicitly, this doctrine relies on revisionist arguments presented above, and on a narrow definition of terrorism which excludes states as perpetrators. The authors painstakingly enumerate ‘different type of direct involvement in terror’, and makes use of the principle of proportionality in a quasi-mathematical exercise of ethical calculus. For countries recognized as democratic, this kind of new doctrine provides a veil of moral legitimacy to what would otherwise constitute targeted killing and serious breaches of international laws. For authoritarian regimes, the force of law suffices to condone similar acts, without bothering to develop complex ethical arguments. The counter-terror laws passed in the Syrian Arab Republic in 2012 are a topical example34.
An ideological threat to humanitarian medicine and impartiality
Attacks against medical humanitarian missions are not overwhelmingly the fact of military engagement by international, national or armed non-state actors (Table 1). Yet, recent incidents against health facilities and personnel deserve particular attention for the moral and legal precedents that they represent. Each situation could be analysed as a distinct scenario involving both deliberate and accidental actions. The a