06194nam a2200253 4500001000700000010001500007100004100022101000800063200015800071210006300229300023700292330516200529606002705691606003005718606002805748606002905776606001705805606002105822606002905843606001205872700001805884701001705902701002105919384467 a1874635420 a20070926d2005 y0pory50 ba aeng aMedical investigation and documentation of torturebRecurso eletrónicoea handbook for health professionalsfMichael Peel, Noam LubellgJonathan Beynon aColchestercHuman Rights Centre. University of Essexd2005 aEdição apoiada pelo United Kingdom Foreign and Commonwealth Office. Ficheiro de 2,06 Mb em formato pdf (122 f.). Também disponível através de: https://www.fco.gov.uk/Files/KFile/MidtHb.pdf.Acedido em 26 de Setembro de 2007. aForeword. Acknowledgements. Executive summary. Glossary of specialised terms. 1 Introduction. 1.1 Who is this Handbook for? 1.2 How to use the Handbook. 2 The prohibition of torture. 2.1 Introduction. 2.2 What is torture? 2.2.1 The prohibition in international law. 2.2.2 Definition of torture. 2.2.2.1 Definitions of torture and other ill-treatment. 2.2.2.2 Key elements of torture. 2.2.2.3 Other ill-treatment. 2.2.2.4 Relationship between torture and ill-treatment. 2.2.2.5 The use of the terms ‘torture’ and ‘ill-treatment’ in this Handbook. 2.2.2.6 Forms of torture and other ill-treatment. 2.2.3 The subjective element of suffering. 2.2.4 Additional rules relevant to the prevention of ill-treatment. 2.3 The perpetrators. 2.3.1 State actors (those who act on behalf of the state). 2.3.2 Non-state actors. 2.3.2.1 Protection from third parties. 2.3.3 Obligation to investigate and bring to justice. 2.4 Situations in which torture allegations may arise. 2.4.1 Formal inspection of detention facilities. 2.4.2 Official complaints to human rights bodies and other organisations. 2.4.3 Recently released detainees. 2.4.4 NGO information gathering. 2.4.5 Late allegations. 3 Medical Ethics. 3.1 Introduction. 3.2 Duties of the health professional. 3.2.1 International codes. 3.2.2 Ethical rules directly prohibiting involvement in torture. 3.2.3 Primary loyalty to the patient. 3.2.4 Dual obligations. 3.2.5 The treatment of prisoners and detainees. 3.2.6 Issues surrounding examinations of individuals in the presence of security forces. 3.2.7 Abusive medical treatment. 3.2.8 Consent and confidentiality. 3.2.9 Security. 3.2.10 Involvement of other health professionals in torture. 3.2.11 Seeking further information and support. 4 General guidelines for gathering evidence and documenting findings. 4.1 The aims and goals of investigation. 4.2 Multidisciplinary approach to documentation. 4.2.1 Role of the health professional in the team. 4.2.2 Role of the lawyer in the team. 4.2.3 Role of the NGO member in the team. 4.3 Documenting the allegations. 4.3.1 The aim of medical documentation. 4.3.2 Types of evidence. 4.3.3 Medical evidence. 4.4 Gathering of evidence. 4.4.1 Essential information. 4.4.2 Quality of information. 4.4.3 Comparing records. 4.5 Compiling medical documentation. 4.5.1 Report writing. 4.5.2 Destination. 4.5.3 Content. 4.5.4 Inconsistencies. 4.5.5 Glossary. 4.6 Opinion. 4.6.1 Individual lesions. 4.6.2 Psychiatric assessment. 4.6.3 Overall picture. 5 Interviewing. .1 Introduction. 5.2 Vulnerability of witnesses. 5.2.1 Protecting survivors and witnesses. 5.2.2 Vulnerability. 5.2.3 Interviewing children. 5.3 The environment of the interview. 5.3.1 Physical environment. 5.3.2 Gender considerations. 5.3.3 Cultural and religious awareness. 5.3.4 Time and space. 5.4 The interview itself. 5.4.1 Types of questions. 5.4.2 Cognitive techniques. 5.4.3 Summarising and clarifying. 5.5 Working with interpreters. 5.5.1 Second and third languages. 5.5.2 Gender and age of interpreters. 5.5.3 Local and international interpreters. 5.5.4 Using an interpreter. 5.5.5 Family members. 5.6 After the interview. 5.6.1 Team debriefing. 6 Medical examination and documentation. 6.1 Background. 6.1.1 Medical history taking. 6.2 Common pathologies. 6.2.1 Introduction. 6.2.2 Psychological diagnoses. 6.2.3 Memory. 6.2.3.1 Normal inconsistencies in testimony. 6.2.3.2 Pathological processes. 6.2.4 Early skin lesions. 6.2.4.1 Bruises. 6.2.4.2 Abrasions. 6.2.4.3 Incisions. 6.2.4.4 Lacerations. 6.2.4.5 Burns and scalds. 6.2.4.6 Complex lesions. 6.2.4.7 Interpretation. 6.2.5 Scarring. 6.2.5.1 Keloid scarring. 6.2.5.2 Post-inflammatory hyperpigmentation. 6.2.6 Head injuries and post-traumatic epilepsy. 6.2.7 Fractures. 6.2.8 Joint damage. 6.2.9 Nerve damage. 6.2.10 Electrical injuries. 6.3 Order of examination. 6.3.1 Psychological assessment. 6.3.2 Upper limbs. 6.3.3 Head and neck. 6.3.4 Chest, back and abdomen. 6.3.5 Lower limbs. 6.4 Sexual assault. 6.4.1 Examination of women. 6.4.2 Examination of men. 6.4.3 Perianal examination. 6.5 Investigations. 6.6 Medical photography. 7 Visiting places of detention. 7.1 Why visit places of detention? 7.1.1 Places and stages of detention prone to torture. 7.1.2 Constraints on documentation during visits to places of detention. 7.2 What to assess in a place of detention? 7.2.1 General conditions of detention. 7.2.2 How much time to allow for visits. 7.2.3 Documenting specific methods of torture or other ill-treatment. 7.3 Composition of the visiting team. 7.4 Safeguards for visits. 7.4.1 Choosing which prisoners to talk to. 7.4.2 Privacy of interviews. 7.4.3 Informing and obtaining consent from prisoners. 7.4.4 Touring the premises. 7.4.5 Health services in place of detention. 7.5 What to do with the information? 7.5.1 The use of named or anonymous allegations. 7.5.2 Compiling and using a report of the visit. 7.5.3 Repeating the visits. 8 Further information. 8.1 Organisations. 8.2 Comprehensive works. 8.3 Articles. 8.3.1 General. 8.3.2 Physical examination. 8.3.3 Psychological assessment. 8.4 Documents of international standard setting. Annex: Anatomical drawings. aGUIA DE INFORMAÇÃO aINVESTIGAÇÃO MÉDICA aPROFISSIONAL DE SAÚDE aPERÍCIA MÉDICO-LEGAL aMETODOLOGIAS aRECOLHA DA PROVA aTÉCNICAS DE ENTREVISTA aTORTURA aPEELbMichael aLUBELLbNoam aBEYNONbJonathan