Freedom from torture is an indisputable human right and prohibition of torture is a basic principle of International Human Rights Law. This prohibition is absolute and allows no exception. On this day in support of victims of torture the world should reaffirm that torture and other inhuman or degrading treatment is unacceptable and cannot be tolerated.
Torture is one of the most heinous crimes a human being can commit against another. It is not confined to the so-called ‘rogue’ states but is also practised in states that are deemed to be democratic. According to Amnesty International, torture is practised in more than half of the world’s countries. Torture is widespread and is not accounted for. It is used as a method of interrogation and as a tool of oppression. Its victims are often from particularly vulnerable groups, many of them poor and illiterate.
Fighting torture has been a long-standing campaign of many human rights organisations the world over. Supreme Court Directives, National Human Rights Commission (NHRC) guidelines and official sanctions, have not yet deterred officials from inflicting torture on individuals in their custody.
Torture has become endemic in the police stations and prisons of India. It has become an integral part of daily law-enforcement throughout the country. Many cases of death as a direct result of torture sustained in police and military custody are reported quite often.
Though most of the countries of the world signed the United Nations Convention Against Torture (CAT) in October 1997, the violation continues and its perpetrators still for the most part enjoy impunity.
So far, as many as 144 countries have ratified the CAT and only eight countries, including India, have not formally approved the Convention. India is in the company of the little known countries like Dominican Republic, Gambia, Nauru and Sudan.
Though torture is not specifically prohibited under the constitution, legal safeguards against torture are substantial in India. Indian courts have held that Article 21 (The Right to Life) implies protection against torture. However, the practice continues and prosecution for those carrying out torture is rare. India has also incorporated several Acts and laws to combat torture such as—the protection of Civil Rights Act 1955, Prisoner’s Act 1900, Care and Protection of Children Act 2003, etc.
Excluding areas of armed conflict, those who are particularly vulnerable to torture by Police include those arrested in criminal investigations and those who have been arrested in order to force the surrender of relatives. The police use torture routinely as part of the investigative process, in order to extract confessions or information, or even to falsely incriminate other individuals.
Within the country there is public acknowledgment of the problem of torture and strong calls from many areas of society for an end to the practice. Recommendations to combat torture have been made at the highest level by members of the Law Commission, the National Police Commission, the Supreme Court, the NHRC and other bodies.
Acts of torture are often committed with the involvement or the acquiescence of the medical profession. Even if they are not directly involved in the act, they may indirectly contribute by remaining silent when they realise that torture has taken place. This frequently happens as doctors are often the first to observe the injuries—physical and psychological—inflicted by torture. The role and importance of the medic in combating torture is increasingly recognised all over the world. This has culminated in the adoption of the 1999 Manual on Effective Investigation and Documentation of Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (The Istanbul Protocol) (3). This protocol builds upon numerous declarations and resolutions (such as the Declaration of Tokyo, 1975 (4)) which demonstrate that the support of the medical profession is essential if torture is to be combated successfully. Because medics are often the first to document a case of torture, their evidence can be crucial for prosecuting the perpetrators. Doctors also have the ability to reduce the physical and emotional scars of torture.
A medic may be hesitant in assessing or treating a victim of torture due to lack of knowledge of the correct procedures, or a fear of the repercussions. Appropriate interviewing and documentation, sensitive and compassionate treatment, dealing with the police and state authorities, and in case the victim has died, conducting a detailed autopsy, may all be required of doctors.
A complete medical report in addition to giving forensic evidence in a court of law may also be necessary. Such requirements may place a huge time and resource burden on already highly pressured medics and impact upon their ability to treat others. Such actions may also place them in conflict with powerful individuals and institutions and put them at personal and professional risk.
Scarce information of International and National Laws to combat torture and the endemic nature of this heinous act in India presents further difficulty to the medical professionals.
Although the Governmental guidelines in this regard are still awaited, the Indian Medical Council’s professional conduct, etiquette and ethics regulations, 2002 states, “The physician shall not aid or abet torture nor shall he be a party to either infliction of mental or physical trauma or concealment of torture inflicted by some other person or agency in clear violation of human rights.”
International and national guidelines are often lengthy and complicated documents and are likely to be sought only subsequent to contact with a torture victim. In the absence of adequate information and knowledge during an initial consultation, the victim may be inappropriately assessed, treated and advised. This could result in further suffering for the victim and insufficient or inaccurate documentation that would endanger a successful prosecution of the perpetrators.
The call for medics to be knowledgeable and active against torture is gaining momentum but steps to educate and empower these professionals remain inadequate. Education programmes are urgently required as part of postgraduate study and perhaps more importantly at the undergraduate stage, so that the incorporation of the principles of human rights in health care becomes standard practice.
While torture is endemic, doctors’ training programmes on torture remain rare in India. The PSG Institute of Medical Sciences and Research along with the Department of Forensic Medicine at Coimbatore Medical College sought the assistance of an NGO, the Institute of Human Rights Education of People’s Watch, Tamil Nadu (PW-TN) for such training. Over the last decade, PW-TN has acquired extensive experience in educating various sectors of society on the issue of torture. Their focus was on legal and paralegal professions but attention has now also turned to the medical community.