[Federal Register Volume 60, Number 203 (Friday, October 20, 1995)]
[Proposed Rules]
[Page 54288]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-25913]




[[Page 54287]]

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Part II





Department of Justice





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Bureau of Prisons



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28 CFR Parts 549 and 551



Plastic Surgery and Inmate Organizations; Proposed Rules

Federal Register / Vol. 60, No. 203 / Friday, October 20, 1995 / 
Proposed Rules 

[[Page 54288]]


DEPARTMENT OF JUSTICE

Bureau of Prisons

28 CFR Part 549

[BOP-1020-P]
RIN 1120-AA26


Plastic Surgery

AGENCY: Bureau of Prisons, Justice.

ACTION: Proposed rule.

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SUMMARY: In this document, the Bureau of Prisons is proposing revised 
regulations concerning the circumstances and procedures under which the 
Bureau approves plastic surgery for inmates. The proposed regulations 
establish criteria under which plastic surgery may be approved: 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.

DATES: Comments due by December 19, 1995.

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 proposing to amend 
its regulations on plastic surgery (28 CFR part 549, subpart D). A 
final rule on this subject was published in the Federal Register on 
June 29, 1979 (44 FR 38236).
    Under its current regulations on plastic surgery, the Bureau 
provides, within available resources, corrective and reconstructive 
surgery for an inmate to correct obvious disfigurement. Approval for 
such surgery follows when the surgery is indicated for medical reasons 
or when it is believed that such surgery will assist the inmate's 
institutional or post-release adjustment.
    The proposed regulations stipulate in the statement of purpose 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, or when some question 
exists as to whether the surgery qualifies as a component of presently 
medically necessary standard of treatment. Further revisions to the 
regulations include simplification and reorganization of the procedures 
for approval and ``informed consent.'' Procedures relating to staff 
processing of inmate identification records have been removed and have 
been made part of internal instructions to staff.
    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.
    Interested persons may participate in this proposed rulemaking by 
submitting data, views, or arguments in writing to the Bureau of 
Prisons, 320 First Street NW., HOLC Room 754, Washington, DC 20534. 
Comments received during the comment period will be considered before 
final action is taken. All comments received remain on file for public 
inspection at the above address. The proposed rule may be changed in 
light of the comments received. No oral hearings are contemplated.

List of Subjects in 28 CFR Part 549

    Prisoners.
Wallace H. Cheney,
Acting 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), it is proposed to amend part 549 
in subchapter C of 28 CFR, chapter V 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. 95-25913 Filed 10-19-95; 8:45 am]
BILLING CODE 4410-05-P