Ethical Codes, Cultural Relativism and Confidentiality as a combination of four key elements: information, competency, voluntariness and consent. According to the Istanbul Protocol, ‘physical examination for evidence purposes in an inquiry requires consent in the sense that the patient understands factors such as how the health data gained from the examination will be used, how it will be stored and who will have access to it’ 13. The patient should understand the objectives of the examination, the process, the use of evidence, the roles of each of the team members (including the interpreter), the possibilities and the limitations of the mission, and the possible outcomes and consequences. Valid informed consent should also be obtained for photographic documentation of injuries, samples collection and audio recordings of interviews. The consent should be reflected in a form signed by the patient and the examiners. See Annex 5 for further information and templates of two different consent forms. Where relevant, the form(s) should be translated into the local language prior to the examination. Where possible, it is advisable to consult a legal practitioner in the relevant jurisdiction to ensure valid consent for use in future legal proceedings. d. Confidentiality All those involved in the mission, including non-medical staff involved in the facilitation of practicalities of the mission, should be conscious of the sensitivity of the mission. Their obligations related to confidentiality should be specified in the contract (Annex 3). There should be a careful assessment of what information can and what cannot be shared with people outside the team. A well-meant advocacy or awareness raising initiative, or a simple slip of the tongue can be detrimental to the mission, the success of the case, and sometimes the safety of persons involved. Additionally, the fundamental ethical principle of doctor-patient confidentiality implies that, as a general rule, the examination should be conducted in private with the sole presence of the medical team and, where relevant, the interpreter. The alleged victim may specifically request the presence of a particular third person but even in this case it is advisable for the team to spend a few minutes alone with the examinee and, if necessary, an independent interpreter. For further information on the modalities of the examination, see Chapter 6. e. Impartiality The medical team carrying out a forensic examination is bound by principles of impartiality and independence. In practical terms this means that they should refrain from public comment on the case while it is ongoing, and only have professional interaction with the alleged victims and others involved in the case. Thus, for example, the team should not 15