text: Sustainment Operations During Armed Conflict
  Ethical Considerations for the Provision of Medical Support
  5-130. International law, as it pertains to the treatment of detainees and civilians during conflict, helps to
  ensure the ethical treatment of all sick and wounded personnel. The determination of eligibility for medical
  treatment in Army MTFs is established in accordance with command guidance, practical humanitarian and
  medical ethical considerations, availability of U.S. medical assets (in relationship to the threat faced by the
  force), and potential training opportunities for medical forces. Any personnel requesting medical care should
  receive a timely medical assessment of their condition. Although individuals may not be eligible for treatment
  in accordance with Army regulations or command policy, life, limb, or eyesight-saving procedures will be
  provided to stabilize the individual for transfer to the appropriate civilian or other nation MTF. See FM 4-02
  for additional detail.
  5-131. The conduct of armed hostilities on land is regulated by both written and unwritten law. This law of
  land warfare is derived from two sources: customs and lawmaking treaties such as the Geneva and Hague
  Conventions. The rights and duties set forth in these conventions are part of the supreme law of the land;
  violation of any one of them is a serious offense. The following are several ethical considerations applicable
  to the conduct of AHS support:
  • Self-defense, as defined by the Geneva Conventions, restricts medical personnel to the use of small
  arms for self-protection and defense of patients. The increased demand for medical support during
  large-scale combat operations will prohibit use of medical personnel for perimeter defense and other
  security details.
  • Class VIII supplies and equipment are also afforded protective status under the provisions of the
  Geneva Conventions. Captured medical supplies and equipment are protected from intentional
  destruction. Units having custody of enemy supplies and equipment will turn them over to the
  supporting medical facility. Local or captured Class VIII materiel will only be used to support
  detainees.
  5-132. The Geneva Conventions also stipulate that religious buildings, shrines, and other consecrated places
  of worship are only used for aid stations, medical installation, or for the housing of wounded personnel
  awaiting evacuation, if an emergency situation requires such use. See FM 6-27 and FM 4-02 for additional
  information.
  Battlefield Flow
  5-133. Casualty information is collected and reported through official channels as quickly as possible with
  the standard being that it is passed to the Casualty and Mortuary Affairs Operations Division normally within
  hours of knowledge of an incident. A casualty is any person who is lost to the organization by having been
  declared deceased, duty status-whereabouts unknown, excused absence-whereabouts unknown, missing,
  injured, or ill. Units will report all casualties to include American civilians, DOD and DA Civilians,
  contractors authorized to accompany the force, and personnel of other Services. The scope and scale of
  personnel losses expected during large-scale combat operations against a peer competitor has the potential to
  overwhelm the casualty reporting process timelines and negatively impact the notification process.
  Commanders should consider supplementing the casualty reporting system at critical nodes with HR
  squads/teams or ad hoc teams (immaterial of branch or military occupational specialty) with sufficient
  capability to gather and report casualty information in a timely manner.
  Note. Based on guidance from the JTF, joint force land component command, or coalition forces
  land component command, the ASCC may delegate authority to corps-level commanders to
  release casualty reports directly to the Casualty and Mortuary Affairs Operations Division with a
  copy provided to the theater casualty assistance center.
  5-134. Due to the personal nature of information within casualty reports, the theater casualty information
  center, established by the ASCC human resources operations center, reports casualty information to the
  Casualty and Mortuary Affairs Operations Division using Defense Casualty Information Processing System
  as the official means of casualty reporting. In the absence of the ASCC human resources operations center,
  the senior element G-1/AG must immediately assume the role of the theater casualty information center.