- In which of the following contexts may expert medical reports and testimony be of value?
- Prosecution of alleged perpetrators
- Challenging the credibility of statements extracted by torture
- Reparations and rehabilitation of alleged victims
- Exonerating law enforcement officials accused of torture and ill treatment
- Human rights investigations
- Medical assessments of asylum applicants
- All of the above
- Regardless of the context of a medical evaluation, the purpose of written reports and oral testimony by medical experts is to assess the degree to which physical and psychological findings correlate with the individual allegations of abuse.
- True
- False
- Which of the following may be relevant qualifications for medical expertise on physical and/or psychological evidence of torture?
- Medical education and clinical training
- Psychological/psychiatric training
- Experience in documenting evidence of torture and Ill-treatment
- Relevant training courses and seminars
- Relevant publications and presentations
- All of the above
- Physicians who are not psychiatrists may qualify as experts on psychological evidence of torture and ill treatment:
- True
- False
- Clinicians should not review the alleged victim’s affidavit as it may create a bias for the evaluating clinician.
- True
- False
- Which of the following are true about written reports and oral testimony?
- They require accurate and effective communication skills
- They should be factual and carefully worded; jargon should be avoided
- They should not include any opinion(s) that cannot be defended under oath or during cross-examination
- The quality can only be as good as the interview and examination conducted
- All of the above
- Which of the following sources of information should not be used as a reference to a medical evaluation or torture and ill treatment?
- Client affidavit of alleged torture and ill treatment
- NGO (non-governmental organization) Human rights reports
- Government reports on torture and ill treatment practices
- Medical records following the alleged torture and ill treatment
- None of the above
- Written reports and oral testimony represent an opportunity for clinicians to educate adjudicators on physical and psychological evidence of torture and ill treatment.
- True
- False
- Clinicians who are conducting their first medical evaluation may enhance the accuracy and credibility of their evaluation by conducting the evaluation under the supervision of, or having it formally reviewed by, a more experienced clinician.
- True
- False
- Historical information such as descriptions of torture devices, body positions and methods of restraint, descriptions of acute and chronic wounds and disabilities, and identifying information about perpetrators and the place(s) of detention may be very useful in corroborating an individual’s allegations of torture.
- True
- False
- The need for medical and/or psychological care should be noted in your medical evaluation only when the alleged torture victim’s attorney requests it.
- True
- False
- The clinician’s interpretation of findings and conclusions, should relate various categories of evidence, i.e., physical and psychological evidence of torture, and historical information as well.
- True
- False
- Which of the following considerations support the clinical assessments of credibility and argue against the possibility of malingering or simulation?
- Lack of over-endorsement of physical and/or psychological symptoms
- Lack of a suspiciousness or defensiveness
- Consistency between the observed affect of the interviewee and the content of the evaluation.
- Consistency between an individual’s pre-torture personality and the meaning the individual assigns to his or her torture/ill treatment experiences
- Inconsistencies that are attributable to an individual’s torture experience
- All of the above
- Exaggeration of psychological symptoms usually indicates that the individual’s allegation of torture and ill treatment are false.
- True
- False
- Which of the following may be helpful in explaining inconsistencies in the alleged victim’s account of torture and ill treatment?
- Disorientation during torture, blindfolding, drugging, and lapses of consciousness
- Neurological or psychological memory disturbances
- Feelings of guilt or shame
- Cultural differences in the perception of time
- Lack of trust in the examining clinician and/or interpreter
- Fear of reprisals
- Lack of privacy during the interview
- All of the above
- It is often helpful to include a statement on the veracity of testimony in a written medical report, such as: “I personally know the facts recited below, except as to those stated on information and belief, which I believe to be true.”
- True
- False
- The presence of diagnostic criteria for PTSD or Major Depressive Disorder (MDD) provides stronger evidence of torture and/or ill treatment than sub-threshold symptoms of these diagnoses.
- True
- False
- Which of the following are important considerations for clinicians who provide testimony on torture and ill treatment in court?
- Do not “react” to provocative statements.
- Clarify questions that you do not understand before providing an answer.
- Do not offer opinions on subjects about which you are not qualified to comment.
- Speak clearly, slowly, and make eye contact with whomever you are speaking.
- All of the above
- Which of the following can help to distinguish psychological symptoms caused by torture and ill treatment versus other traumatic experiences or losses?
- Temporal relationships between the onset of psychological symptoms and the alleged torture and ill-treatment
- Trends in psychological symptoms in relation to external stressors
- Content of nightmares and intrusive recollections
- Triggers for intrusive recollection, reliving experiences, and avoidance reactions
- All of the above
- Istanbul Protocol guidelines for medical evaluations of alleged torture and ill treatment include a formal assessment of the individual’s credibility.
- True
- False
Search
-
- Preface
- Introduction
- 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
- 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
- Torture
- Module 2: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
- The Istanbul Protocol
- An Overview of the Istanbul Protocol
- 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
- Documenting the allegations
- Module 2 Presentation: Istanbul Protocol Standards for Medical Documentation of Torture and Medical Ethics
- Self-Assessment and Quiz
- 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
- 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
- Preliminary Considerations
- 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
- Module 4 Presentation: Torture Methods and their Medical Consequences
- Self-Assessment and Quiz
- Module 5: Physical Evidence of Torture and Ill-Treatment
- Module 6: Psychological Evidence of Torture and Ill-Treatment
- Module 7: Case Example #01
- Module 8: Case Example #02
- Module 9: Report Writing and Testifying in Court