It is a contravention of medical ethics for health personnel, particularly physicians: (a) To apply their knowledge and skills in order to assist in the interrogation of prisoners and detainees in a manner that may adversely affect the physical or mental health or condition of such prisoners or detainees and which is not in accordance with the relevant international instruments; (b) To certify, or to participate in the certification of, the fitness of prisoners or detainees for any form of treatment or punishment that may adversely affect their physical or mental health and which is not in accordance with the relevant international instruments, or to participate in any way in the infliction of any such treatment or punishment which is not in accordance with the relevant international instruments. [principle 4] It is a contravention of medical ethics for health personnel, particularly physicians, to participate in any procedure for restraining a prisoner or detainee unless such a procedure is determined in accordance with purely medical criteria as being necessary for the protection of the physical or mental health or the safety of the prisoner or detainee himself, of his fellow prisoners or detainees, or of his guardians, and presents no hazard to his physical or mental health. [principle 5] There may be no derogation from the foregoing principles on any ground whatsoever, including public emergency. [principle 6] Rule 22 of the Standard Minimum Rules for the Treatment of Prisoners provides: (1) At every institution there shall be available the services of at least one qualified medical officer who should have some knowledge of psychiatry. … IMPLICATIONS The role of the medical officer in a prison or place of detention is extremely sensitive. The medical officer is the one person in the institution whom the director cannot tell what to do in respect of his or her professional duties. The primary relationship of the medical officer with the prisoner is that of doctor to patient. This means that issues of medical confidentiality between doctor and patient must be respected. The medical officer must be particularly careful not to be involved in any way in the disciplining or punishment of prisoners or in restraining a prisoner for any reason other than a medical one. 73