PROFESSIONAL TRAINING SERIES No. 8/Rev.1 …

1 OFFICE OF THE UNITED NATIONSHIGH COMMISSIONER FOR HUMAN RIGHTSG enevaPROFESSIONAL TRAINING SERIES No. 8 NATIONSNew York and Geneva, 2004 IstanbulProtocolManual on the Effective Investigation andDocumentation of Torture and Other Cruel,Inhuman or Degrading Treatment or PunishmentUNITED NATIONS PUBLICATIONS ales No. 92-1-116726-4 ISSN 1020-1688 NOTEThe designations employed and the presentation of the material in thispublication do not imply the expression of any opinion whatsoever on the part ofthe Secretariat of the United Nations concerning the legal status of any country,territory, city or area, or of its authorities, or concerning the delimitation of itsfrontiers or boundaries.** *Material contained in this publication may be freely quoted or reprinted, pro-vided credit is given and a copy of the publication containing the reprinted materialis sent to the Office of the High Commissioner for Human Rights, United Nations,1211 Geneva 10, 92-1-154156-5 HR/P/PT/8 on the Effective Investigation and Documentation of Torture andOther Cruel, Inhuman or Degrading Treatment or PunishmentIstanbul ProtocolSubmitted to theUnited Nations High Commissioner for Human Rights9 August 1999 PARTICIPATING ORGANIZATIONSA ction for Torture Survivors (HRFT), GenevaAmnesty International, LondonAssociation for the Prevention of Torture, GenevaBehandlungszentrum f r Folteropfer, BerlinBritish Medical Association (BMA)

2 , LondonCenter for Research and Application of Philosophy and Human Rights, Hacettepe University, AnkaraCenter for the Study of Society and Medicine, Columbia University, New YorkCentre Georges Devereux, University of Paris VIII, ParisCommittee against Torture, GenevaDanish Medical Association, CopenhagenDepartment of Forensic Medicine and Toxicology, University of Colombo, ColomboEthics Department, Dokuz Eyl l Medical Faculty, Izmir, TurkeyGaza Community Mental Health Programme, GazaGerman Medical Association, BerlinHuman Rights Foundation of Turkey (HRFT), AnkaraHuman Rights Watch, New YorkIndian Medical Association and the IRCT, New DelhiIndochinese Psychiatric Clinic, Boston, United States of AmericaInstitute for Global Studies, University of Minnesota, Minneapolis, Unites StatesInstituto Latinoamericano de Salud Mental, SantiagoInternational Committee of the Red Cross, Geneva International Federation of Health and Human Rights Organizations, Amsterdam, The NetherlandsInternational Rehabilitation Council for Torture Victims (IRCT)

3 , CopenhagenJohannes Wier Foundation, Amsterdam, The NetherlandsLawyers Committee for Human Rights, New YorkPhysicians for Human Rights Israel, Tel AvivPhysicians for Human Rights Palestine, GazaPhysicians for Human Rights USA, BostonProgram for the Prevention of Torture, Inter-American Institute of Human Rights,San Jos Society of Forensic Medicine Specialists, Istanbul, TurkeySpecial Rapporteur on Torture, GenevaSurvivors International, San Francisco, United StatesThe Center for Victims of Torture (CVT), Minneapolis, United StatesThe Medical Foundation for the Care of Victims of Torture, LondonThe Trauma Centre for Survivors of Violence and Torture, Cape Town, South AfricaTurkish Medical Association, AnkaraWorld Medical Association, Ferney-Voltaire, FrancevCONTENTSPageContributing authors and other INTERNATIONAL LEGAL humanitarian law.

4 United obligations to prevent Nations bodies and mechanisms .. organizations .. Inter-American Commission on Human Rights and the Inter-American Court of Human Rights .. European Court of Human Rights .. European Committee for the Prevention of Torture andInhuman or Degrading Treatment or The African Commission on Human and Peoples Rights and theAfrican Court on Human and Peoples Rights .. International Criminal Court .. ETHICAL of the legal ethics .. Nations statements relevant to health professionals .. from international PROFESSIONAL codes of medical ethics .. common to all codes of health-care duty to provide compassionate care .. consent .. professionals with dual guiding all doctors with dual obligations .. arising from dual obligations .. INVESTIGATION OF of an investigation into torture.

5 On the Effective Investigation and Documentation of Tortureand Other Cruel, Inhuman or Degrading Treatment or Punishment .. of a torture investigation .. of the appropriate investigative body .. the alleged victim and other and obtaining physical evidence .. of inquiry .. the scope of the inquiry ..107222. The power of the commission .. commission s staff .. of witnesses .. of of evidence .. of of evidence .. of the commission .. 118-11924IV. GENERAL CONSIDERATIONS FOR of inquiry, examination and documentation .. safeguards with respect to detainees .. visits to detention centres .. of questioning .. the history and pre-arrest .. of detention and of detention .. and conditions of detention .. of torture and of the background.

6 Of torture methods .. of re-traumatization of the interviewee .. of interpreters .. issues .. for referral .. of findings and conclusions .. EVIDENCE OF 161-23333 AInterview structure .. history .. symptoms .. symptoms .. of an interview .. physical examination .. 177-182353. Chest and system .. system .. and peripheral nervous systems .. and evaluation following specific forms of torture .. and other forms of blunt trauma .. to the feet .. positional shock torture .. torture including diagnostic tests ..23344VI. PSYCHOLOGICAL EVIDENCE OF considerations .. central role of the psychological context of the psychological evaluation .. consequences of psychological classifications .. psychological/psychiatric evaluation.

7 And clinical considerations .. interview process .. of the psychological/psychiatric evaluation .. assessment .. and on the Effective Investigation and Documentation of Torture and Other Cruel,Inhuman or Degrading Treatment or Punishment .. drawings for the documentation of torture and ill-treatment ..65IV. Guidelines for the medical evaluation of torture and ill-treatment ..73viiiCONTRIBUTING AUTHORS AND OTHER PARTICIPANTSP roject coordinatorsDr. Vincent Iacopino, Physicians for Human Rights USA, Boston, United StatesDr. nder zkalip i, Human Rights Foundation of Turkey, Istanbul, TurkeyMs. Caroline Schlar, Action for Torture Survivors (HRFT), Geneva Editorial committeeDr. Kathleen Allden, Indochinese Psychiatric Clinic, Boston, and Department ofPsychiatry, Dartmouth Medical School, Lebanon, New Hampshire, United StatesDr.

8 T rkcan Baykal, Human Rights Foundation of Turkey, Izmir, TurkeyDr. Vincent Iacopino, Physicians for Human Rights USA, Boston, United StatesDr. Robert Kirschner, Physicians for Human Rights USA, Chicago, United StatesDr. nder zkalip i, Human Rights Foundation of Turkey, Istanbul, TurkeyDr. Michael Peel, The Medical Foundation for the Care of Victims of Torture,LondonDr. Hernan Reyes, Center for the Study of Society and Medicine, Columbia Univer-sity, New YorkMr. James Welsh, Amnesty International, LondonRapporteursDr. Kathleen Allden, Indochinese Psychiatric Clinic, Boston, and Department ofPsychiatry, Dartmouth Medical School, Lebanon, New Hampshire, United StatesMs. Barbara Frey, Institute for Global Studies, University of Minnesota,Minneapolis, United StatesDr.

9 Robert Kirschner, Physicians for Human Rights USA, Chicago, United StatesDr. ebnem Korur Fincanci, Society of Forensic Medicine Specialists, Istanbul,TurkeyDr. Hernan Reyes, Center for the Study of Society and Medicine, ColumbiaUniversity, New YorkMs. Ann Sommerville, British Medical Association, LondonDr. Numfondo Walaza, The Trauma Centre for Survivors of Violence and Torture,Cape Town, South AfricaContributing authorsDr. Suat Alptekin, Forensic Medicine Department, Istanbul, TurkeyDr. Zuhal Amato, Ethics Department, Dok z Eylul Medical Faculty, Izmir, TurkeyDr. Alp Ayan, Human Rights Foundation of Turkey, Izmir, TurkeyDr. Semih Ayta lar, Sonomed, Istanbul, TurkeyDr. Metin Bakkalci, Human Rights Foundation of Turkey, Ankara,Dr. mit Bi er, Society of Forensic Medicine Specialists, Istanbul, TurkeyDr.

10 Ye im Can, Human Rights Foundation of Turkey, Istanbul, TurkeyDr. John Chisholm, British Medical Association, LondonDr. Lis Danielsen, International Rehabilitation Council for Torture Victims,CopenhagenDr. Hanan Diab, Physicians for Human Rights Palestine, GazaixMr. Jean-Michel Diez, Association for the Prevention of Torture, GenevaDr. Yusuf Do gar, Human Rights Foundation of Turkey, Istanbul, TurkeyDr. Morten Ekstrom, International Rehabilitation Council for Torture Victims,CopenhagenProfessor Ravindra Fernando, Department of Forensic Medicine and Toxicology,University of Colombo, ColomboDr. John Fitzpatrick, Cook County Hospital, Chicago, United StatesMs. Camile Giffard, University of Essex, United KingdomDr. Jill Glick, University of Chicago Children s Hospital, Chicago, United StatesDr.