Army Action Plan: Standard Operating Procedures for Advance Directives for Detainees at Guantanamo Bay

DEMCNTION HOSPITAL
SOP NO: JMG all
GUANTANAMO BAY, CUBA
Title: ADVANCE DIRECTIVES Page 1013 Effective Dare: 1 Apr 2003
SCOPE: JOINT MEDICAL GROUP
L BACKGROUND:
As a consequence of cheese, battle injury and non-battle injury it is assumed that some
loss of life may occur among detainees.
IL ADVANCED DIRECTIVES
•

A. Detainees have the right to self-determination and the opportunity to
request advance directives or living wills.
Given the inherent difficulty in next of lin notification, nohealth camsurrogates will be diosen. The 117 Commander will act as the health are =negate forall detainees under advisement of the TIP Surgeon and .TIP 011110 Staffludge
Advocate.
C. To the degree possible., cultural sensitivity will be maintained
executing these r MO.equests. Per detainees wishing to mecute an advance directivedlivingwill, form
NBCTI 632W24 will be completed mad placed in the reconi • The medical
officer will ensure the detainee understamis this .process and its implicatices .prior to
e.accepting the directive.
IIL DO NOT RESUSCITATE
A. Detainees have the right to end-of-life medical cam. They also have
the right to refuse resuscitation in the event of cardiopulmceary, arrest. Detainees
requesting Such orders will discuss them with a medical officer.

B. Only the medical officer can write a DNR order; it must be reviewedand approved by•he Detention Hospital CO, the 77F Surgeon and
Documentation within the medical Staff Judge Advocate.
minimum: record must be clear and include the following at a
• Diagnosis and prognosis Description of the detainees mental state
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Express wishes of the detainee and evidence of informed
consent
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Reference to an advanced directive/living will if one exists
IV. SUICIDE A. The =died staff is trained to recognize signs of suicidal thinking and
behavior. Detainees will be screened during in-processing and if identified as "ar
dereferred for psychiatric evaluation.
B. Duty medical staff and security personnel Will be infained of anydetainees on a "suicide watch" and follow the inatnrctions of the consulting psychiatrist.
The 1IF Surgeon
determinadons via the Detention Hospital CO will be apprised of any such
.

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STANDARD OPl3RATING PROCEDURES
Detention Hospital
Civantanamo Bay, Cuba

REVIEWED AND APPROVED BY:
Officer In Charge
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IMPLEMENTED BY:

Director for Administration.
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Senior Enliged Advisee
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ENTERIC SOP SUPERSEDED BY:
71de: SOP NO:. Date:
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