Part I: Recognition and usage 14 Medical doctors: the key to prevent impunity By Dr Michael Peel GP Clinical Lead for Hammersmith and Fulham PCT based at HM Prison Wormwood Scrubs Formerly Senior Medical Examiner, Medical Foundation for the Care of Victims of Torture, London Medical doctors are often among the first persons to come into contact with a torture survivor after the incident. It is therefore crucial that doctors possess the skills to provide proper treatment and documentation of the mental or physical injuries. To be effective, doctors must know what questions to ask, which physical and psychological signs to look for, and how to present the findings in a format making them admissible as evidence in court cases. One of the purposes of the Istanbul Protocol is to advise doctors and other clinicians about their involvement in the prevention of torture, and particularly in documenting its consequences. Due to their expertise, doctors are essential facilitators in any campaign against torture. Doctors can write medico-legal reports (MLRs) based on examinations of survivors to be used as evidence of acts of torture for a number of purposes. Doctors can also provide therapeutic services to survivors for their immediate and long-term physical conditions, and inform people about these processes. Finally they can provide education on the ineffectiveness of torture and its moral and ethical consequences; also they can advocate for disciplinary processes and, if necessary, legal processes to be commenced against colleagues who have been involved in torture. Medico-legal report writing Clinicians can write MLRs for a number of purposes. These include supporting those claiming assault by state agents, those seeking redress from institutions and governments, those seeking asylum in safe countries, and those documenting allegations of widespread ill-treatment for national and international human rights monitors. MLRs cannot in themselves prove torture since the definition of torture includes other elements of crime such as the requirement that it is performed by or with the acquiescence of a