Arming Hospital Ships of the Future: Hybrid Wars Require a Major Change.

This article focuses on the need to modernize and arm future U.S. Navy hospital ships in response to evolving threats posed by hybrid warfare, which increasingly targets civilian infrastructure and medical facilities. Current Geneva Convention protections require hospital ships to remain unarmed, openly marked, and use unencrypted communications, but these conventions do not reflect the realities of modern conflicts where adversaries, including state and non-state actors, deliberately attack medical platforms, as exemplified by Russia’s invasion of Ukraine. The authors argue that future hospital ships should be tactically capable, defensible, and equipped with modern self-defense weapons (such as machine guns, Phalanx Close-In Weapon Systems, and laser systems) and encrypted communications to ensure survivability and operational effectiveness. They recommend designing new or retrofitted gray-hulled vessels that balance humanitarian mission visibility with necessary defensive measures to operate safely in contested environments, thereby supporting both combat casualty care and humanitarian assistance/disaster relief missions.