text: Chapter 3
  each detainee which facilitates the identification of injuries which may have occurred in the
  detention facility.
  * Detainees who report for routine sick call should be visually examined to determine if any unusual
  or suspicious injuries are apparent. If present, the health care provider should determine from the
  detainee how the injuries occurred. Any injuries which cannot be explained or for which the
  detainee is providing evasive responses should be noted in the medical record and should be
  reported to the chain of command, technical medical channels, and United States Army Criminal
  Investigation Command.
  * Health care personnel may enter the holding areas of the facility for a variety of reasons. These
  can include, but are not limited to, conducting sanitary inspections, providing TCCC, and
  dispensing medications. When in the holding areas of the facility, health care personnel must be
  observant. Should they observe anything suspicious which might indicate that detainees are being
  mistreated, they should report these suspicions immediately to the chain of command. Should
  they observe a detainee being mistreated, they should take immediate action to stop the abuse and
  then report the incident.
  3-43. Detained personnel must have access to the same available standard of medical care as the U.S. and
  unified action partners to include respect for their dignity and privacy. In general, the security of detainees’
  medical records and confidentiality of medical information will be managed the same way as for the U.S.
  and multinational forces. During detainee operations, the patient administrator, the United States Army
  Criminal Investigation Command, the International Committee of the Red Cross, and the medical chain of
  command can have access to detainee medical records besides the treating health care personnel.
  3-44. Health care personnel shall safeguard patient confidences and privacy within the constraints of the law.
  Under U.S. and international law and applicable medical practice standards, there is no absolute
  confidentiality of medical information for any person. Detainees shall not be given cause to have incorrect
  expectations of privacy or confidentiality regarding their medical records and communications, however,
  whenever patient-specific medical information concerning detainees is disclosed for purposes other than
  treatment, health care personnel shall record the details of such disclosure, including the specific information
  disclosed, the person to whom it was disclosed, the purpose of the disclosure, and the name of the medical
  unit commander (or other designated senior medical activity officer) approving the disclosure. Similar to
  legal standards applicable to U.S. citizens, permissible purposes include preventing harm to any person,
  maintaining public health and order in detention facilities, and any lawful law enforcement, or national
  security-related activity.
  3-45. In any case in which the medical unit commander (or other designated senior medical activity officer)
  suspects that the medical information to be disclosed may be misused, he should seek a senior command
  determination that the use of the information will be consistent with the applicable standards.
  3-46. The information disclosed to a physician during the course of the relationship between physician and
  patient is confidential to the greatest possible degree. The patient should feel free to make a full disclosure
  of information to the physician in order that the physician may most effectively provide needed services. The
  patient should be able to make this disclosure with the knowledge that the physician will respect the
  confidential nature of the communication. The physician should not reveal confidential communications or
  information without the express consent of the patient, unless required to do so by law. The obligation to
  safeguard patient confidences is subject to certain exceptions, which are ethically and legally justified
  because of overriding social considerations. Where a patient threatens to inflict serious bodily harm to
  another person or to himself and there is a reasonable probability that the patient may carry out the threat, the
  physician should take reasonable precautions for the protection of the intended victim, including notification
  of law enforcement authorities.
  3-47. Patient consent for the release of medical records is not required. The MTF commander or
  commander’s designee, usually the patient administrator, determines what information is appropriate for
  release. Only that specific medical information or medical record required to satisfy the terms of a legitimate
  request will be authorized for disclosure.
  3-48. Because the chain of command is ultimately responsible for the care and treatment of detainees, the
  detention facility chain of command requires some medical information. For example, detainees suspected