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Effective Training Tool: The Istanbul Protocol

Istanbul Protocol Cover

The Manual on Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, commonly known as the Istanbul Protocol, outlines international legal standards and sets out specific guidelines on how to conduct effective legal and medical investigations into allegations of torture and ill treatment.

Development of the Istanbul Protocol (IP) was undertaken by more than 75 forensic physicians, psychologists, human rights monitors, and lawyers representing 40 organizations and institutions from 15 countries. PHR's Senior Medical Advisor Dr. Vincent Iacopino was a lead author and project coordinator of the IP, which became an official United Nations document in 1999.

Istanbul Protocol provisions for medical evaluations and reports include:

  • Evaluations must conform to established standards (as outlined in the IP)
  • Evaluations must be under the control of medical experts, not security personnel
  • Medical evaluations and written reports must be prompt and accurate
  • Written report should include:
    • Identification of alleged victim and conditions of evaluation
    • Detailed account of allegations, including torture methods and physical and psychological symptoms
    • Record of physical and psychological findings
    • Interpretation of findings and recommendations
    • Identification and signature of the medical expert(s)
Man on Table

Forensic medical evaluations conducted in compliance with the Istanbul Protocol constitute critically important evidence in torture cases. Trained clinicians examine all signs and sequelae of physical and psychological abuse and produce a medical-legal affidavit documenting their conclusions. These affidavits serve as key evidence to prosecute perpetrators of torture, to help victims obtain redress in civil courts, and to substantiate claims of asylum in new countries.

Since 1999, PHR has trained health professionals around the world using the Istanbul Protocol methods and principles to help increase the number of independent, qualified, and motivated forensic medical experts who can provide evidence of torture and work together to end the culture of impunity on a national basis.

Working with local partners, PHR identifies and convenes qualified and dedicated health professional participants who want to work together to end torture in their home country. Participants first learn about the relevant laws, as well as common torture methods and their physical and psychological consequences. Next they learn how to conduct the clinical interview and exam, and how to document physical and psychological evidence while adhering to proper ethical guidelines. All participants practice these skills in simulated cases of torture, in which participants interview role players, evaluate physical and psychological evidence of torture, and present the evidence in mock court cases or advocacy venues. Advanced participants are trained to seek out and train other health professionals, ensuring that a sustainable network is created at the local level. PHR’s efforts to identify, train, and support medical experts in their home states also contribute to an international effort to develop an Istanbul Protocol Plan of Action.

Istanbul Protocol Training Session
Participants of an advanced Istanbul Protocol training session in Cambridge, Massachusetts. (Photo: Kelly Holz/PHR)

 IP Plan of Action Initiative

Building on more than 12 years of global anti-torture initiatives, PHR is working with stakeholders and experts to develop a roadmap for how countries can fulfill their obligations to end torture. The Plan of Action will assist countries by providing them with:

  1. A statement of principles and critical steps that must be taken for effective torture investigation and documentation;
  2. A set of detailed and concrete actions for countries to take to establish and maintain a system of effective and independent torture investigations; and
  3. A comprehensive collection of supplemental resource materials for the various stakeholders (policy makers, politicians, legislators, prosecutors, judges, health professionals, etc.) who are involved in torture investigations and documentation.

PHR is working closely with critical international and regional organizations, including leading NGOs, National Human Rights Institutions, and the National Preventive Mechanisms under the Optional Protocol to the UN Convention Against Torture. The initiative is supported by the UN High Commissioner for Human Rights.