Model Curriculum on the Effective Medical Documentation of Torture and Ill-treatment

Educational Resources for Health Professional Students

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Torture is one of the most traumatic and destructive human experiences. Its purpose is to deliberately destroy not only the physical and emotional well-being of individuals but also, in some instances, the dignity and will of entire communities. Although international human rights and humanitarian law consistently prohibit torture under any circumstance, torture and ill-treatment are practised in nearly half of the world’s countries. Prevention of and accountability for torture are essential to the rule of law and the development of civil society. It concerns all people because these practises impugn the very meaning of our existence and our hopes for a brighter future. Respect for such a basic human right may well demonstrate our capacity to respect other human rights as well.

In recent years, health professionals have recognised the importance of human rights in health, and increasingly have worked to protect and promote human rights as a means of promoting health and preventing human suffering. They have played an important role in the prevention of and accountability for torture through the effective investigation and documentation of torture and ill-treatment. Health professionals were instrumental in the development of the first international guidelines for medico-legal documentation of torture and ill-treatment that are contained in the UN’s Manual on the Effective Investigation and Documentation of Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (Istanbul Protocol). The Istanbul Protocol was developed in 1999; it was the result of three years of analysis, research, and drafting undertaken by more than 75 forensic doctors, physicians, psychologists, human rights monitors, and lawyers representing 40 organisations and institutions from 15 countries.

Medical documentation of torture and ill-treatment is often crucial in judicial proceeding, human rights investigations and monitoring, and in the care of torture survivors. Medical evaluations of torture and ill-treatment involve a thorough clinical evaluation of an individual’s physical and/or psychological health. Medico-legal documentation of torture and ill-treatment requires a careful clinical history and examination by a health professional who is knowledgeable about the medical and psychosocial consequences of torture and sensitive to cross-cultural issues and interpersonal dynamics between traumatised individuals and persons in positions of authority.

This Model Curriculum on the Effective Medical Documentation of Torture and Ill-treatment (Model Curriculum) was developed to enable health professional students to effectively investigate and document torture and ill-treatment. It consists of nine Modules and related supporting documents and contains essential information for students to develop the knowledge and skills required to conduct medical evaluations of torture and ill-treatment. The Modules include information on how to interview an alleged torture victim as well as the comprehensive guidelines for performing clinical examinations to detect physical and psychological evidence of torture and ill-treatment.

Each Module includes a summary of objectives and content, suggested discussion questions and teaching formats, and a list of primary references. The Modules are designed to be used by instructors in seminar discussions or lecture presentations, and by individual students or student groups. The Content of the Model Curriculum is based on the Istanbul Protocol and a number of manuals and resources that were subsequently developed by Istanbul Protocol authors and editors, and their colleagues (see Resources below).