Objectives
- To familiarize students with the purpose, history, significance of the Istanbul Protocol
- To review the overall content of the Istanbul Protocol
- To be aware of the limitation and possible misuse of the Istanbul Protocol
- To understand Istanbul Protocol standards for procedural safeguards relevant to the medical documentation of torture and ill-treatment
- To understand the medical ethical principles relevant to the medical investigation and documentation of torture and ill-treatment
- To identify the duties of health professionals in the process of investigating and documenting torture and ill-treatment
- Review current, country-specific rules and regulations regarding medical documentation of torture and ill-treatment [to be provided by Instructors]
- To identify country-specific challenges in applying international ethical standards to the effective investigation and documentation of torture and ill-treatment
Content
- Review of the International Standards for the Effective Investigation and Documentation of Torture and Ill-treatment, the Istanbul Protocol
- Purpose
- History
- International recognition of the Istanbul Protocol
- Overview of Istanbul Protocol content
- Misuse of the Istanbul Protocol
- Medical Ethics relevant to the investigation and documentation of torture and ill-treatment
- Duties of the health professional
- International codes
- Ethical rules prohibiting torture
- Primary loyalty to the patient
- Dual Obligations
- The treatment of prisoners and detainees
- Issues surrounding examinations of individuals in the presence of security forces
- Abusive medical treatment
- Consent and Confidentiality
- Security
- Involvement of health professionals in torture
- Seeking further information and support
- UN Committee against Torture
- Country-specific legal responsibilities of the health professionals for forensic documentation of torture and ill-treatment [to be provided by instructors]
- General guidelines for gathering evidence
- The aims and goals of investigation
- The role of health professionals, defense lawyers and NGO workers
- The role of judges and prosecutors
- Documenting the allegations
- The aim of medical documentation
- Types of evidence
- Medical evidence
- Gathering of evidence
- Essential information
- Comparing records
Discussion Topics
- Discuss the value of the Istanbul Protocol for the effective medical investigation and documentation of torture and ill-treatment and its potential for misuse
- Compare and contrast international medical ethical standards for torture documentation and country-specific legal responsibilities of the health professionals for forensic documentation of torture and ill-treatment and provide recommendations for any conflicts identified
- Discuss international and country-specific strategies to address potential personal risks to health professionals who document torture and ill-treatment
- Discuss how health personnel in international and national professional organisations, academics and governmental and non-governmental organisations can work together for the effective investigation and prevention of torture
- Discuss the role of alternative (non-governmental) medical reports. Discuss how have they been used internationally and locally and what their effect has been.
- Discuss the relationship between health and human rights and whether health professionals have a duty to protect and promote human rights, including freedom from torture and ill-treatment
Teaching Formats
- Group Activity:
- Divide the class into several groups and assign each group with one or more (or all) of the Discussion Topics.
- A facilitator should be identified to moderate the discussion and rapporteur should be identified to record the group’s findings and report them when the class reconvenes.
- After 20-30 minutes of group discussion, the entire class should reconvene
- Rapporteurs should briefly report on their group’s findings
- Open class discussion
- Individual Research/Assignment:
- Conduct literature research on the complicity of medical personnel in torture and write a 2-page essay developing a series of country-specific policy recommendations for the government, medical licensing board and national medical association.
- Develop of country-specific list of organisations and bodies relevant to torture and ill-treatment
- If not discussed in class, research the legal status of alternative (non-governmental) forensic medical reports. Indicate how have they been used internationally and locally and what their effect has been.
- Journal Entry: (Instructor to assign Write a few paragraphs — no more than a page)
- Respond to one or more of the Discussion Topics
- Do health professionals have a duty to protect and promote human rights? Explain why or why not.
- How can and should health professioinals document torture and ill treatment when they (or their family members) face the risk of reprisals?
Primary Resources
- The Istanbul Protocol, Chapter II- Relevant Ethical Codes
- Medical Investigation and Documentation of Torture: A Handbook for Health Professionals
- Trainers’ Guidelines for Health Professionals: Training of Users
- Psychological Evaluation of Torture Allegations: An International Training Manual
- Action Against Torture: A Practical Guide to the Istanbul Protocol for Lawyers
Section Contents
- The Istanbul Protocol
- An Overview of the Istanbul Protocol
- Medical Ethics
- Introduction
- Duties of the health professional
- International Codes
- Ethical rules directly prohibiting involvement in torture
- Primary loyalty to the patient
- Dual Obligations
- The treatment of prisoners and detainees
- Issues surrounding examinations of individuals in the presence of security forces
- Abusive medical treatment
- Consent and confidentiality
- Security
- Involvement of other health professionals in torture
- Seeking further information and support
- Country-specific legal responsibilities of health professionals for forensic documentation of torture and ill-treatment
- General Guidelines for Gathering Evidence and Documenting Findings
- Documenting the allegations
- Module 2 Presentation: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
- Self-Assessment and Quiz