ill-treatment), (ii) a full account of objective medical findings based on a thorough examination, and (iii) the doctor’s conclusions in the light of (i) and (ii), indicating the degree of consistency between any allegations made and the objective medical findings. Whenever injuries are recorded which are consistent with allegations of ill-treatment made, the record should be systematically brought to the attention of the relevant authority. Further, the results of every examination, including the above-mentioned statements and the doctor’s conclusions, should be made available to the detained person and his lawyer. The CPT also wishes to stress that all medical examinations should be conducted out of the hearing and – unless the doctor concerned expressly requests otherwise in a particular case – out of the sight of law enforcement officials and other non-medical staff.” 66 Medical professionals must balance their responsibilities towards their patients with those they bear to society at large. This may result in dilemmas, for example, where the victim has not requested or consented to the reporting of evidence of ill-treatment. The Istanbul Protocol acknowledges this problem. It underlines the need for a case-by-case approach. The protocol advises that allegations could be reported in a non-identifiable manner or remitted to a responsible body outside the immediate jurisdiction.”67 Equally, the Istanbul Protocol has recognised that medical personnel: “. . . may discover evidence of unacceptable violence, which prisoners themselves are not in a realistic position to denounce. In such situations, doctors must bear in mind the best interests of the patient and their duties of confidentiality to that person, but the moral arguments for the doctor to denounce evident maltreatment are strong, since prisoners themselves are often unable to do so effectively. Where prisoners agree to disclosure, no conflict arises and the moral obligation is clear. If a prisoner refuses to allow disclosure, doctors must weigh the risk and potential danger to that individual patient against the benefits to the general prison population and the interests of society in preventing the perpetuation of abuse.”68 The CPT has recently put forward a solution to these dilemmas. In its 23rd General Report it has proposed a new standard according to which: 66. CPT’s Report on the visit to Azerbaijan carried out from 24 November to 6 December 2002, CPT/Inf (2004) 36, para. 26. See also the CPT’s Report on the visit to Albania carried out from 13 to 18 July 2003, CPT/Inf (2006) 22, paras. 45-49; the CPT’s Report on the visit to Lithuania from 17 to 24 February 2004, CPT/Inf (2006) 9, para. 96. 67. See paras. 68-70, 72-73 of the Istanbul Protocol. 68. Ibid, para. 73. Effective investigation of ill-treatment – Guidelines ► Page 34