Medical doctors: the key to prevent impunity state agent, and for a specific purpose. Therefore, the final determination as to whether torture has occurred must be made by a judicial body, which is capable of also assessing these additional elements of the incident. However, an MLR can corroborate an account of ill-treatment given by a survivor, and can sometimes provide a high level of proof that a particular technique has been used. Since ill-treatment is the essential element of the torture crime, the MLR takes a very important role in facilitating redress and reparation for torture survivors. To achieve this, doctors need to work closely with lawyers advising survivors of torture to demonstrate collectively that torture has occurred. Help can also be drawn from other sources such as NGOs and national and international bodies investigating allegations of torture. The medical assessment and conclusions The MLR must be based on both a physical and psychological evaluation of the survivor. This evaluation must be conducted according to the guidelines provided by the Istanbul Protocol. The account of events provided by the survivor can suggest parts of the body or mental state of the person where the examination should focus. This could be shoulder movements after suspension, damage after falanga (repeated beating of the feet) or specific behaviour associated with different forms of psychological torture. Further details on relevant symptoms can be found in the Istanbul Protocol. However, it is important to conduct a full medical examination of the survivor as there may be injuries of which he or she is unaware, perhaps because they are on a part of the body that he or she cannot see, or because they were caused towards the end of an episode in which the survivor lost consciousness. When medical conclusions are drawn on the basis of the physical and psychological evaluation of the survivor it is very important that these are accurate and maintain a high level of objectivity. It is important to remember that the doctor is collecting evidence and does not function as a judicial body. This implies that any absence of medical evidence should not be construed as an indication that torture has not taken place. The Istanbul Protocol recommends the use of the following terms to give an opinion on individual lesions: 15

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