A/68/295 medical examinations are not conducted in a superficial manner and to act diligently so as to ascertain the condition of the person examined, allowing that person to freely communicate with the physician (see CAT/OP/MEX/1, paras. 132, 133, 135, 172 and 173). Medical examinations should be thorough enough to detect any psychological consequences of torture or propensity to commit suicide. Furthermore, Rule 24 should insist on the obligation of medical personnel to detect, treat, properly document and refer to the authority responsible for investigating allegations of torture or other ill-treatment any signs of torture or other ill-treatment or any case where there are allegations or reasonable grounds to believe that torture or other ill-treatment may have occurred prior to admission or while in detention (see the Principles on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, annex, paras. 6 (a) and (c)). 54. Furthermore, the Rules should be reformulated to integrate principles of clinical independence and medical ethics, as well as principles of equality and non-discrimination: the requirement to respect the autonomy of patients, the need for the informed consent of the person concerned (Convention on the Rights of Persons with Disabilities, art. 25 (d)) and confidentiality, including with regard to HIV testing, the reproductive health of inmates and their medical files (see the United Nations Rules for the Treatment of Women Prisoners, rule 8). 7 In addition, the Rules should include an express recognition that persons deprived of liberty must always have access to adequate health care, including adequate medical, psychiatric and dental care and medication. Persons deprived of liberty should have access to a level of health care that is equivalent to that available to the general population. Currently, Rule 22 (1) already stipulates that prison health services should be organized in close cooperation with the general health administration of the community or nation, and the World Health Organization (WHO) has stated that prison health policies must be integrated into national health policies. 8 To achieve this, prison health-care services should be integrated under the ministry of health. 55. The Rules should adopt special measures to address the particular health needs of persons deprived of liberty belonging to vulnerable or high-risk groups (see para. 47 above). The Rules should allow the prison administration to facilitate the compassionate release of terminally ill persons on the ground of their health status. 56. Finally, the Special Rapporteur emphasizes that health professionals must not, under any circumstance, consent or acquiesce to torture or other ill-treatment, let alone take active part in any such ill-treatment (Principles of Medical Ethics, principles 2 and 3, and the Ethical Principles for Medical Research Involving Human Subjects). Such prohibition extends to such practices as examining detainees to determine their “fitness for interrogation”, as well as to providing medical treatment to ill-treated detainees so as to enable them to withstand further abuse (E/CN.4/2003/68, para. 26 (n)). It is important that the Rules exclude the involvement and role of health-care personnel in any disciplinary or security-related measures (Rule 32 (1)). Medical personnel shall, nonetheless, closely monitor the mental and physical health of inmates undergoing punishment and visit them as deemed medically necessary or upon the request of the person deprived of liberty. __________________ 7 8 14/23 World Health Organization (WHO), “WHO guidelines on HIV infection and AIDS in prisons” (Geneva, 1993). WHO, Health in Prisons: A WHO Guide to the Essentials in Prison Health (2007). Available from www.euro.who.int/__data/assets/pdf_file/0009/99018/E90174.pdf. 13-42285