The Istanbul Protocol is a set of guidelines for the effective investigation and documentation of torture and ill-treatment. These international standards help both legal and forensic experts to investigate and document torture and ill-treatment. The medical guidelines, in particular, help forensic experts to assess the degree to which medical findings correlate with individual allegations of abuse and to effectively communicate the findings and interpretations to the judiciary or other appropriate authorities.
Medical experts involved in the investigation of torture must conform to the highest ethical standards, including obtaining informed consent before any examination is undertaken. The examination must conform to established standards of medical practise. In particular, examinations shall be conducted in private under the control of the medical expert and outside the presence of security agents and other government officials. The medical expert should promptly prepare an accurate written report which includes at least the following: case-specific, identifying information; a detailed record of the subject’s allegations of torture and/or ill-treatment, including all complaints of physical and psychological symptoms; a record of all physical and psychological findings on clinical examination; an interpretation as to the probable relationship of the physical and psychological findings to possible torture and ill-treatment; recommendations for any necessary medical and psychological treatment and/or further examination; and the identify those carrying out the examination. The report should be confidential and communicated to the subject or his or her nominated representative.
According to the Istanbul Protocol, the following guidelines should be applied with due consideration to the purpose of an individual evaluation:
- Relevant Case Information
- Clinician’s Qualifications
- Statement Regarding Veracity of Testimony
- Background Information
- Allegations of Torture and Ill-treatment
- Physical Symptoms and Disabilities
- Physical Examination
- Psychological History/Examination:
- Photographs
- Diagnostic Test Results
- Consultations
- Interpretation of Physical and Psychological Findings
- Conclusions and Recommendations
- Statement of Truthfulness (for judicial testimonies)
- Statement of Restrictions on the Medical Evaluation/Investigation (for subjects in custody)
- Clinician’s Signature, Date, Place
- Relevant Appendices
As the Istanbul Protocol makes clear, the absence of physical and/or psychological evidence in a medical evaluation does not rule-out the possibility that torture or ill-treatment was inflicted.