Medical evidence is a very important type of evidence as it can add strong support to witness testimony. It is rare for medical evidence to be conclusive – prove with certainty that torture occurred – because:
- Many forms of torture leave very few traces, and even fewer leave long-term physical signs that they ever occurred.
- Injuries or marks which are alleged to have resulted from torture cannot always be distinguished with a high degree of certainty from the effects of other causes.
What medical evidence usually can do is demonstrate that injuries or other clinical findings recorded in the alleged survivor are consistent with or highly consistent with the torture described. Where there is a combination of physical and psychological evidence compatible with an allegation, this will strengthen the overall value of the medical evidence.
When obtaining medical evidence, it is important to be aware of the difference between therapeutic (treating a patient’s symptoms) and forensic (legal) medicine. The objective of forensic medicine is to assist the courts and other appropriate authorities in medico-legal matters, for example, by establishing the causes and origins of injuries. Sometimes both therapeutic and forensic functions are carried out by the same health professionals but, where possible, they should be separated to avoid a possible conflict between the two roles. Failing that, the possible conflict should be recognised and discussed by the clinical evaluator.