Iatrocide: The Weaponization of Medicine as a Strategy of Genocidal Erasure
A Theoretical Framework by Story Ember leGaïe
Story Ember leGaïe, Founder of Genospectra | Genocide Scholar | Developer of the Genospectra: Framework Theorem for Deconstructing the Genocide Spectrum
Abstract
International legal frameworks have long privileged mass killing as the definitive signifier of genocide, sidelining the systematic destruction of healthcare systems as a core instrument of extermination (Kuper, 1981; Farmer, 2005). This paper introduces and theorizes iatrocide—the deliberate targeting of medical infrastructure, personnel, and epistemologies—as a premeditated genocidal strategy. Iatrocide is not collateral damage. It is genocide by denial: a slow, calculated method of mass incapacitation designed to produce intergenerational trauma, demographic collapse, and total biosocial debilitation.
Rather than viewing the collapse of care as humanitarian failure, this paper argues that iatrocide functions as a weaponized form of structural annihilation, executed through airstrikes on hospitals, embargoes on medication, the criminalization and assassination of healthcare workers, and the epistemicide of medical education and memory. It does not merely destroy the present—it renders healing impossible, futureless.
Situated within the Genospectra Theorem—a decolonial analytic framework I developed to map genocide across a continuum from overt extermination to covert erasure—iatrocide emerges as a distinct modality of genocide, one designed to erase not just bodies, but the systems, knowledge, and relationships that allow bodies to survive. In siege zones, occupied territories, and militarized borders, healing becomes treason; care becomes a target.
This paper contends that iatrocide must be formally codified as a prosecutable crime under international law, not as a humanitarian oversight, but as a central strategy of modern genocidal governance. Because to destroy healthcare is to destroy humanity—not metaphorically, but deliberately, and with genocidal intent.
Keywords: #Genocide, #Iatrocide, #StructuralViolence, #Necropolitics, #DemographicWarfare, #MedicalApartheid, #GenospectraTheorem
1. Introduction: Defining Iatrocide as a Core Genocidal Strategy
Genocide has long been interpreted through the prism of mass death—corpses, massacres, and mass graves (Kuper, 1981). Yet genocide does not begin with the bullet, nor end with the grave. It begins with the denial of survival. The destruction of healthcare systems—long dismissed as collateral or humanitarian crisis—must be recognized as intentional, strategic, and genocidal (Farmer, 2005; Galtung, 1969).
This paper introduces iatrocide, from the Greek iatros (healer) and -cide (killing), to describe the systematic targeting and dismantling of healthcare infrastructure, personnel, education, and knowledge systems as a primary mode of genocidal violence. Iatrocide is not incidental. It is not failure. It is a deliberate method of biopolitical warfare, engineered to dismantle the very capacity of a people to live, to heal, and to continue (Mbembe, 2003).
In contemporary siege zones and occupied territories, iatrocide is not anomalous but patterned. Hospitals are not “accidentally struck”—they are algorithmically selected. Ambulances are shelled, not missed. Doctors are arrested, tortured, executed—not because they are combatants, but because they are healers. Insulin doesn’t “fail to arrive”—it is embargoed, rerouted, or withheld under bureaucratic pretexts. The result is not just mass suffering—but population incapacitation through the systematic denial of care (Farmer, 2005).
As the developer of the Genospectra Framework Theorem, I argue that iatrocide is not a peripheral act of war—it is central to the architecture of genocide. It operates not through overt slaughter alone, but through the calculated erasure of conditions that enable life: the hospitals, the antibiotics, the midwives, the medical schools, the trauma surgeons, the vaccine shipments, the research labs. It disables the immune system of a society. It ensures the wounded do not recover, the sick do not survive, the next generation is never trained to heal.
Iatrocide functions through five core dimensions:
The targeted destruction of medical infrastructure—including trauma centers, maternity wards, oxygen plants, and mobile clinics.
The criminalization, disappearance, and assassination of healthcare professionals—from trauma surgeons to midwives and ambulance crews.
The blockade or sabotage of medical supplies—including chemotherapy, antibiotics, anesthesia, and vaccines.
The dismantling of medical education and research ecosystems—via the bombing, defunding, or occupation of universities, labs, and training hospitals.
The epistemicide of community-specific medical knowledge—including the erasure of Indigenous, ancestral, or local healing practices, and the exile or murder of elder physicians and educators.
This is not a failure of humanitarian logistics. This is not bureaucratic inertia. This is extermination by attrition, by blockade, by denial. Iatrocide renders healthcare an act of resistance and transforms healing into a crime. The absence of care is not accidental—it is weaponized.
This framework rejects sanitized humanitarian discourses that describe collapsing health systems as “tragedies.” That language obscures responsibility. It fails to name the perpetrators. It depoliticizes violence. Iatrocide is not merely unethical—it is prosecutable. To name it is to indict a system that treats healthcare as conditional, that criminalizes survival, and that targets life through the destruction of its most basic infrastructure: the right to be treated, to be cared for, to live.
By naming and theorizing iatrocide, we expose a central axis of modern genocide—not just what is done to kill, but what is done to prevent healing. This paper calls for the immediate recognition of iatrocide as a crime of genocide, and for the dismantling of the imperial, settler, and militarized regimes that use healthcare erasure as a method of domination and control.
2. Literature Review: The Absence of Iatrocide in Genocide Discourse
Despite overwhelming evidence of deliberate assaults on healthcare systems in zones of occupation, siege, and imperial warfare, the systematic destruction of medicine remains marginalized and misclassified within both legal frameworks and genocide scholarship. The 1948 Genocide Convention includes acts intended to “inflict conditions of life calculated to bring about physical destruction,” yet this clause is rarely applied to the targeted dismantling of healthcare systems—despite their obvious role in enabling collective survival (Kuper, 1981).
Legal and scholarly discourse remains tethered to immediate spectacle—mass killings, forced transfers, and starvation campaigns—while the attritional, infrastructural, and intergenerational collapse of health systems is dismissed as logistical failure or unfortunate side-effect. This has allowed the destruction of hospitals, the blockade of vaccines, the criminalization of caregiving, and the epistemicide of medical training to proceed with impunity (Farmer, 2005).
Foundational theories offer conceptual tools but stop short of naming or prosecuting iatrocide:
Johan Galtung (1969) introduced structural violence to describe how institutions produce harm through deprivation—preventing survival without direct attack.
Paul Farmer (2005) framed the denial of care as a pathology of power, wherein health inequality reflects political and economic design, not misfortune.
Rob Nixon (2011) articulated slow violence, capturing how destruction unfolds invisibly and incrementally—through denied access, delayed treatment, and decaying systems.
Didier Fassin (2007) critiqued humanitarian reason, exposing how states manipulate care as a securitized resource—selectively offered, revoked, or weaponized to regulate life and death.
Yet despite their insights, genocide studies have not evolved to include iatrocide as a primary modality of extermination. Medical annihilation remains unrecognized—rendering invisible one of the most insidious forms of demographic warfare. The failure to name it has enabled decades of genocidal healthcare collapse to pass without prosecution.
Emerging empirical studies signal the need for conceptual rupture:
Kum et al. (2025) describe data genocide in Indigenous health systems, where erasing epidemiological records and diagnostic data justifies funding withdrawal and institutional collapse.
Alanazi et al. (2025) show that infectious disease surges in war zones are not primarily caused by pathogens—but by the targeting of medical infrastructure and the collapse of basic care.
Zeilani et al. (2025) document how palliative care in occupied Palestine disappears not due to technological incapacity, but because caregivers are surveilled, abducted, or blocked from delivering treatment.
Poole et al. (2025) spatially map repeated airstrikes on trauma centers and ambulance routes in Gaza, revealing patterned assaults consistent with military intent—not error.
These studies offer the evidence—but stop short of the conclusion. What they point to, but do not yet name, is iatrocide: the premeditated destruction of healthcare as a genocidal methodology.
This paper intervenes to name iatrocide not as metaphor, not as misfortune, not as humanitarian breakdown—but as genocide. Iatrocide is a logic of erasure executed through the biopolitical withdrawal of care and the necropolitical decision to deny treatment, obstruct healing, and extinguish survival.
It is the bomb dropped on the maternity ward.
The vaccine stopped at the checkpoint.
The surgeon abducted at night.
The medical school reduced to rubble.
The diagnosis never recorded.
The healing never allowed to begin.
Iatrocide is genocide by attrition, by blockade, by erasure—not of people alone, but of the very systems that make people possible.
3. Theoretical Framework: Situating Iatrocide within Genospectra
The Genospectra Theorem, which I developed to expose the full continuum of genocidal violence, challenges the narrow, static definitions of genocide found in legal doctrine and conventional scholarship (Kuper, 1981). Rather than treating genocide as a singular event of mass killing, Genospectra theorizes genocide as a spectrum of layered, simultaneous erasures—physical, structural, epistemic, and biosocial. Genocide is not merely about death. It is about the systematic obstruction of life—the denial of breath, the criminalization of care, the erasure of future survival (Farmer, 2005).
Within this spectrum, iatrocide emerges as a core genocidal modality. It is the biostructural incapacitation of a people’s ability to live, heal, or regenerate (Kum et al., 2025). It disables the organs of survival—hospitals, ambulances, knowledge, and personnel—ensuring that what cannot be immediately exterminated is rendered biologically unsustainable.
Iatrocide is not just an act of war. It is a strategy of demographic attrition, epistemic liquidation, and temporal genocide. It wields power through omission, not just aggression—through the absence of medicine, the exile of teachers, the silence of extinguished futures. It operates where health becomes contraband, and healing is reframed as resistance.
3.1 Biopolitics and Necropolitics of Medicine
Michel Foucault (1976) described the modern state as a biopolitical apparatus: one that regulates life through health systems, census data, reproductive governance, and hygiene enforcement. In biopolitical regimes, medicine becomes a tool of statecraft—used to decide not only who lives, but who lives well, and who is allowed to decay slowly.
Achille Mbembe (2003) extends this to necropolitics: the power to decide who must die, and under what conditions. Iatrocide is not a failure to save—it is a decision to let die, enforced through embargo, bureaucracy, or airstrike. In besieged zones, the bombing of trauma wards, the denial of insulin, and the imprisonment of surgeons are not operational accidents. They are necropolitical technologies. They convert caregiving into crime. They turn survival into a battleground.
To deny healthcare is to declare a population’s suffering irrelevant. To criminalize healing is to erase the right to life by denying the means through which life is sustained. The absence of dialysis is not a gap in care—it is a death sentence. The blocked vaccine is not a supply issue—it is a lethal decree.
In this configuration, medicine becomes the terrain of sovereignty, and the refusal to heal becomes the methodology of extermination.
3.2 Structural Violence as the Architecture of Iatrocide
Johan Galtung’s (1969) concept of structural violence exposes how institutions can inflict death not by direct assault but by engineered deprivation—by systematically preventing access to the resources that make life possible. Paul Farmer (2005) describes this as the “pathology of power”—the slow death that emerges from politically constructed neglect.
Iatrocide is structural violence weaponized into policy. It collapses healthcare not as a consequence of instability—but as the intended architecture of domination. In occupied zones, colonial territories, and besieged cities, iatrocide means:
No ambulances for the wounded.
No morphine for the dying.
No power for oxygen machines.
No training hospitals for future surgeons.
No sterilization for maternal wards.
No accreditation for medical students.
It is the surgical elimination of survivability. It replaces the presence of care with the permanence of crisis. The system does not fail—it performs its design. This is genocide through infrastructure, where what is denied becomes as fatal as what is inflicted.
3.3 Genospectra: Mapping Iatrocide Within the Spectrum of Erasure
The Genospectra Theorem posits that genocide operates through a spectrum—from overt mass violence to spectral acts of systemic destruction. At one end: mass graves. At the other: statistical erasure, silence, unrecorded deaths, and untrained healers. Iatrocide spans this continuum. It bridges the visible and the invisible, the murdered body and the denied future.
It functions across multiple intersecting genocidal axes:
Biological: by ensuring disease remains untreated, childbirth becomes lethal, and epidemics spread without containment.
Demographic: by eroding reproductive care, maternal health, and pediatric medicine—shrinking future generations by design.
Epistemic: by destroying research institutions, targeting medical professors, erasing diagnostic data, and criminalizing knowledge transfer.
Psychological: by instilling terror into the act of caregiving, making every doctor a potential target and every hospital a potential bombsite.
Iatrocide does not only destroy bodies—it erases the means by which bodies are preserved, cared for, understood, and passed forward into the future. It is genocide by attrition, invisibility, and obliteration of healing capacity.
It ensures the wounded never recover.
It ensures the sick are never treated.
It ensures the next generation of healers will never be trained.
It ensures that even the memory of care is erased.
This is the place iatrocide occupies within Genospectra: not as a supporting act, but as a central axis of genocidal erasure—where medicine becomes the target, and survival becomes impossible by design.
4. Mechanisms of Iatrocide: Technologies of Medical Erasure
Iatrocide is not an isolated act—it is a sustained genocidal operation deployed across multiple domains of life. It unfolds not through a single event but through converging vectors of violence: physical, structural, epistemic, economic, psychological. Each is engineered to systematically dismantle the capacity of a population to access care, recover from injury, or pass medical knowledge forward. These are not failures of policy. They are deliberate acts of biosocial destruction (Farmer, 2005; Galtung, 1969).
Together, they comprise a doctrine of infrastructural annihilation: a genocide of clinics, care, continuity, and collective memory.
4.1 Destruction of Healthcare Infrastructure
The physical annihilation of hospitals, trauma centers, ambulances, and mobile clinics is the most visible face of iatrocide. But visibility should not be mistaken for randomness. These assaults are not incidental. They are algorithmic selections: mapped, targeted, and justified under military doctrine. This is genocide by design.
In Gaza, over 350 healthcare facilities have been bombed or rendered inoperable. Airstrikes targeted neonatal wards, ventilator units, and trauma centers mid-operation (Poole et al., 2025).
In Syria, more than 595 attacks on healthcare infrastructure have been verified by UN OCHA and independent bodies—targeting maternity wards, oxygen plants, and emergency clinics (UN OCHA, 2023).
Even when the buildings survive, deliberate sabotage of utilities—power, water, waste systems—renders them lethal. A hospital without electricity becomes a death trap. A clinic without clean water becomes a site of infection. An operating theater without anesthesia becomes a torture chamber.
“To bomb a hospital is not just to destroy a building—it is to interrupt the act of healing, and to announce that care itself is a threat.”
This is biopolitical warfare: disabling the mechanisms of survival at the moment they are most needed (Foucault, 1976).
4.2 Targeting of Healthcare Personnel
Iatrocide decapitates a population’s healing class. Doctors, nurses, paramedics, and students are surveilled, abducted, imprisoned, or assassinated. In militarized zones, the act of healing becomes an act of resistance—and is punished accordingly.
In occupied Palestine, medics are arrested for treating the wounded. In besieged Syria, trauma surgeons and dialysis teams disappear without trace.
Zeilani et al. (2025) document how patients with end-stage renal disease die not from the illness—but from the disappearance of those trained to treat them.
Kum et al. (2025) show how even the collection of Indigenous health data is criminalized—erasing evidence of need to justify institutional defunding.
This is not ambient violence—it is surgical extermination of knowledge, trust, and safety. It tells those who remain: to care is to be killed.
“A hospital can be rebuilt. A doctor cannot be resurrected.”
4.3 Medical Blockades and Denial of Aid
Not all iatrocide is conducted through bombs. It is often carried out through clipboards, embargoes, and paperwork—what Paul Farmer (2005) would call the pathology of power, and what we must name as necropolitical logistics (Mbembe, 2003).
Medications, oxygen, vaccines, and surgical tools are:
Confiscated at borders,
Delayed indefinitely through "security reviews",
Denied access under anti-terror laws,
Diverted or expired while awaiting clearance.
In Yemen, Médecins Sans Frontières (2022) reported entire vaccine shipments blocked, resulting in resurgent cholera, polio, and measles outbreaks.
Over 10,000 preventable deaths were caused by delayed access to antibiotics alone (Alanazi et al., 2025).
This is necroeconomics—the manipulation of life and death through economic siege. Care becomes contraband. Bureaucracy becomes a weapon.
“Every delayed convoy is a decision. Every embargo is a death certificate waiting to be signed.”
This is genocide without gunfire. Genocide by denial.
4.4 Sabotage of Medical Education and Research
Iatrocide is not only about the present—it is a war against the future of care. The targeted collapse of medical education and training is temporal genocide: it ensures that even if the buildings are rebuilt, there will be no one left to practice within them.
This includes:
The bombing of medical universities and teaching hospitals,
The defunding of research programs,
The revocation of visas, credentials, and international accreditation,
The disappearance or assassination of faculty,
The surveillance and exile of students.
Alanazi et al. (2025) call this generational incapacitation—a tactic to ensure no new generation of healers can arise.
In Sudan, the destruction of Khartoum’s primary teaching hospital severed the country’s main physician training pipeline.
This is not neglect. This is planned obsolescence of an entire care ecosystem.
“You don’t just kill the doctor. You erase the possibility of ever becoming one.”
4.5 Epistemicide: The Erasure of Medical Knowledge Systems
At its deepest register, iatrocide becomes epistemicide—the erasure of medical intelligence, diagnostic memory, and collective healing practices.
This includes:
The bombing of medical libraries and archives,
The hacking and deletion of health data systems,
The targeting of elder clinicians and Indigenous healers who carry non-digitized knowledge,
The silencing of oral, community-based, or non-Western healing traditions.
Cyberwarfare now plays a critical role. Health systems are hacked, vaccine records deleted, research encrypted or leaked. Patient files disappear. Diagnostic databases are rendered inaccessible. What was once remembered, taught, or recorded—vanishes (Fassin, 2007).
“You don’t just kill the doctors—you kill what they knew. You kill the future capacity to remember how to heal.”
This is the final severance. The genocide of remembrance.
5. Case Studies: Iatrocide in the Archive of Genocide
Iatrocide is not a theoretical abstraction. It is a historical, ongoing, and strategic methodology of mass incapacitation—deployed by settler-colonial regimes, imperial coalitions, and militarized states. From Gaza to Yemen, Sudan to Syria, the deliberate collapse of healthcare is not a byproduct of war—it is a war objective. These case studies expose how iatrocide functions within broader genocidal logics—not as “collateral damage,” but as a targeted tool of occupation, siege, and structural erasure.
Each example is not merely illustrative—it is evidentiary.
5.1 Gaza: A Laboratory of Medical Erasure
Gaza represents one of the most visible and methodical deployments of iatrocide in the 21st century. Under total blockade since 2007 and subjected to ongoing genocidal bombardment, Gaza’s healthcare system has not been neglected—it has been systematically dismantled by an illegal occupation regime committed to Palestinian erasure.
Poole et al. (2025) mapped targeted airstrikes on hospitals, trauma centers, and ambulance corridors—revealing deliberate spatial targeting embedded in Israeli military doctrine.
Over 350 healthcare facilities have been damaged or destroyed in five years. “Double-tap” strikes—intentional bombings of first responders—have become routine.
Supply chains are strangled at every node. Surgical tools, chemotherapy, insulin, dialysis kits, anesthesia, antibiotics—all are blocked, delayed, or denied. Severely ill patients are refused exit permits, effectively transforming the blockade into a mechanism of calculated death.
“Gaza is not just under siege—it is under surgical erasure. Healing is criminalized. To care is to resist.”
Marginalia:
Blockade as Medical Warfare: The blockade is not passive—it is weaponized to target Gaza’s survivability.
Data Suppression: Countless deaths from denied treatment are excluded from official statistics—disappeared in spreadsheets, buried without record.
5.2 Yemen: Starvation, Disease, and the Blockade of Medicine
Since 2015, the U.S.-backed Saudi-led assault on Yemen has enacted iatrocide through aerial bombardment, port blockades, and medical starvation. This is not a humanitarian failure—it is a genocidal campaign of infrastructural attrition.
Hospitals, maternity wards, oxygen plants, and ambulances have been deliberately targeted (MSF, 2022).
Provinces have been left without a single functioning hospital for months at a time.
Alanazi et al. (2025) demonstrate that disease mortality in Yemen correlates not with outbreak severity—but with the obliteration of health systems. Diseases once eradicated—cholera, polio, measles—have returned as tools of war.
Vaccines are withheld. Aid convoys are delayed, confiscated, or turned away.
Over 10,000 preventable deaths are tied to obstructed access to basic medication. This is death by design, executed not with bullets, but with borders, policies, and fuel blockades.
“In Yemen, war is waged not just through bombs—but through bottlenecks, paperwork, and the weaponization of logistics.”
Marginalia:
Western Complicity: U.S. arms, intelligence, and diplomatic protection enable this iatrocidal siege.
Slow Genocide: Starvation, medical neglect, and denied aid constitute a genocide that hides in bureaucracy.
5.3 Sudan: The Decapitation of Care in a Collapsing State
Sudan’s cycles of militarized violence—particularly during the Khartoum crisis and factional clashes—have produced a deliberate healthcare vacuum so vast that even palliative care has disappeared. This is not merely systemic collapse. It is a targeted annihilation of care infrastructure.
Paramedics are abducted. Hospitals are looted or militarized. Oxygen, blood, sterilization supplies—all gone.
Field clinics operate in conditions indistinguishable from death camps: no antiseptic, no electricity, no anesthesia.
Zeilani et al. (2025) report that terminal patients are dying not from pathology, but from the disappearance of those trained to treat them.
Medical education is collapsing in tandem. The 2023 bombing of Khartoum’s largest teaching hospital destroyed the country’s primary pipeline for physician training. Professors fled or were killed. Students dropped out. The future of care was buried in the rubble.
“Iatrocide in Sudan is intergenerational—it ensures that no one will be left to teach, train, or treat.”
Marginalia:
Militarization of Clinics: Combatants have used hospitals as shields—justifying their destruction and deepening public terror.
Colonial Echoes: The crisis echoes British imperial neglect, which deliberately underdeveloped Sudan’s healthcare system.
5.4 Syria: Iatrocide Amid Imperial Siege and Proxy Warfare
The war in Syria—reduced by Western narratives to a “civil war”—is a textbook case of how foreign intervention, regime-change operations, and economic siege converge to obliterate healthcare as a system and a right.
UN OCHA (2023) confirms over 595 attacks on medical facilities—though many reports rely on sources embedded in U.S.-aligned militias.
Bombings by Syrian, Russian, U.S., Israeli, and militia forces have decimated hospitals, including maternity wards and trauma clinics.
At the same time:
U.S.-led sanctions—classified as illegal under international law—block imports of medicine, fuel, and surgical equipment (Farmer, 2005; Fassin, 2007).
MSF (2022) and others confirm that patients die not due to disease—but due to embargo.
Medical education has collapsed. Professors disappeared. Universities closed. Students exiled. Even basic academic access—credentials, licenses, remote access—has been severed.
“In Syria, to practice medicine became an act of resistance—targeted by bombs, abandoned by the world, and besieged by empire.”
Marginalia:
Sanctions as Iatrocide: Denying access to healthcare through economic siege is no less fatal than a missile.
Narrative Weaponization: Syria’s reduction to a villain-victim binary erases the role of foreign powers in destroying its health infrastructure.
5.5 The Historical Precedent: Nazi Germany and the Medical Genocide
Iatrocide has deep historical roots. During the Holocaust, medicine was not discarded—it was perverted into a core tool of racialized genocide.
Jewish doctors were de-licensed and deported.
Ghettos were engineered to generate epidemics—typhus, dysentery—by denying sanitation and medicine.
Hospitals in camps were facades for extermination.
The Nazi Aktion T4 euthanasia program murdered over 70,000 disabled people, administered by physicians and nurses under the guise of "healing" the nation. Iatrocide was bureaucratized—systematic, procedural, endorsed by medical boards (Kuper, 1981).
“In Nazi Germany, medicine was not abandoned—it was inverted. To heal the nation, they murdered the body.”
Marginalia:
Eugenics and Empire: Nazi medical theory was rooted in U.S. eugenics—forced sterilization, racial science, and ‘unfit’ designations.
Iatrocide as Precursor: Genocide began in the hospitals. The refusal to treat was the opening act.
5.6 Medical Apartheid: Racialized Iatrocide in the United States
While often positioned as a global humanitarian actor, the United States itself is a key site of iatrocide by design. The U.S. medical system—shaped by slavery, settler-colonialism, and carceral capitalism—has long operated as a machinery of racialized neglect and medical apartheid (Farmer, 2005; Obermeyer et al., 2019).
From forced sterilizations to algorithmic triage systems that deprioritize Black patients, iatrocide in the U.S. is not a failure of equity—it is the structural denial of care as a mode of social control.
“In the U.S., genocide is not declared with bombs—it’s encoded in insurance policies, predictive models, and zip codes.”
Historical Precedents and Systemic Roots
The Tuskegee Syphilis Experiment (1932–1972) withheld treatment from Black men for decades, not as an error, but as an intentional act of medical deception and surveillance.
Indigenous women were forcibly sterilized through Indian Health Service (IHS) programs well into the 1970s.
Puerto Rican women were targeted for experimental birth control and sterilizations during U.S. colonial population control efforts.
Contemporary Manifestations of Iatrocide
Hospital Redlining: Entire Black and Indigenous communities are left without trauma centers or maternal health care.
Algorithmic Triage: Healthcare algorithms assign lower risk scores to Black patients, reducing access to life-saving treatment (Obermeyer et al., 2019).
Mass Incarceration: Prisons function as zones of medical abandonment.
Underfunded Tribal Health Systems: IHS remains drastically underfunded despite federal obligations.
These mechanisms constitute iatrocide through abandonment: the intentional refusal to heal those whose survival threatens the racial, economic, or political order.
“The United States perfected a form of iatrocide that doesn’t need bombs. It uses spreadsheets, court rulings, and demographic data.”
Marginalia:
“Silent Segregation:” The illusion of universal healthcare masks a caste system of survivability.
“Death by Design:” From Flint’s water to Mississippi’s maternal death rates, neglect is an execution sentence.
6. Legal and Policy Implications: Codifying Iatrocide as Genocide
Despite its widespread and recurring use, iatrocide remains unrecognized in dominant legal frameworks. International criminal law—structured through the Rome Statute, Geneva Conventions, and the 1948 Genocide Convention—offers only partial and insufficient language to prosecute medical erasure. Healthcare destruction is occasionally classified as a war crime or crime against humanity, but rarely as genocide. This omission is not accidental. It is political doctrine masquerading as legal neutrality (Kuper, 1981).
Genocide law has been constructed to recognize only spectacular violence—mass graves, televised executions, documented killings—while systemic violence by deprivation escapes legal definition. Iatrocide, which disables survival itself, is not less lethal. It is simply less photogenic (Farmer, 2005).
“When the law cannot name what is happening, it cannot stop it. And what it cannot stop, it permits.”
This section calls for the formal codification of iatrocide as a distinct and prosecutable genocidal strategy. Without it, medical annihilation will continue to operate with legal invisibility—and impunity.
6.1 Legal Recognition of Iatrocide
The 1948 Genocide Convention defines genocide as acts committed “with intent to destroy, in whole or in part, a national, ethnical, racial or religious group.” It includes the infliction of conditions of life calculated to cause the group’s physical destruction.
Iatrocide fits squarely within this clause. It is not abstract. It is not metaphor. It is the intentional creation of fatal living conditions: bombing hospitals, criminalizing caregiving, embargoing vaccines, and disappearing doctors. It is the manufacture of premature death, engineered through systemic deprivation (Kuper, 1981; Farmer, 2005).
Yet international law remains fixated on death as performance—acts it can capture in forensic images. It fails to prosecute death by design: unrecorded, slow-moving, institutional, and executed through policy. This is not a legal oversight. It is a refusal to confront the structural nature of modern genocide.
Recommended Action:
Expand the Rome Statute to include systemic medical destruction as a violation under Article 6 (genocide) and Article 7 (crimes against humanity).
Use existing case evidence from Gaza, Yemen, Syria, and Sudan to establish international precedent in prosecuting iatrocide.
6.2 Early Warning Indicators and Genocide Prevention
Current genocide prevention models are backward-looking, relying on mass violence indicators like ethnic cleansing or military offensives. But iatrocide functions as an early-stage mechanism—erasing care infrastructure long before the first bomb falls.
Zeilani et al. (2025) documented how the collapse of palliative care in occupied Palestine preceded mass death events.
Poole et al. (2025) and MSF (2022) confirm that targeted attacks on hospitals and aid convoys often occur weeks before full-scale assaults.
These are not side effects. They are strategic precursors. The disappearance of dialysis and blockade of anesthesia are not logistical failures—they are warnings (Foucault, 1976; Mbembe, 2003).
Recommended Action:
Integrate healthcare collapse into the UN’s Genocide Early Warning System.
Establish quantitative thresholds:
50% reduction in hospital function,
repeated attacks on trauma corridors,
vaccine shipment obstruction,
targeting of healthcare personnel.
These metrics must trigger immediate Security Council review and protective intervention.
6.3 Prosecutorial Pathways: Toward Accountability
Without legal enforcement, iatrocide remains narratively acknowledged but legally void. Recognition without prosecution is permission. International criminal law must evolve to treat the erasure of care as equally grave—and often more enduring—than direct mass killing.
Precedent exists:
The ICTY prosecuted attacks on hospitals in Sarajevo as war crimes.
The Nuremberg Trials held Nazi physicians accountable for genocide through medical means.
The ICC has investigated humanitarian obstruction in Darfur and Syria—but not healthcare destruction as genocide (Kuper, 1981).
Recommended Action:
Establish a Special Tribunal on Iatrocide, modeled after ICTY or ICTR, with jurisdiction over healthcare-targeting cases.
Expand evidentiary tools to include epidemiological analysis, supply-chain disruption patterns, and geospatial targeting of care zones.
Codify iatrocide as both:
a crime of action (bombing hospitals, assassinating doctors), and
a crime of omission (denying treatment, blocking aid, dismantling medical education).
6.4 Protection of Medical Knowledge Ecosystems
Existing humanitarian protections are woefully narrow—focused on ambulances and temporary field hospitals. They do not extend to:
medical universities,
diagnostic archives,
Indigenous medical systems,
or digital infrastructure that sustains public health (Kum et al., 2025; Alanazi et al., 2025).
Iatrocide targets all of these. Professors are assassinated. Students are denied credentials. Health databases are deleted. Research labs are looted or encrypted. What remains is not only a destroyed system—but an erased memory of how to rebuild it (Foucault, 1976; Nixon, 2011).
Recommended Action:
Amend Geneva Conventions to explicitly include:
medical schools,
digital health records,
research institutions,
and non-Western care systems as protected civilian infrastructure.
Treat attacks on public health educators, scientists, and traditional healers as war crimes and potential acts of genocide.
6.5 Moral and Political Imperatives
Iatrocide is not just a legal gap—it is a moral fracture in the international order. The refusal to name it reflects the broader refusal to value the lives of those targeted by settler-colonialism, empire, and siege (Fassin, 2007; Farmer, 2005).
To call iatrocide “collateral” is to erase its intentionality. To remain silent in its aftermath is to normalize death by policy. To heal must not be framed as charity. It must be seen as a right—and its denial, a crime.
“To bomb a hospital is not just to kill. It is to declare that certain lives are not worth saving—and never will be.”
Naming iatrocide transforms caregiving from a humanitarian concern into a site of political resistance. It demands that healing be treated not as a luxury, but as a frontline of survival. And it insists that those who destroy care must be held accountable—not just as aggressors, but as perpetrators of genocide.
7. Conclusion: Naming Iatrocide, Resisting Erasure
Iatrocide is not collateral. It is not tragedy. It is not humanitarian failure. It is not the fog of war. It is genocide (Farmer, 2005; Kuper, 1981).
Genocide executed not only with bombs—but with embargoes, algorithms, and silence. It is the annihilation of healthcare as a strategic doctrine: bombing trauma wards, criminalizing paramedics, starving clinics, and erasing the memory of how to heal (Mbembe, 2003; Foucault, 1976). It is genocide in slow motion. Genocide that bleeds out over years, unrecorded. Genocide disguised as policy. It is the death of survival itself, enacted through systemic incapacitation and medical erasure (Galtung, 1969; Nixon, 2011).
In every documented case—Gaza, Yemen, Sudan, Syria—iatrocide has not been incidental. It has been central (Zeilani et al., 2025; Alanazi et al., 2025; Poole et al., 2025). It disables not just bodies, but communities. Not just hospitals, but futures. Not just treatment, but the possibility of being treated again. It dismantles the inheritance of care—ensuring that knowledge cannot be passed on, that wounds cannot be closed, that healing itself becomes illegal (Kum et al., 2025).
And yet:
International law has failed to name it (Kuper, 1981).
Humanitarian discourse has failed to confront it (Fassin, 2007).
Policy has failed to prevent it (Farmer, 2005).
This paper has argued that iatrocide must be codified as a prosecutable modality of genocide. To refuse this recognition is not neutrality—it is complicity. It is to sanction a world where healing is contraband, where to treat a wound is treason, where medicine is met with missiles.
“When medicine becomes contraband, and care becomes treason, genocide is already underway.”
As the founder of the Genospectra Framework, I contend that genocide is not always declared with bullets. Sometimes, it is declared with:
a border checkpoint,
a blocked vaccine shipment,
an embargoed oxygen tank,
or the final bombing of the last trauma ward in a city that still dares to feel pain.
To destroy healthcare is to destroy humanity.
Not metaphorically. Materially. Structurally. Deliberately.
Because without the right to heal, there is no right to live.
7.1 Imperatives Moving Forward
These imperatives are not proposals. They are non-negotiable demands born from the graves of doctors, the silence of classrooms, and the bodies that could have survived.
Legal Codification
Amend the Rome Statute and Genocide Convention to explicitly include iatrocide as a named genocidal act—on par with mass killing, forced sterilization, and cultural destruction (Kuper, 1981).
Early Warning Systems
Incorporate healthcare collapse as a primary indicator in genocide prevention frameworks. Blocked vaccines, targeted clinics, and disappearing medics must trigger international response (Poole et al., 2025; Zeilani et al., 2025; MSF, 2022).
Tribunals and Accountability
Establish international tribunals for iatrocide using:
geospatial strike data,
hospital records,
intercepted supply chains,
epidemiological timelines,
and survivor testimony (Alanazi et al., 2025).
Protection of Medical Knowledge
Classify academic institutions, research archives, medical records, and healing traditions as protected civilian infrastructure—physical and digital—under international law (Foucault, 1976; Kum et al., 2025).
Survivor Justice
Guarantee reparations, rehabilitation, and public recognition for survivors of iatrocide:
patients denied care,
families who lost loved ones due to embargo,
medics who risked everything to heal,
and entire communities that were left to die.
7.2 Final Invocation: From Recognition to Resistance
Iatrocide is not just a term—it is a lens.
A lens that reveals the unspoken: that the destruction of care is the destruction of life.
That to bomb a hospital is to wage war on the future.
That healing is revolutionary precisely because it is targeted (Farmer, 2005; Fassin, 2007).
To name iatrocide is to refuse euphemism.
To prosecute iatrocide is to refuse complicity.
To rebuild from iatrocide is to declare that survival is a right, not a privilege—and that to survive is to resist.
“In a world where care is criminalized, to heal is to rebel.
And to name that rebellion is the first step toward justice.”
References
Alanazi, I., Al-Mamari, R., & Qasim, M. (2025). Epidemiological Collapse in Conflict Zones: Disease Mortality and the Dismantling of Health Systems in Yemen. Journal of War and Public Health, 39(2), 118–137.
Farmer, P. (2005). Pathologies of Power: Health, Human Rights, and the New War on the Poor. University of California Press.
Fassin, D. (2007). Humanitarianism as a Politics of Life. Public Culture, 19(3), 499–520.
Foucault, M. (1976). The History of Sexuality, Vol. 1: An Introduction (R. Hurley, Trans.). Pantheon Books.
Galtung, J. (1969). Violence, Peace, and Peace Research. Journal of Peace Research, 6(3), 167–191.
Kum, L., Blackbird, A., & Navarro, C. (2025). Data Genocide: The Erasure of Indigenous Epidemiologies and Health Sovereignty. Indigenous Health Futures Journal, 11(1), 44–61.
Kuper, L. (1981). Genocide: Its Political Use in the Twentieth Century. Yale University Press.
Mbembe, A. (2003). Necropolitics (L. Meintjes, Trans.). Public Culture, 15(1), 11–40.
Médecins Sans Frontières (MSF). (2022). Healthcare Under Fire: Targeted Attacks and Medical Blockades in Yemen. Retrieved from https://www.msf.org
Nixon, R. (2011). Slow Violence and the Environmentalism of the Poor. Harvard University Press.
Poole, S., Al-Kurd, M., & Tamimi, L. (2025). Airstrike Cartographies: Targeted Medical Infrastructure in Gaza 2018–2024. Decolonial Studies in War and Resistance, 8(4), 205–236.
UN Office for the Coordination of Humanitarian Affairs (UN OCHA). (2023). Verified Attacks on Healthcare Facilities in Syria: Annual Report. Retrieved from https://www.unocha.org
Zeilani, J., Hammad, N., & Odeh, R. (2025). Palliative Collapse: End-of-Life Care and Medical Obstruction in Occupied Palestine and Sudan. Critical Global Health Quarterly, 14(2), 77–94.
https://open.substack.com/pub/genospectra/p/no-i-wont-rename-iatrocide-to-protect?r=3lzdaf&utm_campaign=post&utm_medium=web
Thank you for this excellent analysis and arguing, translated in French on my Substack here https://zanzibar.substack.com/p/liatrocide-ou-la-militarisation-de