AR 600-20, Army Command Policy - Army Publishing Directorate ...

procedures or care. (This provision also applies if the Soldier is believed incompetent and medical board action is
pending.) These Soldiers may also be given routine medical care needed to treat minor ailments.
(6) Diagnostic medical care. Medical care of a diagnostic nature may be undertaken in order to determine whether a
situation exists that would authorize other medical care to be performed.
(7) Physical and other examinations. Physical examinations and associated procedures, and dental or radiological
examinations may be required when one or more of the following apply:
(a) Required by law or regulation.
(b) Authorized to be performed without consent by law or other regulations.
(c) Directed by an individual’s commander or other appropriate official in order to determine the individual’s fitness
for duty.
(8) Obtaining evidence. Nothing in this paragraph limits the authority of appropriate officials to order the performance
of medical procedures for the purpose of obtaining evidence without the consent of the individual concerned, and
without board action in cases where such procedures are authorized under other regulations or the Military Rules of
Evidence (MRE), MCM.
d. Refusal to submit to medical care other than care described in paragraph c, above.
(1) Soldiers who refuse to submit (or whose court-appointed guardian or other legal representative objects) to
recommended medical care will be referred to a medical board (see AR 40–3, para 7–5).
(2) Soldiers will be referred to a medical board if they refuse to submit to dental care and/or radiographic (X-ray)
procedures deemed necessary by the installation dental surgeon to create dental record and panographic records of the
oral dentition to—
(a) Aid in remains identification.
(b) Treat dental conditions judged to be prejudicial to military operations or deployment that may result in
evacuation or treatment within the first 12 months (see AR 40–400).
(3) When a Soldier refuses to submit to recommended care because of religious practices, the provisions of
paragraph 5–6 apply.
e. Medical board proceedings when medical care is refused.
(1) The examining medical boards report should contain the following information:
(a) Statement that the proposed treatment will relieve the incapacity and aid the Soldier’s return to a duty status.
(b) Statement that the proposed treatment is an established procedure that qualified and experienced physicians
ordinarily would recommend and undertake.
(c) Statement that the Soldier’s refusal to undergo treatment is reasonable or unreasonable, or, in the case of a
mentally incompetent Soldier, a statement that compulsory treatment is warranted. Consideration should be made of the
risks ordinarily associated with the proposed treatment, the Soldier’s age, general physical condition, and his or her
reasons for refusing treatment.
(2) Generally, refusal of medical care is considered unreasonable without substantial evidence that the treatment is
inadvisable. However, in deciding whether refusal of medical treatment, including surgery, is reasonable or unreasonable,
the board should consider among other things—
(a) Existing evidence that the physical or mental treatment is inadvisable.
(b) Previous unsuccessful operations and procedures.
(c) Any special risks involved in the proposed medical treatment.
(3) The report of the medical board proceedings will show the need and risk of the proposed medical care refused
by the Soldier. Moreover, it will show that the Soldier was given the chance to appear in person and will indicate if the
Soldier’s condition permitted appearing. The report will further show that the Soldier was given the chance to submit a
written statement explaining the grounds for refusal. Any statement submitted will be sent with the report.
(4) Soldiers believed to be incompetent will be aided by a representative who may appear in their behalf. The
representative need not be legally qualified.
(5) The Soldier will be informed of the approved findings and advised whether the board has determined that the
proposed medical care is needed to—
(a) Protect the Soldier’s health.
(b) Protect the health of others.
(c) Enable the Soldier to perform his or her duties properly.
(6) The board findings must also state that the proposed care will have a positive effect.
f. Results of medical board proceedings. Soldiers must be given the results of the board proceedings and offered the
opportunity to accept the prescribed medical care. If the Soldier still refuses, the MTF commander will send the
medical board proceedings to HQDA (DASG–HS–AS), 5109 Leesburg Pike, Falls Church, VA 22041–3258 for
review. When refusal to submit to the prescribed medical care is based on religion, TSG will refer the medical board
proceedings to the DCS, G–1 for review and an advisory opinion before action.
(1) TSG will either approve or disapprove the medical board proceedings and return them to the MTF commander.
(2) If TSG approves the medical board proceedings, the Soldier is again given the chance to accept treatment. If the
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