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Module 2 Presentation: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
Module 2 Answers
Toolkits > Istanbul Protocol Model Medical Curriculum > Module 2: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics > Self-Assessment and Quiz

Self-Assessment and Quiz

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  1. The Istanbul Protocol can best be described as:
    1. The duties of states to ensure the effective investigation and documentation of torture and ill treatment
    2. Guidelines for the effective investigation and documentation of torture and ill treatment
    3. International Legal obligations of states to respect The intentional infliction of severe mental or physical pain or suffering
    4. International standards that enable medical and legal experts to prove or disprove allegations of torture and ill treatment
  2. The guidelines contained in the Istanbul Protocol are not designed to be fixed; rather, they represent an elaboration of the minimum standards contained in the Istanbul Principles and should be applied in accordance with a reasonable assessment of available resources.
    1. True
    2. False
  3. The Istanbul Protocol has been recognised by UN and regional human rights bodies as the international standard for the effective investigation and documentation of torture and ill treatment.
    1. True
    2. False
  4. A forensic medical evaluator should avoid conveying empathy during evaluations of alleged torture victims because it may compromise his or her objectivity in the collection of physical and psychological evidence.
    1. True
    2. False
  5. Although there may be considerable variability in the psychological effects of torture and ill-treatment, the effects are often profound and result in long-term psychological disability.
    1. True
    2. False
  6. According to the Istanbul Protocol, what are the most common psychological problems that torture victims suffer from?
    1. There are no common psychological problems
    2. Posttraumatic stress disorder (PTSD) and depression
    3. Paranoia
    4. Sexual dysfunction
  7. Physical evidence of trauma is always of greater legal value than psychological evidence.
    1. True
    2. False
  8. In addition to providing medical evidence of torture and ill treatment, the Istanbul Protocol can be used to exonerate police who are accused of torture and ill treatment of detainees.
    1. True
    2. False
  9. Which of the following are procedural safeguards for detainees?
    1. Police may be in the presence of the detainee when s/he is being examined
    2. The detainee’s lawyer should be present during the request for examination
    3. Prisoners should be examined at the most convenient location
    4. A copy of the examination should not, under any circumstances, be transferred to law enforcement officials
    5. Requests for medical evaluations by police should be considered valid
  10. If the forensic medical examination supports allegations of torture, the detainee should not be returned to the place of detention.
    1. True
    2. False
  11. The presence of police, security forces, and/or other third parties during the examination may be grounds for disregarding a negative medical report.
    1. True
    2. False
  12. The term “medical ethics” refers to the moral framework that each health professional is bound to in their work.
    1. True
    2. False
  13. The use of hoods or blindfolds during any contact between a detainee and a health professional is absolutely unacceptable under any circumstances.
    1. True
    2. False
  14. Which of the following is not a provision under the World Medical Association’s 1975 Tokyo Declaration?
    1. Doctors shall not be present during any procedure during which torture is used
    2. The doctor shall not countenance, condone or participate in the practise of torture or other forms of cruel, inhuman or degrading procedures
    3. The doctor’s fundamental role is to alleviate the stress of his or her fellow man and no motive whether personal, collective, or political shall prevail against this higher purpose
    4. None of the above
  15. Which of the following is not an example of a role that a health professional may play in the participation of torture and ill treatment?
    1. A health professional might be asked to resuscitate a torture victim after he/she has become unconscious
    2. A health professional might provide certain instruments to the torturers/perpetrators
    3. A health professional might be asked to falsify or misrepresent a medical report
    4. A health professional might perform a medical evaluation in order to assess that the victim will be able to withstand torture
    5. A health professional might provide confidential medical information to interrogators
    6. All of the above
  16. Which of the following are essential elements of informed consent?
    1. Mental competence
    2. Full disclosure regarding risks and benefits
    3. The individual understands the information provided
    4. Consent is voluntary and not coerced in any way
    5. The individual provides verbal or written authorization of consent
    6. All of the above
  17. When health professionals are pressured or required by law to disclose information to third parties about patients without consent, they should make clear to any authority requesting information that they are bound by professional duties of confidentiality.
    1. True
    2. False
  18. Under which of the following circumstances would it be appropriate for a physician to feed a hunger striker?
    1. When the physician’s moral beliefs compel him or her to do so
    2. If the hunger striker is already in a comatose state and no prior directives have been established
    3. Immediate family members insist on feeding after the hunger striker became comatose, even though the attending physician documented that the detainee was competent, rational and understood the risk of his actions
    4. None of the above
  19. The ethical duties of medical personnel do not apply in non-clinical encounters with detainees, such as interrogation.
    1. True
    2. False
  20. Effective medical and legal investigations of torture and ill treatment requires obtaining the following essential information?
    1. Identity of the victim
    2. Identity of the perpetrators
    3. Description of how the individual came into the hands of the perpetrators
    4. Description of the location where the abuse took place
    5. Description of the form of abuse
    6. Possible witnesses
    7. All of the above
Module 2 Presentation: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
Module 2 Answers
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  • Istanbul Protocol Model Medical Curriculum

    • Preface
      • Copyright and Acknowledgements
      • Resources
      • Glossary
    • Introduction
      • Curriculum Materials
      • Summary of Content
      • How to Use These Educational Resources
    • Module 1: International Legal Standards (Overview)
      • Torture
        • What is Torture
        • Purpose of Torture
        • History of Torture
        • Other Definitions
        • Cruel Inhuman & Degrading Treatment & Punishment (CID)
        • Prohibition of Torture in International Law
        • The United Nations Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 1984
        • Torture in the World Today
        • Country-Specific Legal Standards and Torture Practices
        • The Perpetrators
        • Common Situations for Torture Allegations
        • Where Does Torture and Ill-treatment Occur?
        • Obligation to Investigate and Bring Justice
        • Formal Inspection of Detention Facilities
        • Official Complaints to Human Rights Bodies and Other Organizations
        • Recently Released Detainees
        • NGO Information Gathering
        • Late Allegations
      • Prevention and Accountability
        • Prevention
        • Accountability
        • Reparation
      • International Supervisory Machinery and Complaints Procedures
        • The Human Rights Committee
        • The UN Committee against Torture
        • Regional Mechanisms
        • Other monitoring mechanisms
        • The UN Special Rapporteur on Torture and other Cruel, Inhuman and Degrading Treatment or Punishment
        • International criminal courts and tribunals
        • The International Committee of the Red Cross (ICRC)
      • Safeguards Against Torture for Those Deprived of Their Liberty
        • Notifying people of their rights
        • Use of officially recognized places of detention and the maintenance of effective custody records
        • Avoiding incommunicado detention
        • Humane conditions of detention
        • Limits on interrogation
        • Access to a lawyer and respect for the functions of a lawyer
        • Access to a doctor
        • The right to challenge the lawfulness of detention
        • Safeguards for special categories of detainees
      • Module 1 Presentation: International Legal Standards
      • Self-Assessment and Quiz
        • Module 1 Answers
    • Module 2: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
      • The Istanbul Protocol
        • About the Istanbul Protocol
        • Brief History
        • International Recognition of the Istanbul Protocol
      • An Overview of the Istanbul Protocol
        • Legal Investigation of Torture
        • General Considerations for Interviews
        • Physical Evidence of Torture
        • Psychological Evidence of Torture
        • Interpretation of Findings and Referrals
        • Misuse of the Istanbul Protocol
        • Procedural Safeguards for Detainees
      • 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
        • The aims and goals of investigation
        • Multidisciplinary approach to documentation
        • Role of the health professional in the team
        • Role of the lawyer in the team
        • Role of the NGO member in the team
        • Role of judges and prosecutors
      • Documenting the allegations
        • The aim of medical documentation
        • Types of evidence
        • Medical evidence
        • Gathering of evidence
        • Essential information
        • Quality of information
        • Comparing records
      • Module 2 Presentation: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
      • Self-Assessment and Quiz
        • Module 2 Answers
    • Module 3: Interview Considerations
      • Preliminary Considerations
        • Purpose of Medical Evaluations
        • Interview Settings
        • Trust
        • Informed Consent
        • Confidentiality
        • Privacy
        • Empathy
        • Objectivity
        • Safety and Security
        • Procedural Safeguards for Detainees
        • Risk of Re-traumatisation
        • Gender Considerations
        • Interviewing Children
        • Cultural and Religious Awareness
        • Working with Interpreters
        • Transference and Counter-Transference Reactions
      • Conducting Interviews
        • Types of questions
        • Cognitive Techniques
        • Summarising and clarifying
        • Difficulties Recalling and Recounting
        • Assessing Inconsistencies
      • Interview Content
        • Identification and Introduction
        • Psychosocial History (Pre-Arrest)
        • Past Medical History
        • Summary of Detention(s) and Abuse
        • Circumstances of Detention(s)
        • Prison/Detention Place Conditions
        • Allegations of Torture and Ill-treatment
        • Review of Symptoms
        • Psychosocial History (post-arrest)
        • Assessments of Physical and Psychological Evidence
        • Physical Examination
        • Closing
        • Indications for Referral
      • Module 3 Presentation: Interview Considerations
      • Self-Assessment and Quiz
        • Module 3 Answers
    • Module 4: Torture Methods and their Medical Consequences
      • Introduction
      • Torture Methods
        • Beatings/Falanga
        • Ear Trauma
        • Eye Trauma
        • Restraint, Shackling and Positional Torture
        • Suspension
        • Crushing and Stretching Injuries
        • Burning
        • Electrical injuries
        • Asphyxiation
        • Violent Shaking
        • Sexual Assault
        • Sexual Humiliation
        • Prolonged Isolation and Sensory Deprivation
        • Sleep Deprivation
        • Temperature Manipulation
        • Sensory Bombardment
        • Threats of Harm
      • Psychological Consequences of Torture
        • Introduction
        • The Paradox of Psychological Consequences of Torture
        • The Psychological Consequences of Torture
        • Social, Political and Cultural Context
        • Risk factors for Trauma and Torture-Related Disorders
        • Psychological Symptoms
      • Module 4 Presentation: Torture Methods and their Medical Consequences
      • Self-Assessment and Quiz
        • Module 4 Answers
    • Module 5: Physical Evidence of Torture and Ill-Treatment
      • Physical Evidence of Torture
        • Medical history
      • The Physical Examination
        • Dermatologic Evaluation
        • Head and Neck
        • Chest and Abdomen
        • Musculoskeletal System
      • Neurological Examination
        • Head Trauma and Post-traumatic Epilepsy
        • Nerve Damage
      • Examination of Women
        • Examination Following a Recent Assault
        • Examination After the Immediate Phase
        • Follow-up
        • Genital Examination of Women
      • Genital Examination of Men
      • Perianal Examination
      • Medical Photography
        • Assessment for Referral
      • Diagnostic Tests
      • Module 5 Presentation: Physical Evidence of Torture and Ill-Treatment
      • Self-Assessment and Quiz
        • Module 5 Answers
    • Module 6: Psychological Evidence of Torture and Ill-Treatment
      • The Central Role of the Psychological Evaluation
        • Conducting the Psychological Evaluation
        • Psychological Findings and Diagnostic Considerations
        • Components of the Psychological/Psychiatric Evaluation
      • Children and Torture
        • Introduction
        • Developmental Considerations
        • Clinical Considerations
        • Role of the Family
      • Apendix I: Sample Psychological Evaluations
        • Psychological Evaluation #1
        • Psychological Evaluation #2
      • Apendix II: ICD-10
      • Module 6 Presentation: Psychological Evidence of Torture and Ill-Treatment
      • Self-Assessment and Quiz
        • Module 6 Answers
    • Module 7: Case Example #01
      • Introduction
      • Preliminary Considerations
      • Materials
      • Module 7 Presentation: Case Example #01
      • Self-Assessment and Quiz
        • Module 7 Answers
    • Module 8: Case Example #02
      • Introduction
      • Preliminary Considerations
      • Materials
      • Module 8 Presentation: Case Example #02
      • Self-Assessment and Quiz
        • Module 8 Answers
    • Module 9: Report Writing and Testifying in Court
      • Written Reports
        • General Considerations
        • Content of Written Reports
        • Conclusions
        • Inconsistencies
      • Providing Testimony in Court
      • Appendix: Court Testimony Guidelines and Maxims
      • Module 9 Presentation: Report Writing and Testifying in Court
      • Self-Assessment and Quiz
        • Module 9 Answers
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