[Federal Register Volume 61, Number 59 (Tuesday, March 26, 1996)]
[Rules and Regulations]
[Page 13322]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-7157]




[[Page 13321]]

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Part VIII





Department of Justice





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Bureau of Prisons



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28 CFR Part 549



Plastic Surgery; Final Rule

  Federal Register / Vol. 61, No. 59 / Tuesday, March 26, 1996 / Rules 
and Regulations  

[[Page 13322]]


DEPARTMENT OF JUSTICE

Bureau of Prisons

28 CFR Part 549

[BOP-1020-F]
RIN 1120-AA26


Plastic Surgery

AGENCY: Bureau of Prisons, Justice.

ACTION: Final rule.

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SUMMARY: In this document, the Bureau of Prisons is revising its 
regulations concerning the circumstances and procedures under which the 
Bureau approves plastic surgery for inmates. Criteria under which 
plastic surgery may be approved are as follows: as a component of 
standard medical/surgical treatment, when necessary for the good order 
and security of the institution, and in other special situations as 
determined by the Medical Director. Additionally, these regulations 
have been reorganized to emphasize ``informed consent'' and to remove 
unnecessary provisions. This revision is intended to provide for the 
continued efficient and orderly operation of the Bureau and its 
institutions.

EFFECTIVE DATE: April 25, 1996.

ADDRESSES: Office of General Counsel, Bureau of Prisons, HOLC Room 754, 
320 First Street, NW., Washington, DC 20534.

FOR FURTHER INFORMATION CONTACT: Roy Nanovic, Office of General 
Counsel, Bureau of Prisons, phone (202) 514-6655.

SUPPLEMENTARY INFORMATION: The Bureau of Prisons is revising its 
regulations on plastic surgery (28 CFR part 549, subpart D). A proposed 
rule on this subject was published in the Federal Register on October 
20, 1995 (60 FR 54288).
    The proposed regulations stipulated in the statement of purpose (28 
CFR 549.50) that the Bureau ordinarily does not perform plastic surgery 
on inmates to correct preexisting disfigurements (including tattoos) on 
any part of the body. Plastic surgery may be performed when it is a 
component of the presently medically necessary standard of treatment. 
Plastic surgery may also be approved under special circumstances: 
namely, for the good order and security of the institution. Approval 
procedures for requests, whether for medical reasons or special 
circumstances, are contained in Sec. 549.51. ``Informed consent'' 
requirements were redesignated as a separate section (Sec. 549.52) for 
the sake of emphasis. Procedures relating to staff processing of inmate 
identification records were removed because these administrative 
details are better addressed in internal instructions to staff.
    The Bureau received one comment on the proposed rule. This comment 
supported the adoption of the proposed rule. The Bureau is therefore 
adopting the proposed rule as a final rule without change.
    Members of the public may submit comments concerning this rule by 
writing to the address cited above. These comments will be considered 
but will receive no response in the Federal Register.
    The Bureau of Prisons has determined that this rule is not a 
significant regulatory action for the purpose of E.O. 12866, and 
accordingly was not reviewed by the Office of Management and Budget. 
After review of the law and regulations, the Director, Bureau of 
Prisons has certified that this rule, for the purpose of the Regulatory 
Flexibility Act (Pub. L. 96-354), does not have a significant impact on 
a substantial number of small entities.

List of Subjects in 28 CFR Part 549

    Prisoners.
Kathleen M. Hawk,
Director, Bureau of Prisons.

    Accordingly, pursuant to the rulemaking authority vested in the 
Attorney General in 5 U.S.C. 552(a) and delegated to the Director, 
Bureau of Prisons in 28 CFR 0.96(p), part 549 in subchapter C of 28 
CFR, chapter V is amended as set forth below.

Subchapter C--Institutional Management

PART 549--MEDICAL SERVICES

    1. The authority citation for 28 CFR part 549 continues to read as 
follows:

    Authority: 5 U.S.C. 301; 18 U.S.C. 3621, 3622, 3624, 4001, 4005, 
4042, 4045, 4081, 4082, (Repealed in part as to offenses committed 
on or after November 1, 1987), 4241-4247, 5006-5024 (Repealed 
October 12, 1984, as to offenses committed after that date), 5039: 
28 U.S.C. 509, 510; 28 CFR 0.95-0.99.

    2. Subpart D, consisting of Secs. 549.50 and 549.51, is revised to 
consist of Secs. 549.50 through 549.52 as follows:

Subpart D--Plastic Surgery

Sec.
549.50  Purpose and scope.
549.51  Approval procedures.
549.52  Informed consent.

Subpart D--Plastic Surgery


Sec. 549.50  Purpose and scope.

    The Bureau of Prisons does not ordinarily perform plastic surgery 
on inmates to correct preexisting disfigurements (including tattoos) on 
any part of the body. In circumstances where plastic surgery is a 
component of a presently medically necessary standard of treatment (for 
example, part of the treatment for facial lacerations or for 
mastectomies due to cancer) or it is necessary for the good order and 
security of the institution, the necessary surgery may be performed.


Sec. 549.51  Approval procedures.

    The Clinical Director shall consider individually any request from 
an inmate or a BOP medical consultant.
    (a) In circumstances where plastic surgery is a component of the 
presently medically necessary standard of treatment, the Clinical 
Director shall forward the surgery request to the Office of Medical 
Designations and Transportation for approval.
    (b) If the Clinical Director recommends plastic surgery for the 
good order and security of the institution, the request for plastic 
surgery authorization will be forwarded to the Warden for initial 
approval. The Warden will forward the request through the Regional 
Director to the Medical Director. The Medical Director shall have the 
final authority to approve or deny this type of plastic surgery 
request.
    (c) If the Clinical Director is unable to determine whether the 
plastic surgery qualifies as a component of presently medically 
necessary standard of treatment, the Clinical Director may forward the 
request to the Medical Director for a final determination in accordance 
with the provisions of paragraph (b) of this section.


Sec. 549.52  Informed consent.

    Approved plastic surgery procedures may not be performed without 
the informed consent of the inmate involved.

[FR Doc. 96-7157 Filed 3-25-96; 8:45 am]
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