MEDICAL CONDITIONS AND LAWENFORCEMENT PERSONNELLEARNING OBJECTIVE: Recognize thepolicies and procedures pertaining toprisoner patients, victims of alleged sexualassault and rape, substance abuse andcontrol, probable-cause searches, andline-of-duty and misconduct investigations.Some medical conditions, by their veryoccurrence, will result in the involvement of lawenforcement personnel. Individuals who are injuredwhile committing a criminal offense; victims of abuse,neglect, or assault; impaired or injured as a result ofdrug abuse; or injured as a result of a traffic accidentwill often be the subject of an official investigation.Many times the investigators will want to question thepatient or the healthcare providers treating the patient.Often, the medical records of the patient will berequested by the authorities. Occasionally, officialswill want to take the patient into custody.Under the Posse Comitatus Act, a federal statuteenacted in 1956 (18 U.S.C. § 1385), it is unlawful forthe U.S. military to be used to enforce or assist in theenforcement of federal or state civil laws. There aremany exemptions to this act, but the issue forhealthcare providers is settled by asking the followingquestion: “Is the medical procedure being done on thispatient for a legitimate medical reason, or is it onlybeing performed to assist civil law enforcement?”Provided there is a reasonable medical justification forthe procedure, the results of the procedure may beshared with civil law enforcement officials under thecircumstances discussed below.Cooperation with law enforcement officials, to theextent possible, is required. Provided there are nomedical contraindications, patients who are eithersuspected of having committed an offense or who arepresumed victims of criminal activity will be madeavailable to speak with investigators. As discussedpreviously, access to medical treatment records isgoverned by the Privacy Act and FOIA. Generally,records of patients may be made available to U.S. Navyinvestigators once they have established a need toknow the information. This determination will usuallybe made by the hospital JAG or public affairs officer.Other Department of Defense, federal, state, or locallaw enforcement officers may have access to treatmentrecords if access is necessary as part of a criminalinvestigation and there is no unwarranted violation ofthe privacy rights of the individual involved.Similarly, local health and social service departmentsmay be provided information from the record. Thesame guidelines that apply to access to treatmentrecords apply to staff members’ discussing withinvestigating officers the details of the medicaltreatment provided to a patient.DELIVERY OF A PATIENT UNDERWARRANT OF ARRESTNo patient may be released from treatment beforeit is medically reasonable to do so. Once it isdetermined that the individual can be released withoutsignificant risk of harm, the following guidelinesregarding release to law enforcement authorities apply.Nonactive Duty Patients—When a nonactiveduty patient is released from medical treatment,the facility no longer exercises any degree ofcontrol, and normal legal processes will occur.No official action by hospital personnel isrequired before local authorities take custody ofthe released patient. There may be occasions,however, when law enforcement officials shouldbe notified of an imminent release of a patient.Active Duty Patients—The commandingofficer is authorized to deliver personnel tofederal law enforcement authorities who displayproper credentials and represent to the commandthat a federal warrant for the arrest of theindividual concerned has been issued. There arecircumstances in which delivery may be refused;however, guidance should be sought from ajudge advocate of the Navy or Marine Corpswhen delivery is to be denied.Normally, it is the responsibility of the permanentcommand to take custody and control of an active dutymember suspected of committing an offense. If themember is an unauthorized absentee and the commandto which he is assigned is not in the same geographicarea as the treatment facility, release of the patientshould be coordinated with the nearest TransientPersonnel Unit or Military Prisoner Escort Unit. Closeliaison with the member’s permanent command shouldalso be established.In cases where delivery of an active duty patient isrequested by local civil authorities, and the treatmentfacility is located within the requesting jurisdiction oraboard a ship within the territorial waters of suchjurisdiction, commanding officers are authorized to15-11
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