Army Action Plan: Standard Operating Procedures for Detainee Refusal of Care

L SNCL: (1) DoD Policy on Medical Care for Bonny Persons Under US Control , Detained in Conjurcdon with Operation ENDURING FREEDOM,1 0 April
2002.
(2) U.B. Southern Command Confidentiality Policy for Interactions BetweenHealth Care Providers and Enemy ParsonsUnder U.S.
Control, Detained
in won with Operation ENDURING FREEDOM, 6 August 2002.
IL BACKGROUND. The Detainees held at Joint Talk Force MP) OTMO
Prisoners of War, they are considered to be unlawftd combatants. The Detai are 'rot

goal*" do
for the Goma Convention Rules; however, they will be tressed , i not
instars
n a
consistent with the principles of tbe Geneva Convention relative to the treannent
'
of prisoners of Var.
IlL POLICY:
A. Detainees under U.S. control suffering from a serious disease, or whose
condition necendtmes *eclat treatment, surgery,
provided," hospital core, or rehabilitation shall be

to the extent f easible, the medics' attention required by their
the policies delineated in enclosure (1). " state of health per
B. JTF military medical personnel will provide medical care as
correc" n2plicable to
military correctional Willies (SOUTFICOM Policy Manoranclum 11-02) found in
enclosure (2)."•
IV. PROCEDURES:
A.
Detainees may refuse care that is not required to protect their ve,.
health interests (l
Vii" imbe/organs), the lives or health of others. or legitimate li significant
of the United"States. securitj,
B. Detainees will be treated humanely at all times.
C. Force should be avoided whenever reasonable.
D.
Do not use force in 'dations where the risk of danger to the detainee exceeds
the risk of not getting the tresernent.
E.
Do not use medical treatments as a discipline tool in order to modify detainee
behavior. Joint Detainee. Operations Group and the ITF Commander will bundle thedisci"pline ofdeutinees
F. Time out or a delay in moo treatments by 1-2 hours is acceptable to diffuse the
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SOP: OSe
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situation, allow the detainee to reconsider, and/or acOust to the realities of his situation.

G. Refusals are sadly an expression or art attempt to achieve control by the
detainee. These control issues are usually related to a personal issue and not a larger

group or philosophy issue.
H. Ramadan is a religious holiday that requires fasting all day for an entiremonth. Mediation and clinic schedules will need to be adjusted during t hat time period.
I. The detainees come from a boner culture. Ewe:live cfiscussion and permission seeking ibr a benign procedure that dom =Inquire informed consent isfly counterisoductive. The detainees have a generally ballade view of life.
Threatening the detainee with a shatter life span for not taking his blood pressure medicadon or lipid-lowering medication will carnally not convince the detainee to take the
medication.
• J. The Bloethica Committee, Naval Hospital OTMO is another source to help
resolve significant issues of bioethical conflict.
K. Inibrmed consent with a wive language interpreter as the witness will be
obtained for all surgeries and me of anesthesia.
L. The Senior Medical Officer will review all requests for the me of force andprovide final approval for the one of fume in the case of medical hutment or
monagement.
M.
JTF Commander has final decision for all medical miners in regards to issues
concerning national security.

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DETAINEE REFUSAL OF CARE .SOP: IiSf Page 3 of 3
STANDARD OPERATING PROCEDURES
Detention Hospital
Glinting= Bay, Cuba

REVIEWED AND APPROVED BY:
Officer In Charge" Date
IMPLEMENTED BY:
Director for Administration"
Dam
Senior Enlisted Advisor
ANNUAL REVIEW LOG:
BY: "
'Date:By:" Date:By:" Date:
BY:"
Date:
By:" Date:
Br"
Date:

SOP REVISION LOG:
Revision to Page:"
Date:Revision to Page: " Date:"

Revision to Page:"
Date:Revision to Page:" Date:" Revision to Page:" Date:Revision to Page:" Date:

ENTIRE SOP SUPERSEDED BY:
Title:" SOP NO:
Deb:

Copy so: Joint Task Force Surgeon's Office
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