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Part III: Paths forward
harm is minimised while justice is maximised. The
Istanbul Protocol entails special provisions on how to
avoid retraumatisation of victims.
d. The need for comprehensive medical examinations versus
constraints on time and resources. A thorough history
of a torture allegation coupled with a detailed physical and psychological evaluation naturally increases
the value of a medical report as evidence for the allegation. The Istanbul Protocol provides comprehensive
guidelines on how to develop these elements. However,
in real-life situations where doctors may have limited
resources and time with each patient, the standards in
the Protocol cannot always be fully implemented. In
such cases “best available practice” must be applied.
The Istanbul Protocol emphasises that its guidelines
are not fixed; rather they represent minimum standards that should be applied while taking into account
available resources. In countries where torture is
common practice, decision-makers and government officials often narrow the problem down to “a few rotten
apples” in the system and/or excuse themselves with
e.g. lack of laboratory capacity or forensic equipment
to undertake proper documentation. However, states
are obliged to give high priority to all cases of alleged
torture regardless of the means at hand to document
and pursue them, and excuses of this kind therefore
cannot justify stalling or abandoning such cases.
e. The need for general knowledge and collaboration
versus specialised expertise. Government officials as
well as health and legal professionals who meet torture
survivors in their daily work must know their obligations and be adequately trained to address the needs
of this specific group. But as mentioned, in many countries the skills and knowledge required to investigate
and document torture are scarce. Moreover, ensuring
effective training can be challenging. While different groups within the medical and legal professions
should be brought together – and trainings should be
multidisciplinary - to enhance mutual understanding
and collaboration, hierarchical structures and adher-
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