Invisible injuries: concussive effects and international humanitarian law

The concussive effects of weapons used on the modern battlefield can cause Traumatic Brain Injury (TBI). Indeed, TBI has been termed the "signature wound" of the ongoing conflicts in Iraq and Afghanistan. To date, the injury has not been taken into account by armed forces in their application of international humanitarian law norms regarding attacks that affect civilians. Of particular note in this regard are the rule of proportionality and the requirement to take precautions in attack. This article opens the discussion about this recently discovered consequence of warfare for the civilian population. It examines the state of the science regarding TBI and queries whether the understanding of such injuries has reached the point at which commanders in the field are obligated to begin considering, as a matter of humanitarian law, the risk of causing TBI to civilians when they attack enemy forces. It concludes with a practical assessment of how they might do so.