and/or Article 3 (prohibition of torture and inhuman or degrading treatment or punishment) of the ECHR.22 Patients who are dependent on psychoactive drugs are at risk of developing a potentially life‑threatening withdrawal syndrome during their frst days after imprisonment. Therefore, appropriate medical care is needed. The CPT has identifed shortcomings in this regard in several country visits23 and there is at least one case of withdrawal syndrome with a fatal outcome, in the case law of the Court in Strasbourg, that was seen as a violation of Article 3 of the ECHR (prohibition of inhuman and degrading treatment or punishment).24 According to the legislation in many countries, as well as the CPT standards,25 the EPR paragraph 42.3c,26 the Declarations of the World Medical Association (WMA)27 and the Istanbul Protocol,28 a prison physician has the obligation to document signs of violence and particularly any signs of ill‑treatment that she/ he becomes aware of, and report these to the authorities with the patient’s consent. The documentation must be prepared without delay, because phys‑ ical signs of violence disappear with time, and it must be properly presented before a court.29 Such signs should be immediately reported to the relevant authorities in order to prevent the continuation of violence and ill‑treatment. Also, the physical examination on admission should serve to screen for signs of violence or ill‑treatment. Repeated omissions to appropriately do this have been criticised during CPT country visits.30 Allegations of ill‑treatment should be 22. Keenan v. UK 27229/95; Güveç v. Turkey 70337/01; Riviere v. France 33834/03; Renolde v. France 5608/05; De Donder and De Clippel v. Belgium 8595/06; Dybeku v. Albania 41153/06; Ketreb v. France 38447/09; Mouisel v. France 67263/01; Tarariyeva v. Russia 4353/03. 23. CPT/Inf (2004)20; (2006)14; (2007)42; (2012)32. 24. McGlinchey and others v. UK 50390/99. 25. CPT Standards 2002 (rev. 2011). 26. CM: Recommendation Rec(2006)2 on the European Prison Rules. 27. World Medical Association: Declaration of Tokyo. Guidelines for physicians concerning tor‑ ture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment. Tokyo 1975, rev. Divonne‑les‑Bains (2005); World Medical Association: Declaration concerning support for medical doctors refusing to participate in, or to condone, the use of torture or other forms of cruel, inhuman or degrading treatment, Hamburg (1997); World Medical Association: Resolution on the responsibility of physicians in the denuncia‑ tion of acts of torture or cruel or inhuman or degrading treatment of which they are aware, Helsinki (2003). 28. UN: Istanbul Protocol. The manual on efective investigation and documentation of torture and other cruel, inhuman or degrading treatment or punishment (New York/Geneva 2004). 29. CPT Standards 2002 (rev. 2011). 30. CPT/Inf (2009)1; (2009)13; (2009)37; (2010)1; (2010)33; (2011)24; (2012)1. Medical ethics in prison Page 17