MEDICAL CONDITIONS AND LAW
LEARNING OBJECTIVE: Recognize the
policies and procedures pertaining to
prisoner patients, victims of alleged sexual
assault and rape, substance abuse and
control, probable-cause searches, and
line-of-duty and misconduct investigations.
Some medical conditions, by their very
occurrence, will result in the involvement of law
enforcement personnel. Individuals who are injured
while committing a criminal offense; victims of abuse,
neglect, or assault; impaired or injured as a result of
drug abuse; or injured as a result of a traffic accident
will often be the subject of an official investigation.
Many times the investigators will want to question the
patient or the healthcare providers treating the patient.
Often, the medical records of the patient will be
requested by the authorities. Occasionally, officials
will want to take the patient into custody.
Under the Posse Comitatus Act, a federal statute
enacted in 1956 (18 U.S.C. § 1385), it is unlawful for
the U.S. military to be used to enforce or assist in the
enforcement of federal or state civil laws. There are
many exemptions to this act, but the issue for
healthcare providers is settled by asking the following
question: Is the medical procedure being done on this
patient for a legitimate medical reason, or is it only
being performed to assist civil law enforcement?
Provided there is a reasonable medical justification for
the procedure, the results of the procedure may be
shared with civil law enforcement officials under the
circumstances discussed below.
Cooperation with law enforcement officials, to the
extent possible, is required. Provided there are no
medical contraindications, patients who are either
suspected of having committed an offense or who are
presumed victims of criminal activity will be made
available to speak with investigators. As discussed
previously, access to medical treatment records is
governed by the Privacy Act and FOIA. Generally,
records of patients may be made available to U.S. Navy
investigators once they have established a need to
know the information. This determination will usually
be made by the hospital JAG or public affairs officer.
Other Department of Defense, federal, state, or local
law enforcement officers may have access to treatment
records if access is necessary as part of a criminal
investigation and there is no unwarranted violation of
the privacy rights of the individual involved.
Similarly, local health and social service departments
may be provided information from the record. The
same guidelines that apply to access to treatment
records apply to staff members discussing with
investigating officers the details of the medical
treatment provided to a patient.
DELIVERY OF A PATIENT UNDER
WARRANT OF ARREST
No patient may be released from treatment before
it is medically reasonable to do so.
Once it is
determined that the individual can be released without
significant risk of harm, the following guidelines
regarding release to law enforcement authorities apply.
Nonactive Duty PatientsWhen a nonactive
duty patient is released from medical treatment,
the facility no longer exercises any degree of
control, and normal legal processes will occur.
No official action by hospital personnel is
required before local authorities take custody of
the released patient. There may be occasions,
however, when law enforcement officials should
be notified of an imminent release of a patient.
Active Duty PatientsThe commanding
officer is authorized to deliver personnel to
federal law enforcement authorities who display
proper credentials and represent to the command
that a federal warrant for the arrest of the
individual concerned has been issued. There are
circumstances in which delivery may be refused;
however, guidance should be sought from a
judge advocate of the Navy or Marine Corps
when delivery is to be denied.
Normally, it is the responsibility of the permanent
command to take custody and control of an active duty
member suspected of committing an offense. If the
member is an unauthorized absentee and the command
to which he is assigned is not in the same geographic
area as the treatment facility, release of the patient
should be coordinated with the nearest Transient
Personnel Unit or Military Prisoner Escort Unit. Close
liaison with the members permanent command should
also be established.
In cases where delivery of an active duty patient is
requested by local civil authorities, and the treatment
facility is located within the requesting jurisdiction or
aboard a ship within the territorial waters of such
jurisdiction, commanding officers are authorized to