particularly in pre‑trial institutions. This issue has been addressed repeatedly by the CPT, also in recent country visits.36 Notwithstanding its importance, it must be borne in mind that, as a rule, the medical examination on admission, like any other medical intervention, needs the consent of the patient.37 The health‑care personnel are obliged to ofer such an examination; however, the prisoner has the right to renounce it. In cases where the examination is refused, it must be documented in the medical fle of the prisoner. Medical examination after incidents of violence In line with CM Recommendation R (1998) 7 and the CPT Standards, Prison health‑care services may help prevent violence against prisoners by system‑ atically recording injuries and, if necessary, regularly transmitting general information to the competent authorities concerning the problem of violence in prison.38 Medical examinations after incidents of violence provide a fundamental safeguard against ill‑treatment and impunity as well as against inter‑prisoner violence. This relates not only to screening for signs of violence during medical examinations on admission, but also to medical examinations after every inci‑ dent of violence during detention. Any allegation of violence or ill‑treatment has to be recorded, followed by a thorough medical examination, medical documentation of the fndings and the physician’s conclusion, and these must be forwarded to the relevant prosecutor with the consent of the patient as grounds before the court.39 In addition, every incident of violence should be included in the systematic statistical recording of violence, conducted by the health‑care professionals, in order to help the authorities to assess the level of violence in a prison and to draw up preventive measures against violence. Negligence in following these recommendations has been criticised by the CPT during several country visits.40 36. CPT/Inf (2012)1; (2012)9; (2012)17; (2012)19; (2012)21; (2012)32. 37. CPT Standards 2002 (rev. 2011). 38. CPT Standards 2002 (rev. 2011); CPT/Inf (2011)33; (2011)24; (2012)17; (2012)34. 39. CPT Standards 2002 (rev. 2011). 40. Slawomir Musial v. Poland 28300/06, Aerts v. Belgium 25357/94. Medical ethics in prison Page 19