Page 27 - ประมวลสรุปความรู้เกี่ยวกับพิธีสารอิสตันบูลและพิธีสารมินนิโซตา
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ISTANBUL PROTOCOL
F. Specialized diagnostic tests ....................................................................................... 113
G. Assessment of functional disability ............................................................................. 114
H. Children ................................................................................................................... 114
VI. PSYCHOLOGICAL EVIDENCE OF TORTURE AND ILL‑TREATMENT ..................... 115
A. General considerations ............................................................................................. 116
1. Central role of the psychological evaluation ................................................................ 116
2. Context of the psychological evaluation ..................................................................... 117
B. Psychological consequences of torture and ill-treatment .............................................. 118
1. Cautionary remarks ............................................................................................... 118
2. Common psychological responses .............................................................................. 118
3. Diagnostic classifications .......................................................................................... 121
C. Psychological/psychiatric evaluation ........................................................................ 124
1. Ethical and clinical considerations ............................................................................ 124
2. Interview process .................................................................................................... 125
3. Components of the psychological/psychiatric evaluation ............................................... 125
4. Neuropsychological assessment ................................................................................. 129
5. Children and torture .............................................................................................. 133
D. Lesbian, gay, bisexual, transgender and intersex persons and torture and ill-treatment 140
VII. ROLE OF HEALTH PROFESSIONALS IN DOCUMENTING TORTURE AND
ILL‑TREATMENT IN DIFFERENT CONTEXTS ........................................................... 143
A. State obligations and ethical obligations of health professionals ................................. 144
B. Contexts in which documentation may be necessary .................................................... 145
C. Challenges ............................................................................................................... 146
1. Fear of reprisals ..................................................................................................... 146
2. Lack of training ...................................................................................................... 146
3. Lack of time, heavy workload and inadequate number of health professionals ................. 147
4. Lack of adequate professional space or conditions ....................................................... 147
5. Non-disclosure ...................................................................................................... 147
6. Vicarious trauma and burnout ................................................................................. 147
D. Implementing ethical obligations ................................................................................ 147
1. Real or perceived obligations to third parties .............................................................. 148
2. Implicit and explicit bias .......................................................................................... 148
3. Limited opportunities for referral .............................................................................. 148
E. Guidance and procedures ......................................................................................... 148
1. Clinical evaluations in legal contexts .......................................................................... 148
2. Clinical evaluations in non-legal contexts ................................................................... 149
F. Reporting and regulation .......................................................................................... 150
G. Monitoring and ensuring the quality of all official evaluations ...................................... 151
VIII. IMPLEMENTATION OF THE ISTANBUL PROTOCOL .............................................. 153
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