Human rights experts from the three UN anti-torture mechanisms* have urged States members to provide the necessary material and legal conditions to enable health personnel to assess, report and document torture, cruel or inhumane treatment. On the occasion of the International Day in Support of Victims of Torture, they issued the following joint statement emphasising the vital functions of healthcare professionals in preventing and punishing acts of torture and supporting victims:
“Medical and healthcare professionals have a critical role to play in preventing and holding States accountable for torture and rehabilitating torture survivors.
General practitioners, forensic doctors, nurses, psychiatrists, psychologists, physiotherapists and other healthcare professionals are often the first to detect signs of torture through their daily contact with patients or when certifying deaths. As they can closely inspect and observe the physical and mental conditions of people deprived of liberty, they are in an important position to prevent and report any form of torture and to provide health care to the victims.
To effectively prevent torture, a holistic approach is needed as it gives practitioners insight into the effects of torture upon individuals, their families and communities, a knowledge to deal with these effects and a duty to address this gross human rights violation.
Victims of torture have a right to full rehabilitation, as stated in Article 14 of the Convention against Torture. Healthcare professionals are essential in restoring and repairing the harm suffered by victims.
On this International Day in Support of Victims of Torture, we recall that Member States should provide all necessary material and legal conditions for health personnel to fulfil their professional responsibilities. Unequivocal support and specialised training are of paramount importance. In particular, States should guarantee that all persons deprived of liberty have access to an independent and confidential medical examination. States parties should also involve health care professionals in developing and implementing anti-torture strategies and policies. In times of armed conflict, medical staff must be protected in all circumstances under customary rules of international humanitarian law.
‘States must ensure that all detainees have medical examinations immediately after arrest. Authorities also need to document and investigate torture and its sequelae in order to prevent its recurrence and to fight impunity,’ said Suzanne Jabbour, Chairperson of the Subcommittee on Prevention of Torture. ‘It is fundamental to make perpetrators accountable for their actions and provide justice and rehabilitation to the victims,’ she added.
Documenting torture is often a prerequisite for obtaining justice, asylum, rehabilitation and care and can be therapeutic in acknowledging victims’ experiences. The Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (The Istanbul Protocol), initially published in 2001, provides international guidelines and standards for documentation. The Office of the High Commissioner for Human Rights will launch a revised version of the Manual at the end of June to include a new chapter on the role of health professionals in documenting cases of torture and the importance of high-quality medical findings as evidence in criminal and administrative proceedings. It also guides States to fulfil their treaty obligations under the Convention against Torture and as a jus cogens norm of international law. States parties are encouraged to widely disseminate the revised version amongst healthcare professionals, law-enforcement officials and judicial personnel.
‘Medical professionals are also responsible for reporting the abuse they witness and assisting victims without any undue pressure or reprisals. The Committee against Torture often recommends that the States parties eliminate risks of reprisals and ensure protection to the health practitioners. The Committee also routinely refers to the Istanbul Protocol to guide the States parties on conducting effective torture investigations and gathering evidence to establish redress for victims,’ said Claude Heller, Chairperson of the Committee against Torture.
In the report on the role of forensic and medical sciences in the investigation and prevention of torture and other ill-treatment, the former Special Rapporteur on Torture underlined the necessity of maintaining a close cooperation between health and legal professions for an effective investigation of alleged cases of torture. It is also important to establish clear documentation procedures for the incidence of torture that could serve as valid evidence in court to ensure accountability.
‘At the United Nations Voluntary Fund for Victims of Torture, we have witnessed the life-altering and often chronic consequences of torture on survivors’ mental and physical health that can be transmitted across generations. The need for immediate and long-term specialised health care and psychosocial rehabilitation are essential to overcoming trauma and rebuilding connections. We express our profound admiration for healthcare professionals who provide services to survivors and sometimes risk their own safety in situations of shrinking civic space or armed conflict,’ said Lawrence Mute, Chairperson of the Fund.
For healthcare professionals to fully embrace their essential role in preventing torture and contributing to accountability and redress, States should ensure the necessary education and training for health professionals and medical students.
Health professionals have a special responsibility to share experiences and information about the health consequences of torture, including the destructive character of the practice on victims’ health, its damage to the broader community and requirements to help overcome trauma to reconstruct their lives.”