DoD Instruction Consolidates Detainee Medical Care Policy
By Sgt. Sara Wood, USA
American Forces Press Service
WASHINGTON, Jun. 7, 2006 The Defense Department yesterday issued an instruction detailing the standards of medical care in detainee operations.
DoD Instruction 2310.08, titled "Medical Program Support for Detainee Operations," reaffirms the responsibility of health care personnel to protect and treat all detainees under their care humanely, said Dr. William Winkenwerder, assistant secretary of defense for health affairs.
"It is a comprehensive, thoughtful policy document that's reaffirming high ethical principles and humane care and treatment for detainees and persons under the authority and control of the U.S. armed forces," Winkenwerder said in a telephone interview. "In a phrase, it's a very good document."
This instruction doesn't change any of the current practices at Guantanamo Bay, Cuba, or other places where the U.S. deals with detainees, but is a compilation of various policy memoranda, Winkenwerder said. The instruction reaffirms principles that will be prevalent for years to come, and it gives a single source of reference for military medical personnel who rotate in and out of places like Guantanamo, he said.
"We want our people to have the most explicit, detailed guidance we can offer them," he said.
The instruction goes into detail on several important points dealing with detainee medical care, Winkenwerder said.
First, the instruction emphasizes that humane treatment has always been and will always be the standard for detainee medical care, and health care personnel have a duty to report any possible instances of inhumane treatment or abuse, he said.
The instruction also says that health care personnel, regardless of their role, are not to supervise, conduct or direct interrogations, he said. Behavioral science consultants, who are usually psychologists, do provide consultative services to law enforcement and intelligence personnel, but only in the form of psychological assessments and advice on communications techniques, he said. The consultants cannot advise interrogators to exploit any psychological conditions or weaknesses the detainees may have, because that could result in inhumane treatment, he said.
"The thrust is to coach and counsel the interrogator in a way that allows him or her to build a relationship with the detainee such that there is an exchange of information," he said. "Maybe just looking at their personality, their character, the way they interact - clues are there as to what makes a person more or less comfortable to talk."
The instruction also details the appropriate handling of detainee medical information and records, Winkenwerder said. It also states that health care will be provided to detainees with their consent, except in cases of lifesaving emergencies or when public health is at risk, he said.
A detainee on hunger strike can qualify as a lifesaving emergency, Winkenwerder said, once the detainee's health reaches a certain point. That's when the involuntary feeding procedure would be used, he said. The DoD policy on involuntary feeding is consistent with U.S. law and with the rules of the Federal Bureau of Prisons, he said.
"Our policy reaffirms what our practice has been, which is to preserve life," he said.
There have been many false statements made in the media about DoD's involuntary feeding practices, Winkenwerder said. As it is, the feeding tube is only about 3 millimeters in diameter -- about three times that of a paper clip -- and is applied with lubrication and anesthetic, he said. Restraints are used because of previous attacks on medical personnel, he said, but they are used in a professional, humane manner.
Another important point the instruction makes is that all military health care personnel need to receive appropriate training in detainee medical care, Winkenwerder said. All military health care personnel should be prepared to deal with detainees anywhere in the world, and should know the proper rules and ethics to guide their conduct, he said.
This instruction is being issued now because it is a necessary compilation that goes into detail about detainee medical operations, Winkenwerder said. It was developed with input from medical professionals in and out of the military, including two groups of medical professionals who visited Guantanamo Bay and observed detainee medical operations, he said.