7. The autopsy report 268. The autopsy report should be sufficiently comprehensive for another forensic doctor, at another time and place (and supported by access to the photographs) to be in possession of all the relevant observations required in order to come to his or her own conclusions about the death. At the end of the autopsy report should be a summary of the findings, including the results of special tests. In addition, the prosector should provide his/ her opinion about the identity of the deceased, and injuries and disease present, attributing any injuries to external trauma, therapeutic efforts, post-mortem change, or other ante-mortem, perimortem, or post-mortem causes. As mentioned above (see Paragraph 151), an opinion as to how the injuries might have been caused, and whether they caused or contributed to the death, should be provided. Reasonable, evidence-based conclusions about the circumstances of the death (including where appropriate the manner of death) should be made. Finally, the formal cause of death, as discussed above, should be provided and explained. The full report should be given to the appropriate authorities and (except if they are implicated in the cause of the death) to the deceased’s family. 8. Autopsy signs of possible torture 272. Notwithstanding the aide-memoire, it is crucial that as part of the autopsy examination the prosector should detect, photograph and record in writing all injuries, whether old or recent. This means recording their site, size, shape, symmetry, surrounds, colour, contour, surface (scaly, crusty, ulcerating), course, direction, depth, any associated bruising or oedema and any surrounding pallor/melanosis. Much torture will be missed if there is not an inquiring approach to the autopsy. There should be a willingness to undertake subcutaneous disSection – it is a wellknown principle of forensic medicine that deeper injury is often not visible externally and must be sought. Fractures and dislocations may occur in relatively unusual places for autopsy disSection — often the limbs and the facial bones. Again, these will be missed if not searched for. For these reasons, if whole-body cross-sectional scanning (e.g. CT scanning) is available, its use should be very seriously considered, even if it means having to transport the body to another location. 273. In the conclusions of the report, comments should be made both on the overall pattern of the injuries (the number and location of different injury types) and what this might mean, and also on individual injuries with sufficient specificity to suggest their cause. 269. Torture, in brief, is the intentional infliction of severe mental or physical pain or suffering by or with the consent of State authorities for a specific purpose.119 270. Forensic doctors are at the forefront of detecting torture, and never more so than when undertaking the autopsy of a person who has died in the custody of the State. 271. This Section has extracted much of the information in Table 2 (overleaf) from both the original Minnesota Protocol and from the Istanbul Protocol: Manual on the Effective Investigation and Documentation of Torture and other Cruel, Inhuman or Degrading Treatment or Punishment.120 It is intended as an aide-memoire for forensic doctors who may be about to undertake the autopsy of a potentially unlawful death where the deceased has been, or may have been, in the custody of the State. The annex is not a comprehensive list of all the signs of torture or mistreatment that could occur. In particular it does not cover the myriad effects of neglect (including deprivation of food and water) and withholding medical care. 46 119 At: http://www.ohchr.org/EN/ProfessionalInterest/Pages/CAT.aspx. Art. 1 of the 1984 UN Convention Against Torture defines torture as: “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.” 120 At: http://www.ohchr.org/Documents/Publications/training8Rev1en.pdf. The Minnesota Protocol on the Investigation of Potentially Unlawful Death (2016)