[2] To be convicted of this crime, someone must play a role in a sufficiently-large scale killing of civilians, including those carried out by "the intentional infliction of conditions of life... calculated to bring about the destruction of part of a population".
[12] The Independent International Commission of Inquiry on the Occupied Palestinian Territories issued a report in 2024 stating that the Israeli destruction of the Gaza Strip healthcare system constituted the crime of extermination.
[14][15] Similar to other international crimes, extermination includes both an actus reus (an act of large-scale killing) and mens rea (the intent to participate in this action).
According to William Schabas and other jurists, the only difference from customary international law was to specify that the crime of extermination includes[2] "the intentional infliction of conditions of life, inter alia the deprivation of access to food and medicine, calculated to bring about the destruction of part of a population"[3]—phrasing that Schabas argues was inspired by one of the elements of the crime of genocide,[2] "deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part.
[19] There is no minimum size threshold for the crime; it is assessed based on the circumstances, although case law has recognized incidents ranging from dozens to thousands of victims.
[24] The method of killing is not relevant; it could be carried out indirectly, for example depriving civilians of food or medicine, "creating a humanitarian crisis", blocking aid delivery, forcing people on a death march, or refusing shelter.