Self-Assessment and Quiz |

The primary purpose of a medical evaluation of torture and ill treatment is to assess the degree to which physical and psychological findings correlate with individual allegations of abuse.
1. True
2. False
Which of the following will aid clinicians in earning the trust of individuals who have experienced torture and ill treatment?
1. Active listening
2. Meticulous communication
3. Courtesy, genuine empathy and honesty
4. Explaining what to expect in the evaluation
5. Being mindful of the tone, phrasing and sequencing of questions (sensitive questions should be asked only after some degree of rapport has been developed)
6. All of the above
Clinicians planning to conduct a medical evaluation for physical or psychological evidence of torture and ill treatment should schedule adequate time:
1. About 30 minutes
2. About 1 hours
3. About 2 to 4 hours
4. More than 6 hours
Which of the following is not a procedural safeguard according to the Istanbul Protocol?
1. It is mandatory that detainees undergo a preliminary medical examination at the time of detention; a further examination and evaluation should be made upon their release.
2. The officials who supervise the transportation of the detainee should be responsible to the public prosecutors and not to other law enforcement officials.
3. The medical examination for detainees should be free of charge.
4. Forensic medical services should be under the authority of the police or prison system.
5. Detainees have the right to obtain a second or alternative medical evaluation by a qualified physician during his/her detention.
Clinicians must balance two important requirements in the course of interviewing individuals who allege torture and ill treatment: 1) the need to obtain a detailed accurate account of events, and 2) the importance of respecting the needs of the person being interviewed.
1. True
2. False
The gender of the examining clinician should always be the same as the interviewee.
1. True
2. False
Which of the following are not accurate statements about the use of interpreters for medical evaluations of torture and ill treatment?
1. As a rule, family members should not be used
2. In cases of alleged sexual assault of a woman it is advisable to use a female interpreter if the interviewee does not express a gender preference
3. The age of the interviewer does not matter
4. Interviewers should make eye contact with and speak directly to the interviewee
5. There may be difficulties when the interviewee and the interpreter are from different, ethnic, religious, social, and/or political backgrounds
When a physician is involved in the torture of an individual, he or she may have difficulty trusting the examining clinician. This is an example of:
1. Transference
2. Counter-transference
3. A reaction formation
4. Traumatic delusion
After listening to the audiotape of the 1996 National Public Radio interview with Sr. Diana Ortiz, consider which of the following emotional reactions that an interviewer is likely to have:
1. Anger
2. Helplessness
3. Fear
4. Shame
5. Guilt
6. All of the above
After listening to the audiotape of the 1996 National Public Radio interview with Sr. Diana Ortiz, identify interview considerations that the interviewer did not adequately address:
1. Comfort and privacy
2. Empathy
3. Appropriate use of open-ended and closed questioning
4. Allowing the interviewee to have some control over the interview process
5. All of the above
Before a forensic interview begins, the clinician must inform the interviewee of any limits on the confidentiality of the information he or she provides.
1. True
2. False
As a clinician who provides care to survivors of torture and/or conducts medical evaluations of alleged victims of torture and ill treatment, what strategies do you consider to be effective in managing and limiting secondary trauma and “burn out?”
1. Debriefing with colleagues and seeking counseling if needed
2. Discussing your emotional reactions with the survivor/alleged victim
3. Limiting your exposure to traumatic cases
4. Awareness to, reflection on and modulation of your emotional reactions to interviews with survivors of torture and ill treatment
5. All of the above
Initially, interview questions should be open-ended, allowing a narration of the trauma with minimal interruptions.
1. True
2. False
The accuracy of information obtained in a medical evaluation can be improved by:
1. Clarifying details
2. Summarising key points periodically
3. Scheduling a follow-up interview to address outstanding questions or any inconsistencies
4. Using cognitive techniques such as “You were telling me about being suspended; can you tell me what happened just before that?”
5. All of the above
Which of the following may affect an individual’s ability to recall and recount torture and ill treatment?
1. Disorientation during torture, blindfolding, drugging, and lapses of consciousness
2. Neurological or psychological memory disturbances
3. Feelings of guilt or shame
4. Cultural differences in the perception of time
5. Lack of trust in the examining clinician and/or interpreter
6. Fear of reprisals
7. Lack of privacy during the interview
8. All of the above
Which of the following are appropriate steps for clinicians to take to assess inconsistencies?
1. Ask the individual for further clarification
2. Identify other sources of corroborating information
3. Identify possible reasons for exaggeration or fabrication
4. Schedule an additional interview to discuss inconsistencies
5. Refer the individual to another clinician for a second opinion
6. All of the above
In medical evaluations of torture and ill treatment it is not appropriate to ask questions about prior political activities and/or social beliefs and attitudes?
1. True
2. False
In obtaining information on specific methods of torture and ill-treatment, the clinician should note for each form of abuse: body position, methods of restraint, nature of contact, the duration, frequency, and anatomical location of the alleged abuse, and the subsequent effects of the alleged abuse, i.e. pain, bleeding, loss of consciousness, disabilities, etc.
1. True
2. False
The ethical principles of beneficence and non-malfeasance require that clinicians’ conclusions regarding torture and ill treatment be consistent with the least harmful legal outcome.
1. True
2. False
In the course of documenting medical evidence of torture and ill-treatment, physicians have an ethical duty of identifying and making appropriate referrals for medical and social needs.
1. True
2. False

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