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IV. GENERAL CONSIDERATIONS FOR INTERVIEWS ISTANBUL PROTOCOL

crimes including torture and ill-treatment, but doing (a) “Not consistent with”: the finding could not have
so may place the alleged victim at risk of reprisals been caused by the alleged torture or ill-treatment;
by State officials, including additional ill-treatment
or legal sanctions. In addition, international (b) “Consistent with”: the finding could have been
monitoring bodies, national preventive mechanisms caused by the alleged torture or ill-treatment, but it is
and national human rights institutions should seek non-specific and there are many other possible causes;
to make appropriate referrals for accountability
purposes within their official mandates. (c) “Highly consistent with”: the finding could have
been caused by the alleged torture or ill-treatment and
377. Wherever possible, examinations to document there are few other possible causes;
torture and ill-treatment for medico-legal reasons
should be combined with an assessment of ongoing (d) “Typical of”: the finding is usually observed with
medical, psychological and social needs. When this type of alleged torture or ill-treatment, but there
asked to provide advice or give medical care during are other possible causes;
or after the examination, clinicians must balance
their role as an independent examiner with ethical (e) “Diagnostic of”: the finding could not have been
obligations. For non-urgent matters, advice and caused in any way other than that described.
referral to specialist physicians, psychologists,
physiotherapists or those who can offer social advice The level of consistency denoted by
and support may be appropriate. If medical care is “typical of” is not commonly used to
required urgently, clinicians are obliged to ensure assess psychological evidence of torture
that the interviewee is provided with assistance. or ill-treatment as psychological findings
Clinicians should not hesitate to make a referral for tend to depend on individual factors. In
any consultation that they consider clinically necessary addition, the level of consistency denoted
within the clinical evaluation. Evaluators should be by “diagnostic of” is used more frequently
aware of local rehabilitation and support services. in the interpretation of physical evidence of
torture or ill-treatment and is rarely used in
the interpretation of psychological evidence.
D. Post-interview considerations
381. Additional guidance on the interpretation of
378. After a medico-legal evaluation of alleged torture or physical and psychological evidence of torture or
ill-treatment has been conducted, clinicians begin ill-treatment is further elaborated in chapters V and
the process of writing up a formal report, which VI and annex IV. While interpretations of physical
includes an interpretation of all relevant findings and a and psychological evidence have some differences,
conclusion on the possibility of torture or ill-treatment. both evaluations require clinicians to determine
the level of consistency between all of the clinical
1. Interpretation of findings evidence that the clinician has documented and the
allegations of torture or ill-treatment. In some cases,
379. The Istanbul Principles require clinicians to provide the overall evaluation may report a higher level of
an “interpretation as to the probable relationship consistency than each individual clinical finding,
of the physical and psychological findings to especially if there are many clinical findings that, when
possible torture or ill-treatment”. At a minimum taken together, confirm the same conclusion. It is
this should include an assessment of the level of important to note that the highest level of consistency
consistency between all clinical evaluation findings of an individual finding often determines the level
and the allegations of torture or ill-treatment. If the of consistency for all of the clinical evidence.
clinician considers that there are clinical reasons
for an inconsistent finding, this should be discussed 2. Conclusions and recommendations
(see paras. 342–353 above and 386 below).
382. The Istanbul Principles require clinicians to provide
380. The levels of consistency for such correlations a clinical opinion on the overall possibility of torture
are commonly expressed as follows: or ill-treatment. In formulating a clinical opinion on
the possibility of torture or ill-treatment, clinicians
should consider all relevant clinical evidence, including

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