Page 74 - ประมวลสรุปความรู้เกี่ยวกับพิธีสารอิสตันบูลและพิธีสารมินนิโซตา

II. RELEVANT ETHICAL CODES ISTANBUL PROTOCOL

health”; 265 “adherence to prisoners’ autonomy with of Torture, also require health professionals working
regard to their own health and informed consent in in places of detention to document and report
the doctor-patient relationship”; 266 “confidentiality medical evidence of torture or ill-treatment. 272
of medical information, unless maintaining such
confidentiality would result in a real and imminent 151. “Participation in torture” includes evaluating an
threat to the patient or to others”; 267 and the “absolute individual’s capacity to withstand ill-treatment; being
prohibition on engaging, actively or passively, in acts present at, supervising or inflicting ill-treatment;
that may constitute torture or other cruel, inhuman resuscitating individuals for the purposes of further
or degrading treatment or punishment”. 268 Health ill-treatment or providing medical treatment
professionals are also prohibited from having any immediately before, during or after torture on the
role in the imposition of disciplinary sanctions or instructions of those likely to be responsible for it;
other restrictive measures. 269 This includes solitary providing professional knowledge or individuals’
confinement (22 hours or more a day without personal health information to torturers; and
meaningful human contact), prolonged solitary intentionally neglecting evidence and falsifying reports,
confinement (15 consecutive days), placement of such as autopsy reports and death certificates. 273 In
a prisoner in a dark or constantly lit cell, corporal a situation in which an intervention after torture
punishment or the reduction of a prisoner’s diet is essential to preserve the life of an individual,
or drinking water and collective punishment. 270 such an emergency intervention may be performed.
Furthermore, rule 34 of the Nelson Mandela Rules In addition, health-care personnel are required to
requires health-care professionals who “become report the adverse effects of disciplinary sanctions
aware of any signs of torture or other cruel, or other restrictive measures and advise the director
inhuman or degrading treatment or punishment” to to terminate involuntary separation in order to
“document and report such cases to the competent ensure that such separation does not exacerbate the
medical, administrative or judicial authority”. medical condition or mental or physical disability of
the prisoner. The Principles of Medical Ethics also
149. Regarding women who are deprived of their prohibit any professional relationship with prisoners
liberty, rule 10 of the Bangkok Rules states that or detainees that is not solely to evaluate, protect
“all women are entitled to treatment and care or improve their physical and mental health. Thus,
equivalent to that of community standards for their assessing a detainee’s health in order to facilitate
gender specific health-care needs” and the right to punishment or torture is clearly unethical.
medical confidentiality. 271 In addition, rule 6 (5) of
the Bangkok Rules establishes the duty of health 152. The duty of health professionals not to participate,
personnel to document “any signs of ill-treatment actively or passively, in torture and ill-treatment
or torture” in health screening examinations. practices and to document and report such practices
extends to a wide range of abuses that have been
150. Proper procedural safeguards should be followed recognized as torture or ill-treatment by the Special
in order not to expose the prisoner or associated Rapporteur on torture and the Committee against
persons to foreseeable risk of harm. The relevant Torture. 274 These include, but are not limited to,
procedural safeguards concerning the risks of harm abusive practices related to gender discrimination,
specifically in the context of clinical evaluations of including those under the guise of medical treatment
torture or ill-treatment are discussed in paragraphs or testing, such as virginity testing, anal examinations
312 to 315 below. Regional human rights bodies, to “detect homosexuality”, rape, female genital
such as the European Committee for the Prevention mutilation, forced marriage, child marriage, honour

265 Nelson Mandela Rules, rule 32 (1) (a).
266 Ibid., rule 32 (1) (b).
267 Ibid., rule 32 (1) (c).
268 Ibid., rule 32 (1) (d).
269 Ibid., rule 46 (1).
270 Ibid., rule 43 (1) (a)–(e).
271 Bangkok Rules, rules 8 and 11. See also rules 12–18 thereof, which elaborate duties on the specific gender-based physical and mental health-care needs of women.
272 European Committee for the Prevention of Torture, 23rd General Report of the CPT (1 August 2012–31 July 2013) (Strasbourg, Council of Europe, 2013), paras. 71–84
273 Health professionals must, however, bear in mind the duty of confidentiality owed to patients and the obligation to obtain informed consent for disclosure of information,
particularly when individuals may be put at risk by such disclosure (see paras. 165–171 above).
274 A/HRC/31/57; A/HRC/7/3, paras. 25–26; and OHCHR, “Gender-based crimes through the lens of torture International Women’s Day”, press release, 8 March 2016.

33