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Introduction
Toolkits > Istanbul Protocol Model Medical Curriculum > Preface > Glossary

Glossary

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Medical Terms

Axilla
Armpit.
Brachial plexus
The nerves running from the spine into the arm.
Callus
An area of thickening of bone at the place of healing.
Cerebral oedema (edema)
Swelling of the brain.
Cognitive impairment
Partial impairment of memory, thinking, perception or mood.
Counter-transference
Potential emotional reaction of the clinical evaluator toward the alleged torture victim.
Depigmentation
Complete loss of pigment from a patch of skin.
DSM
Diagnostic and Statistical Manual (American Psychiatric Association).
Haematuria
Blood in the urine.
Hyperpigmentation
Increase in pigmentation of an area of skin.
Hypopigmentation
Partial loss of pigment from an area of skin.
Intrusive memories
Involuntary, unpleasant and recurrent memories of an incident.
Ischemia
Decreased blood flow.
Laceration
A wound in which the skin is torn by blunt force.
Medical Evaluation
An assessment of physical and/or psychological evidence by a clinician.
Medical history
An individual’s personal account of a health problem.
Medico-legal
Relating to that branch of medicine that assists the courts.
Necrotic
Devitalized (death of) body tissues.
Neuropathy
Nerve damage.
Oedematous (edematous)
Swollen.
Parasthesias
A skin sensation such as burning, itching, tingling, with no apparent casuse.
Pathognomonic
A pathological finding that has only one cause.
Perianal
Around the anus.
Petechiae
Clusters of very small bruises.
Psychosomatic symptoms
Apparently physical symptoms that have a psychological cause.
Retinal haemorrhage
Bleeding into the back of the eye.
Sequelae
The consequences of a medical problem.
Striae distensae
Stretch marks of the skin.
Subdural bleeding
Bleeding between certain layers of fibrous tissue covering the brain.
Tonic-clonic fits
The common form of epileptic convulsions or seizures.
Transference
Feelings that a survivor of torture has towards the clinician that relate to past experiences, but which are misunerstood and towards the clinician personally.
Urethral meatus
The aperture at the end of the penis through which urine is voided.

Legal Terms

Allegation
A claim (as yet neither proved nor disproved) that an incident of torture has occurred.
Applicant
Person making an application under an individual complaint procedure.
Application
Submission asking a judicial body to consider a case under an individual complaint procedure.
Arrest
The act of apprehending a person for the alleged commission of an offence or by the action of an authority.
Asylum
Asylum is sought by individuals who do not wish to return to a country, usually their own, where they are at risk. If granted, it means being allowed to remain in a country which is not their own. It may be temporary or permanent.
Corroboration
Evidence which supports or confirms the truth of an allegation.
CPT
Council of Europe’s Committee for the Prevention of Torture.
Declaration
A particularly formed resolution, usually of the United Nations General Assembly, which is not as such legally-binding, but sets out standards which states undertake to respect.
Derogate
To temporarily suspend or limit.
Detention
Depriving a person of personal liberty except as a result of conviction for an offence.
Domestic law or legal system
National law or legal system; law or legal system which is specific to a particular country.
Enforcement (of obligations)
Making the obligations effective; ensuring that they are respected.
Fact-finding
Carrying out an investigation to discover the facts.
Incommunicado detention
Being held by the authorities without being allowed any contact with the outside world.
Individual complaint
A complaint relating to a specific set of facts affecting an individual or individuals.
Instrument
A general term to refer to international law documents, whether legally binding or not.
Judicial procedure
A procedure before a judicial body.
NGO
Non-governmental organisation.
Perpetrator
The person who has carried out an act.
Reparation
Measures to repair damage caused, eg. compensation.
Sanction
A penalty imposed for a state’s failure to respect its legal obligation.
State responsibility
Holding a state accountable under international law.
Treaty
International law document which sents out legally-binding obligations for states.
War Crimes
Grave breaches of the Geneva Conventions 1949, committed in the course of an armed conflict against persons or property protected by the Conventions, and other criminal violations of the rules of war.

Clarifications of Terms

Use of the term “patient”
Individuals who allege torture and ill treatment are sometimes referred to as “patients” even in the context of medico-legal evaluations.
Physicians/Clinicians
The terms “physician” and “clincician” are often used interchangably in this Curriculum. Keep in mind that psychological evidence may be evaluated by physicians, psychologists and clinical social workers. Physical evidence, however, is evaluated by physicians (medical doctors) only.
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Introduction
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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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