CAT/OP/PRT/1 strike. The Subcommittee noted with great concern that even some hospitals, such as the psychiatric hospital of Coimbra, might not have doctors available round the clock. The delegation observed situations in which patients were assessed and medication was prescribed by nurses without the presence of a doctor. In the case of hunger strikes in Porto Prison, nurses measured blood pressure, blood sugar, urine and weight and the doctor made an assessment on the basis of those parameters without seeing the inmates. 84. Some overmedication was noted, for example in the psychiatric hospital of Coimbra and in Porto Prison, with inmates allegedly being given medication as a form of control of disruptive or self-harming behaviour, but possibly to compensate for shortage of staff. Inmates reported that the concept of informed consent for medications was generally not applied. In one psychiatric unit, for example, the delegation encountered a case of a young man who stated that he had to accept an injection as a condition for ending his court order, without having the side effects of such treatment explained to him. Such forms of duress are likely to be degrading for patients. 85. The Subcommittee recommends that the State party ensure that all inmates receive adequate medical attention from doctors, that medication is not used as a form of control to compensate for a shortage of staff and that informed consent for treatment is systematically sought. 86. The Subcommittee notes that all the places visited request the support of the national institute for medical emergencies in case of a medical emergency. Only psychiatric hospitals have medical devices (defibrillators) for emergency situations and staff trained in their use. 87. The Subcommittee recommends that the State party expand the provision of medical devices and supplies, such as defibrillators, to be used in medical emergencies and the associated training for staff to all places of detention in order to ensure that such help can be provided promptly. B. Medical screening and examination 88. The Subcommittee welcomes the new system in place that seeks to check the coherence between a detainee’s testimony regarding injuries sustained during arrest or transfer, at the police station or in prison, on the one hand, and the doctor’s physical examination, on the other. The Subcommittee is concerned, however, that detainees who are injured either at the time of arrest or later at police stations are not automatically referred to or examined by a doctor. The delegation was informed that it was up to the arrested person him or herself to request to see a doctor if they felt they needed one. While initial medical screening is normally conducted upon arrival in prisons, it appears that it is often conducted in the presence of police officers or guards, denying the detainees the right to confidential examination. This creates the risk that the person arrested will not provide all the information about possible injuries for fear of reprisals. In only one of the places visited did the delegation find a confidential registration system for injuries. 89. Furthermore, the delegation observed that records of the initial medical screening did not always include all the necessary details, especially with regard to the description of existing injuries and the circumstances under which they had been sustained. Moreover, results of the initial medical screening were not always recorded comprehensively in the medical files of detainees. The delegation noted a lack of awareness of and lack of training for doctors and nurses on the concept of torture and ill-treatment and the Istanbul Protocol. 90. The Subcommittee wishes to emphasize that medical examinations of persons admitted to detention centres and the proper reporting of injuries found during those examinations constitute important aspects of the process of preventing torture and illtreatment and in combating impunity. 16 Such examinations and registries can also protect police officers and prison staff against false allegations. 16 Committee against Torture, general comment No. 2 (2007) on the implementation of article 2, para. 13. 15