Another factor that facilitates the persistence of torture is a failure by states to conduct prompt and independent forensic medical examinations of those who allege torture. Independent medical examinations play an essential role in criminal investigations into acts of torture, in seeking compensation and in excluding evidence obtained by torture from proceedings. Detainees often have difficulties accessing medical examinations in line with the standards set out in the Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (the Istanbul Protocol),7 and within appropriate time limits, due to a lack of forensically trained doctors. In addition, some countries require law enforcement officials to be present during medical examinations, contrary to international standards. This threatens the safety of detainees and medical practitioners who report torture, reducing their willingness to do so. Each of these issues represents an incentive or factor that is conducive to torture and other ill-treatment. Each section of this publication includes detailed policy recommendations on how to effectively address and eliminate these factors and incentives. 7 8 UN HIGH COMMISSIONER FOR HUMAN RIGHTS, Geneva, PROFESSIONAL TRAINING SERIES No. 8/Rev.1, 2004 “Istanbul Protocol, Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment”.