The experience of İstanbul Protocol: efficiency, quality, difficulties in practice

Year 2019, Volume: 5 Issue: 5, 886 - 893, 04.09.2019

Nurşen Turan Yurtsever

https://doi.org/10.18621/eurj.424157

Abstract

Objectives:
Physicians who witness torture and ill treatment
can be placed in a difficult position if their evidence was not accurately
documented. The guidelines and ethical codes of the Istanbul Protocol require
doctors to attend first and foremost to the well-being of their patients and to
remain bound by the principles of medical ethics. The objective of this study
was to compare the efficiency and the quality of the examination of detainees
or alleged torture cases by medical doctors and the difficulties encountered in
this activity.

Methods: A
questionnaire was developed and sent to physicians in Black Sea Shore region of
Turkey before and 1 year after their receiving training according to the
Istanbul Protocol.

Results: There were
42 physicians who had undergone training according to the Istanbul Protocol and
had answered the questionnaire; 28.6% of these were women and 71.4% men. These
physicians applied the Istanbul Protocol more frequently after having received
training on the Protocol Manual as compared to before the training. The 52.4%
of these physicians reported having been the object of violence or
intimidation.

Conclusions: It was
determined that the physicians' knowledge of physical and psychological
examination increased following their training according to the Istanbul
Protocol. 

Keywords

İstanbul Protocol, human right, torture

References

• [1] UN Convention Against Torture, Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. Article1. New York, 1984.
• [2] Amris K, Danneskiold-Samsøe S, Torp-Pedersen S, Genefke I, Danneskiold-Samsøe B. Producing medico-legal evidence: documentation of torture versus the Saudi Arabian State of Denial. Torture 2007;17:181-96.
• [3] The Declaration of Tokyo. World Medical Association, 1975. In: Ethical codes and declarations relevant to the health professions. London: Amnesty International, 1994.
• [4] Manual on the effective investigation and documentation of torture and other cruel, inhuman or degrading treatment or punishment. Istanbul Protocol. Professional Training Series No. 8. Geneva: United Nations Publications, 2001.
• [5] Lustig SL, Kureshi S, Delucchi KL, Iacopino V, Morse SC. Asylum grant rates following medical evaluations of maltreatment among political asylum applicants in the United States. J Immigr Minor Health 2008;10:7-15.
• [6] Fincanci SK. The role of jurisdiction on persistence of torture in Turkey and public reflections. Torture 2008;18:51-5.
• [7] Ucpinar H, Baykal T. An important step for prevention of torture: the Istanbul protocol and challenges. Torture 2006;16:252-67.
• [8] Iacopino V, Ozkalipci O, Schlar C. The Istanbul protocol: international standards for the effective investigation and documentation of torture and ill treatment. Lancet 1999;354:1117.
• [9] Mendel L, Worm L. Documentation of torture victims, assessment of the Start Procedure for Medico-Legal Documentation. Torture 2007;17;196-202.
• [10] Furtmayr H, Frewer A. Documentation of torture and the Istanbul Protocol: applied medical ethics. Med Health Care and Philos 2010;13:279-86.
• [11] Perera C, Verghese A. Implementation of Istanbul Protocol for effective documentation of torture and review of Sri Lankan perspectives. J Forensic Leg Med 2011;18:1-5.
• [12] Masmas TN, Møller E, Buhmann C, Bunch V, Jensen JH, Hansen TN, et al. Asylum seekers in Denmark: A study of health status and grade of traumatization of newly arrived asylum seekers. Torture 2008;18:77-86.
• [13] Haagensen JO. The role of the Istanbul-Protocol in the uphill battle for torture survivors being granted asylum in Europe and ensuring the perpetrators pay. Torture 2007;17:236-9.
• [14] Burnett A, Peel M. The health of survivors of torture and organised violence. BMJ 2001:322;606-9.
• [15] Moreno A, Iacopino V. Forensic investigations of torture and ill-treatment in Mexico: a follow-up study after the implementation of the Istanbul Protocol. J Leg Med 2008; 29:443-78.
• [16] Koritsas S, Coles J, Boyle M, Stanley J. Prevalence and predictors of occupational violence and aggression towards GPs: a cross-sectional study. Br J Gen Pract 2007;57:967-70.
• [17] Nagata-Kobayashi S, Maeno T, Yoshizu M, Shimbo T. Universal problems during residency: abuse and harassment. Med Educ 2009;43:628-36.
• [18] Shah R, Ogden J. 'What's in a face?' The role of doctor ethnicity, age and gender in the formation of patients' judgements: an experimental study. Patient Educ Couns 2006;60:136-41.
• [19] Boz B, Acar K, Ergin A, Erdur B, Kurtulus A, Turkcuer I, et al. Violence toward health care workers in emergency departments in Denizli, Turkey. Adv Ther 2006;23:364-9.
• [20] Gates DM, Ross CS, McQueen L. Violence against emergency department workers. J Emerg Med 2006;31:331-7.
• [21] Ayranci U, Yenilmez C, Balci Y, Kaptanoglu C. Identification of violence in Turkish health care settings. J Interpers Violence 2006;21:276-96.
• [22] Franz S, Zeh A, Schablon A, Kuhnert S, Nienhaus A. Aggression and violence against health care workers in Germany--a cross sectional retrospective survey. BMC Health Serv Res 2010;10:51.
• [23] Estryn-Behar M, Duville N, Menini ML, Camerino D, Le Foll S, le Nézet O, et al; Next-Study group. [Factors associated with violenceagainst healthcare workers: results of the European Presst-Next study]. Presse Med 2007;36(1 Pt 1):21-35. [Article in French]
• [24] McColl H, Bhui K, Jones E. The role of doctors in investigation, prevention and treatment of torture. J R Soc Med 2012;105:464-71.
• [25] Wenzel T, Mirzael S, Stompe T. The Istanbul Protocol. Swiss Arc Neurol Psychiatr Psychother 2016;167:241-4.