A/69/387 27. The Special Rapporteur has also observed that often judges wrongfully establish prerequisites, such as visible or recognizable marks, before ruling that evidence obtained under torture or other ill-treatment is invalid. This is particularly worrisome in jurisdictions where there is a lack of independent medical examinations, because generally in such countries there is ample opportunity to delay authorization for an examination. Detainees are held for long periods in unacknowledged detention until the signs of torture have disappeared, instead of being promptly brought before a judge and transferred to, for instance, a pretrial detention facility. As a result, even if forensic examination might identify some signs of torture or other ill-treatment, it may fail to establish the time of the abuse or its cause. 13 28. There is a presumption of ill-treatment in detention if an individual’s injuries were not present at the time of arrest. 14 The European Court has stated in this regard that “[w]here an individual, when taken in police custody, is in good health, but is found to be injured at the time of release, it is incumbent on the State to provide a plausible explanation of how those injuries were caused, failing which a clear issue arises under article 3 of the European Convention”. 15 Therefore, rules of evidence should reflect the difficulties of substantiating allegations of ill-treatment in custody. 16 4. Medical ethics 29. According to medical ethical standards, health professionals have the obligation not to participate actively or passively in torture or other ill-treatment. 17 No obligation to a third party can override the duty to protect the individual from torture or other ill-treatment and to report such cases. 18 The World Medical Association has held that health professionals should be made aware of their ethical obligations, including the need to report torture and other ill-treatment, to maintain confidentiality and to seek the consent of victims prior to examination. Victims must __________________ 13 14 15 16 17 18 8/23 See A/HRC/22/53/Add.1, para. 55. See CAT/C/CR/29/1, para. 4 (a); see European Court of Human Rights, Aksoy v. Turkey (app. no. 2198793), 18 December 1996, para. 61. See European Court of Human Rights, Tomasi v. France, Series A No. 241-A, and European Court of Human Rights, Selmouni v. France (app. no. 25803/94), 28 July 1999. See European Court of Human Rights, Mammadov (Jalaloglu) v. Azerbaijan (app. no. 34445/04), 11 April 2007, paras. 60-67. See World Medical Association Declaration of Tokyo, setting out the Guidelines for Physicians Concerning Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment in Relation to Detention and Imprisonment (1975); the World Medical Association Declaration of Geneva: International Code of Medical Ethics; the World Medical Association Declaration of Hamburg concerning Support for Medical Doctors Refusing to Participate in, or to Condone, the Use of Torture or Other Forms of Cruel, Inhuman or Degrading Treatment (1997); the World Medical Association Resolution on the Responsibility of Physicians in the Documentation and Denunciation of Acts of Torture or Cruel or Inhuman or Degrading Treatment (20 03); and the United Nations 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 Punishment. See United Nations Standard Minimum Rules for the Treatment of Prisoners; the United Nations Rules for the Treatment of Women in Prison (the Bangkok Rules); the World Medical Association Declaration of Malta on Hunger Strikes; the World Medical Association Declaration of Edinburgh on Prison Conditions and the Spread of Tuberculosis and Other Communicable Diseases (2011). 14-61535