doctors) to have training on the Istanbul Protocol. This poses a significant issue, as a lack of trained doctors on-site can lead to delays in the detainee being able to access a forensic medical examination, during which time evidence of torture may fade. Timely examinations are crucial to preserving and documenting evidence of torture, and the results can be given to a forensic medical expert if a separate examination is also conducted. Despite this, medical staff often do not take steps to preserve evidence. Victims would be in a considerably stronger position if police officers, prison wardens, hospital administrators, prosecutors and judges were under a legal obligation to request proper forensic medical examinations as a standard procedure whenever there are suspicions or allegations of torture or other ill-treatment.288 In one Central European OSCE participating State, medical staff rarely take photos of a detainee’s injuries, because they are not legally obliged to do so, and a forensic medical expert is usually appointed months after the criminal complaint has been filed against a police officer, by which point visible marks of ill-treatment may have disappeared.289 In other countries photographs must be taken of injuries during the medical examination, which is an important step in the proper documentation of cases of torture as described above.290 124. In one other OSCE participating State, additional legal barriers to accessing a forensic medical examination were reported. For example, situations where a lawyer must submit an official request for a detainee to receive a forensic medical examination, which must be approved by the investigator, prosecutor or judge participating in the case. In practice, such requests are rarely granted and are considered over a long period of time, meaning access is delayed and evidence is not preserved.291 125. The institutional independence of forensic medical institutions and medical staff is a core element for the effective documentation of torture or other ill-treatment and for the subsequent investigation, prosecution, and punishment of perpetrators. While much progress has been made in recent years in terms of scientific advances, medical standards, and in legal norm-setting, the impact of forensic medical science is undermined by a lack of institutional independence, rigorous implementation and sufficient training. As the UN Special Rapporteur on Torture has noted, “health professionals tasked with the medico-legal evaluation of alleged victims of torture, with investigations into deaths in custody and with providing 288 Interim report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, op. cit., note 282, para. 60. 289 Questionnaire response Hungarian Helsinki Committee (2019). 290 Questionnaire response Macedonian Young Lawyers Association (2019). 291 Questionnaire response Nota Bene (Tajikistan) (2019). 80