2 Torture

Torture is the infliction of severe pain or suffering, physical or mental, by or at the instigation of a public official, for a purpose such as obtaining information or a confession. Three consequences follow for the medical examiner: Documentation must be complete and contemporaneous — history, examination findings, photographs, and the person's own account in his words. The examination must be independent — a doctor in the employ of the detaining authority cannot certify the absence of injury without a procedure that guarantees independence. The findings must be described, not concluded — "two parallel linear scars consistent with a heated object" is medical evidence; "the detainee was tortured" is the court's finding. The standard protocol for this examination (known as the Istanbul Protocol) sets out the structure: consent and confidentiality, the clinical history, the physical examination, the interpretation of findings in the light of the person's account, and the report.