forensic evidence in criminal proceedings must enjoy organizational, institutional and functional independence from the police, judiciary, military and prison services. The law and practice must ensure that they act in full impartiality.”292 126. In order to ensure the independence, efficiency and effectiveness of investigations and to include specialized independent institutions and national and international experts, the Istanbul Protocol refers to an “investigative authority” to investigate torture claims. The lack of an established independent body to carry out medical examinations should not, however, be used as an excuse to deny access to medical examinations, thereby contributing to impunity for torture and other illtreatment. The independence of medical staff can be compromised in a number of ways, such as in cases where they are employed by the same ministry as the police, which may create a conflict of interest. In some OSCE participating States, medical examinations of detainees are not performed by an independent body or specialist, but by penitentiary medical staff.293 In others, forensic medical examinations are carried out by professionals within the Ministry of Health.294 However, even where medical staff are employed by a separate ministry, penitentiary medical staff who work alongside detention officers or police officers may allow these professional ties to impact their independence and, in some cases, they may collude with wardens of penal colonies to cover up allegations of torture.295 127. Another factor that affects the independence of medical examinations is the presence of law enforcement officials. As has been emphasized by the CPT, in order for medical examinations to be impartial, they should be conducted out of the sight and hearing of law enforcement officials.296 Despite this, there have been reports from across the OSCE region of law enforcement officials remaining present during medical examinations.297 In one OSCE participating State in South-Eastern Europe, the CPT found that medical examinations were carried out in the presence of police officers, who were often the same police officers who had allegedly 292 Interim report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, op. cit., note 280, para 62. 293 Questionnaire response Armenia Helsinki Association (2019). 294 For instance in Kyrgyzstan, Romania and Tajikistan. 295 Questionnaire response Public Verdict Foundation (2019). 296 CPT, “Developments concerning CPT standards in respect of police custody,” Extract from the 12th General Report of the CPT, published in 2002, CPT/Inf(2002)15-part p.3 para 42. 297 See e.g., “Report on the visit to Azerbaijan” carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 29 March to 8 April 2016, p. 8; OSCE Bishkek, USAID, Freedom House, ‘OBSERVANCE OF THE RIGHT TO FREEDOM FROM TORTURE IN CLOSED FACILITIES OF THE KYRGYZ REPUBLIC MONITORING. RESPONSE. REHABILITATION’ (2012); Amnesty International, ‘SPAIN: OUT OF THE SHADOWS – TIME TO END INCOMMUNICADO DETENTION’ (2009), p. 14; and Questionnaire response Human Rights Association (Turkey) (2019). 81