10 A practical guide to the Istanbul Protocol – for lawyers addition coping capabilities, physical health and disabilities, pre-existing psychological disorders, pre-existing personality, genetic and biological vulnerabilities also affect the symptoms of torture. Understanding the physical and psychological effects of torture is vital when lawyers interview victims with a view to submitting criminal or civil claims for torture. It is important for three main reasons: a. To make sure that the lawyers are asking the right questions and collecting necessary information/evidence to assist in building up their case b. To help lawyers understand the psychological consequences that torture victims may suffer (like PTSD) and avoid re-traumatising the victim during the interview, and c. To prepare lawyers on the difficult subject of torture and to understand unexpected “reactions” or “answers” on the part of victims. For detailed guidelines for lawyers on documenting allegations of torture, see the Essex Torture Reporting Handbook, Part II – Documenting Allegations (http://www.essex. ac.uk/torturehandbook/english.htm) and also see Chapter IV of the Istanbul Protocol, General Considerations for Interviews, F. Assessment of the background (http://www. ohchr.org/Documents/Publications/trainin g8Rev1en.pdf). Under the UN Principles of Medical Ethics Relevant to the Role of Health Personnel, Particularly Physicians, in the Protection of Prisoners and Detainees Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment12 it is a “gross contravention of medical ethics” for doctors to engage in acts which constitute participation in, complicity in, incitement to, or attempts to commit torture. However, as recognised by international medical associations, such as the World Medical Association, there is no express obligation on doctors under professional codes of medical ethics to report suspected cases of torture about which they become aware. The World Medical Association recommends that, where possible, doctors report such cases with the victim’s consent, however, where the victim is unable to express him or herself freely, without explicit 13 consent. Both lawyers and doctors must carry out their work in good faith, placing their professional responsibilities over personal or institutional interests. Working together, lawyers and doctors can do their utmost to ensure that investigators conduct investigations into torture allegations fully, impartially and promptly. If lawyers know or have information about another lawyer or a doctor that is not complying with these general duties, they should report them to their medical and legal organisations respectively. If the breach of duty is sufficient to amount to administrative or criminal responsibility they should be reported to the appropriate authorities described. See the section on “effective procedural remedies”, remedies at the national level, later in this guide (e.g. human rights commissions, disciplinary procedures, police complaint mechanisms).