JKO Medical Ethics and Detainee Operations Questions and Answers

How often, at a minimum, should a detainee's weight be checked while in the detention facility?

Daily

Twice a week

Weekly

Monthly**

Which of the following procedures is NOT part of the detainee in-processing medical examination?

Rectal cavity search*

Height and weight check

Dental screening

Chest x-ray

Article 3 of the Geneva Conventions protects prisoners of war and wounded combatants from all of the following EXCEPT:

Mutilation during interrogation

Murder

Execution after receiving a fair trial**

Cruel treatment and torture

In Middle Eastern culture, the _____ is considered the most unclean part of the body.

Thumb

Sole of the foot **

Right hand

The Qur'an is the holy book of Islam and it guides Muslims in the following areas:

Modesty

Dietary restrictions

Prayer

All of the answers are correct**

Screening Requirements include all of the following EXCEPT?

Physical exam

Body cavity exam**

Medical history review

Chest x-rays and immunizations

Routine vital signs

Dental screening

Height and weight measurement

Key points about dealing with the language barriers include which of the following?

Use translators with some medical expertise

Make sure detainees understand what care you are providing to them

Ensure that detainees don't agree to care they don't understand

All of the answers are correct**

Which of the following statements is/are TRUE about the role healthcare personnel would play in interrogations? Select all that apply.

Medical personnel who help interrogation team should not be a part of the healthcare team**

Healthcare personnel are prohibited from assisting detainee interrogation teams**

Which of the following behaviors would NOT be considered rude or inappropriate according to Middle Eastern culture?

Leaning against a wall

Crossing your legs in the presence of an elder

Standing extremely close to a person during a conversation **

Pointing your shoe sole at someone

The Principles of Medical Ethics require healthcare personnel to avoid which of the following acts?

Participate actively or passively in acts in an attempt to commit torture or other cruel, inhumane or degrading treatment or punishment **

Which transfers require the following minimum documentation: Operative Note (SF 516), Transfer Narrative Summary of Care (SF 502), and radiographs?

Detainees' transfers from Role 2 b to Role 3 treatment units**

Detainee medical records do not need to be at the same standard as those for U.S. and coalition service members.

False

When specialty care is available to coalition forces, specialty care should also be available to detainees in theater.

True

When the Laws of War are broken (breached), there are simple and grave breaches, depending on the severity of the violation. Which of the following is a grave breach?

Poisoning wells and streams

Torture **

Maltreatment of corpse

Pillaging

The detaining forces have an obligation to provide certain groups with either medical care or to ensure that they have access to medical care. Which group should be ensured access to care?

Civilian Population**

Which of the following is NOT a responsibility of Military Intelligence personnel?

Review detainee medical information **

According to the Hague and Geneva Conventions, American Soldiers are required to:

Treat Enemy Prisoners of War humanely **

What should you do during medical examinations to ensure the respect for dignity of the detainee?

Use graduated levels of privacy that are appropriate for the type of examinations

Make every effort to provide same gender medical examiners and security support

Position patients to minimize exposure of their private regions consistent with security requirements

All of the answers are correct **

During a detainee ground transfer, healthcare personnel are in charge of a detainee's restraints.

False

Which of the following statements is/are TRUE about the roles between healthcare personnel and military intelligence? Select all that apply.

BSS Teams personnel assigned to military intelligence are not a part of the healthcare team and will not provide care to detainees**

Healthcare personnel are prohibited from assisting detainee interrogation teams **

Who makes the determination whether an autopsy will be conducted after the death of a detainee?

Armed Forces Medical Examiner **

Which of the duties listed below are owed to Enemy Prisoner of War in accordance with the Geneva Conventions?

Duty to protect

Duty to respect

Duty regarding abandonment

All of the answers are correct **

Which of the following individuals is considered a civilian?

Elderly man appears to be in his 60s and has a limp

Young man, early 20s, appears angry

Middle aged man, mid 40s, dressed like a field worker

Small boy around the age of 5**

Treat enemy casualties and detainees with the same ethics and medical standards of care as for multinational forces. Triage by medical condition only

True

Members of the ICRC arrive to perform an inspection of the medical treatment areas of the detainee facility and ask to visit patients and view medical data. What should you do?

You forward the request for access to the facilities through your Chain of Command **

Which of the following actions would NOT be considered a form of physical abuse?

Using physical restraint for safety of staff **

Using physical restraint as a punitive measure

Kicking a prisoner in the back

Slapping, if it does not cause a bruise

Which of the following stipulations is TRUE regarding the verification of a detainee as being impaired?

Two members of the medical staff must agree to the determination**

Which of the following is the correct order for the standard steps for challenging an unlawful order?

Repeat the order. Request clarification of the order. State your disagreement with the act. Present all moral arguments. Seek to get the order changed. Request rescission of the order, and finally, ask the senior leader to stop the act **

Which of the following statements regarding the Health Insurance Portability and Accountability Act (HIPAA) is TRUE?

Detainees are not covered under HIPAA, so there is no need to maintain detainee records in accordance with its guidance

Detainees are not covered under HIPAA, but they are guaranteed the same standards of care, so this should apply to medical records as well **

The rules and regulations contained in the HIPAA also apply to detainees

Which medications are detainees allowed to have in their possession? Select all that apply.

Heart medication

Albuterol inhalers**

Insulin

Moisturizing creams**

Detainees who have been physically or sexually abused must receive a through medical examination before being released to CID or MPs.

True

Although your shift has just ended, before you may leave you are tasked to screen the detainees so that they can be transferred to another location. They have just knelt for mid-day prayer. The MPs tell you that this procession usually requires about half an hour. What do you do? Select all that apply.

Wait for the prayer to be over to do the screening**

Leave a note for the next shift to do the screening after the prayer (correct)

Which records should be traceably mailed to the Washington National Record Center in Suitland, MD?

Both inpatient and outpatient records

Outpatient records upon release or final disposition of the detainee from detention**

Inpatient records

Which of the following makes up the general legal obligations for military operations worldwide?

The Law of War**

Per AR 190-8 Paragraph 1-5a (4), inhumane treatment of EPW, CI or RP is a serious and punishable violation under the international law and the Uniform Code of Military Justice (UCMJ).

True

When visiting detainee compounds, the International Committee of the Red Cross looks for all of the following EXCEPT:

Completeness of medical records**

Treatment of detainees

Material conditions of detention

Overall legal framework of detention

Which of the following statements is TRUE regarding the separation of Military Police and healthcare responsibilities?

Healthcare personnel will not carry guns in the detention facility **

ATP 4-02.46, Army Health System Support to Detainee Operations give specific guidelines for identifying signs of abuse and procedures to follow should you suspect a detainee has been abused.

True

Which of the 4 Ps of Abuse Prevention states that a system should be in place to reduce the potential for abuse.

Priorities—Have a command philosophy that places honor and dignity at the top of priorities. ???
Policies—It is not good enough to tell everyone to do the right thing...put it in writing.
Procedures—Have systems in place that by nature reduce the potential for abuse. ***
Practices—Continuous exercise of a professional demeanor and conduct.

The following are reasons for complying with the Law of War EXCEPT:

It can cause people to question our motives**

It is the law

It can shorten the length of conflicts

It sets an example for other countries to follow

One of the detainees is an insulin-dependent diabetic, who has been moved from level one security to level four for misbehaving. Now he is refusing his insulin and has been admitted to the ward for monitoring. The medic needs to draw the detainee's blood for baseline results but the patient refuses citing cultural and religious conflicts. What should the medic do? Select all that apply.

Explain to the patient the reason for drawing his blood and for administering insulin to him**

You do not have informed consent, notify the MTF Commander of the situation**

While examining a young female detainee, you discover bruising to her genital area. You ask her if she has been sexually assaulted and she says no, but it is obvious she is scared. What should you do?

Report the incident immediately**

Keep questioning her until she tells you how she got the injury

Nothing. You've fulfilled your obligation

Instruct her to be more careful

Non-Muslim male physicians are not allowed to treat women in many Islamic societies. Please note that for many Muslims treating the illness takes precedence, and seeking permission from the patient and male guardian, will likely result in allowing treatment for illness.

True

In order to be classified as an EPW, a guerilla fighter must do which of the following? Select all that apply.

Commit war crimes

Wear fixed, distinctive insignia**

Operate under a responsible command**

Carry arms openly**

In Middle Eastern cultures, largely Muslim, there are no rules regarding eye contact between the sexes.

false

Prolong handshakes, kissing of the face, grasping elbows, and even prolonged hand holding by two men in public is a sign of friendship and respect.

True

Which of the following is TRUE regarding detainee identification numbers?

Identification numbers are required to order medical tests and provide prescriptions

No detainee will be refused care because of an identification number cannot be provided up front

The Military Police unit in charge of in-processing governs identification numbers

All of the answers are correct**

Being thorough with detainee records helps provide the best care and it helps us to comply with our legal and ethical obligations.

True

You are the triage officer for a detention camp which has just taken a mortar attack. There are a large number of wounded (Coalition Forces and EPWs) and the supply of painkilling drugs is getting low. What should you do?

Ensure the most seriously wounded, regardless of whether they are Coalition Forces or EPWs, are given the drug**

Which of the following statements is/are TRUE about the Behavioral Science Support (BSS) personnel? Select all that apply.

They are exclusively assigned as operational support to detainee operations and intelligence interrogations in the DoD**

They will not provide training in first aid, sanitation, or other health matters**

They will not be used as a medical monitor or safety officer, or to supervise, conduct, or direct detainee operations or intelligence interrogations**

When you are in a deployed environment, which of the following issues can hinder patient identification?

The detainee's name may vary from the initial to the return visit

The detainee was treated prior to formal processing and then returned to Level III medical unit for follow-up care

The detainee's initial pseudo SSN may not reconcile with the actual ISN

All of the answers are correct**

Which of the following is NOT true about the International Committee of the Red Cross?

They direct and coordinate international relief activities

They are delegated by the Geneva Conventions to accomplish their mission

They carry out their mission under the direction of the host country

They provide assistance to victims of war and internal violence

When a detainee dies, the attending medical officer is responsible for which of the following? Select all that apply.

Completing DA Form 2669 (Certificate of Death)**

Determining whether an autopsy will be performed

Reporting the death to the responsible investigating agency

Furnishing a statement detailing whether or not the detainee's death was caused by his own misconduct**

Healthcare personnel are authorized contact with detainees EXCEPT during:

Interrogations**

Before a detainee can be transferred from a Role 2 to a Role 3 medical unit, what conditions must be met? Select all that apply.

Transfer must be authorized by accepting physician

Detainee must be medically stable**

Accepting physician is not required to document the detainee's capture information

Each medical treatment facility commander certifies that the transfer documentation for the detainee is complete**

Physician's documents on detainee capture information has been received

Threatening or humiliating an individual either verbally or non-verbally can be considered what kind of abuse?

Emotional Abuse**

Sexual Abuse

Physical Abuse

Only Geneva Conventions III has an Article 3 that states that the following acts are, and shall remain, prohibited at any time and in any place whatsoever: violence to life and person, in particular cruel treatment and torture, and outrages upon personal dignity, in particular humiliating and degrading treatment.

False**

When it comes to the 4 Ps of Abuse Prevention, which of the following is NOT a correct statement?

Practice - Continuously exercising a professional demeanor and with professional conduct

Priorities - The command philosophy must place honor and dignity at the top of its priorities

Procedures - A system should be in place to reduce the potential for abuse

Policies - Telling people to do the right thing is more important than putting the policy in writing

Which of the following is NOT prohibited under the Geneva Conventions?

Participating in the prisoner interrogations

Conducting medical and scientific experimentation on detained personnel

Transplant procedures for blood and skin grafts with informed consent**

Photographing detainees without informed consent

A supervisor enters with an interrogator. You are ordered to delete potentially damaging information from the medical record. What do you do?

Challenge Order***

Accept Order

MPs provide valuable input regarding the medical care and concerns of detainees. Which statement below is TRUE?

Military police know which detainees repeatedly do not come up for head count and can point them out for medical evaluation**

Medical personnel have specific protections and rights under the Geneva Conventions including:

Protection from intentional attack and the right not to be held longer than 24 hours by the enemy if captured

Protection from intentional attack and the right not to be retained by the enemy

Protection from intentional attack and the right to continue to perform medical duties if retained by the enemy**

All of the answers are correct

Which of the following guidelines are applicable to body cavity searches and exams?

Body cavity exams may be performed for valid medical reasons with the verbal consent of the patient

Body cavity searches are to be conducted only when there is reasonable belief that the detainee is concealing an item that presents a security risk

Both of these answers are correct**

A group of detainees has just been escorted in for screening. A few were coughing and one is on a stretcher and had to be wheeled in. You've been asked to screen them all and that the two obviously uninjured detainees need to be interrogated. Do you complete and process the two uninjured detainees first?

no

When detainees are transferred between roles of care, all these individuals are required to accompany the detainee except?

A chaperone**

While screening a detainee during in-processing, he mentions through the interpreter that he was beaten up by the Iraq National Guard last year. You may ignore his statement since he is a detainee.

False

A large scale operation has just been conducted in your area. The detention facility needs to prepare to screen a large number of detainees. The following resources are available: a dentist, a nurse to administer immunizations, a medic for vital signs and lab specimen station, a medic to perform past medical history interviews, an NCOIC, and a provider. What resources do we need to add? Select all that apply.

2 more providers**

Dental tech**

Behavioral health provider**

During the initial screening exam, it's important that you take pictures of a detainee's existing and pre-existing injuries and wounds.

True

Military Police may make the initial decision to classify a detainee as being on suicide watch. Is this statement correct?

Yes, Military Police may make the initial decision before a detainee is given a mental health assessment**

No, the decision can only be made by healthcare personnel

Which of the following groups of people are NOT entitled to both medical and dental care?

Enemy Prisoners of War

Retained Personnel

Civilian Population**

Other Detainees

Detainee medical records do not need to be at the same standard as those for U.S. and coalition service members.

false

There are 4 Geneva Conventions which cover the protections and treatment of people caught up in armed conflict. Which of these Conventions lists the rights and protections of Prisoners of War?

Geneva Convention III

When recommending treatment to a detainee, they have the right to refuse treatment. If they do decline treatment, which documents does NOT need to be completed?

DD Form 93 (Record of Emergency Data)**

SF 88 (Report of Medical Examination)

SF 600 (Chronological Record of Medical Care)

DA Form 3444 (Treatment Record)

Sick call at detention facilities must be held:

Once a day**

One of the detainees in your treatment facility is about to be released from detention and has requested a copy of his medical records. What should you do?

Give him a copy which has had the unit and healthcare provider personal information edited**

Non-consensual sexual activity can include exhibitionism, inappropriate touching, or sexual intercourse

true

Which of the following is NOT acceptable in the Middle Eastern Culture?

Taking a person's picture without their consent

A detainee is in critical need of care. The MPs have not given him an ISN. You rush to the MP to obtain an ISN, so that you can begin processing. Is this correct?

no

Which of the following statements is TRUE about inpatient services for detainees?

When possible, keep detainee patients separate from Coalition and civilian patients

Which of the following are the responsibilities of the healthcare providers? Select all that apply.

Administer care

Restrain detainee patients for medical purposes

Which of the following statements is FALSE regarding the duties owed civilian detainees under the Geneva Conventions?

They may be used as shields, if necessary

Which of the following responsibilities are roles for security personnel? Select all that apply.

Control detainees (CORRECT)
Report detainee discipline problems (CORRECT)
Discipline detainees (CORRECT)

Which of the persons below does NOT qualify as a protected person under the Geneva Conventions?

Paratroopers exiting aircraft

How long can medical personnel be retained?

Only while needed to treat wounded and sick

Reprisals or acts which are usually violations of war may NEVER be taken to:

Take revenge on the opponent

In accordance with Army Regulation 190-8, all detainees must receive an initial screening chest x-ray and be given any necessary immunizations. This is crucial to stopping the spread of tuberculosis and other communicable diseases.

true

Unconscious or psychotic individuals can be examined without verbal consent as long as one person verifies that the detainee is "impaired" and documents this clearly on the examination report.

false

Which of the following statements are TRUE regarding ICRC visits to detainee compounds. Select all that apply.

All ICRC findings are given to the authorities in charge of the detainee compound (CORRECT)
THE ICRC inspects the treatment of detainees and the material conditions of the detention facility (CORRECT)

Which of the following is NOT true concerning the Qur'an?

It is not the ultimate law in Muslim society