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Chapter 25: Torture and Medical Profession

25.1: Torture

  • Torture — any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as:

    • Obtaining from him or a third person information or a confession,

    • Punishing him for an act he or a third person has committed or is suspected of having committed,

    • Intimidating or coercing him or a third person, or for any reason based on discrimination of any kind; when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.


25.2: Methods of Torture

Physical Torture

  • Asphyxial torture: This is usually done by suffocating the individual.

  • Beating: Using rods, sticks, chains, cables, or other objects beating is done on various parts of the body from head to toe, including genitals.

  • Cold torture: Pouring the thin streams of ice cold water on the nude body or sensitive parts of the body, making the person stand on or walk barefooted or lie down on the ice block, or locking naked in an extremely cold air-conditioned room are some of the techniques adopted here.

  • Ear torture: This comprises hitting the ears with open palms continuously, which will create a rupture of the eardrum/tympanic membrane, causing severe pain and bleeding from the ear resulting in deafness.

  • Electrical torture: Applying electrical shock by electrodes oversensitive parts such as nipples, genitals, oral cavity, anal canal, armpits, etc.

  • Heat torture: Burning using cigarette butts, cigars, hot iron rods, or flames over the sensitive and concealed parts of the body.

  • Irritant torture: Here an irritant like chilly paste/ powder, is applied to the eyes or other delicate parts of the body, especially genitalia.

  • Keeping a person in an abnormal position: The abnormal position could be standing or sitting or lying supine or prone or on one side or crouched with the tying of hands and feet also.

  • Mutilation: This is an extreme degree of torture where multiple injuries are inflicted resulting in the mutilation of the parts of the body or total difficulty in establishing the identity of the person.

  • Pulling and/or twisting of nails/hairs/tongue/teeth/ breasts/genitalia, etc.: This is quite a painful procedure and may be practiced alone or together in combined form.

  • Roller torture: Comprises applying a roller over the parts of the body.

  • Suspension: Here a person is suspended either by hands/ feet for several minutes to hours.

Psychological Torture

  • Deprivation technique: This includes social deprivation, sensory deprivation, perceptual deprivation, sleep deprivation, nutritional deprivation, hygienic deprivation, and health service deprivation.

  • Coercion technique: Impossible choice/incongruent action, humiliation, threats, blind obedience to rules, and sexual torture are some of the types under this category.

  • Communication technique: Counter-effect technique, double blinding technique, disinformation, and distortion of perception and conditioning of new reflexes.

Sexual Torture

  • Sexual torture: It includes rape, penetration of the vagina/ anus by long neck bottles, wooden or metal rods, dildos/ artificial phallus, or such other objects, which can result in injuries or mutilation of the genitalia, causing impotence consequently.

  • Mutilation of the female genitalia

    • Female genital mutilation is a common and popular practice in some African countries and Egypt.

    • Thousands of young girls are subjected to this torture and mutilation in Egypt alone.

  • Gender bias torture especially sexual harassment of women in the workplace is now a hard reality.

    • This is the ultimate form of control, especially in a position of authority.

    • The fear of loss of job, hostility at work, and social stigma still prevent women from complaining about sexual harassment.

  • Post-traumatic stress disorder (PTSD) is more common in rapes, especially by strangers, of physical force being used, weapons being displayed, and injuries being sustained by the victim.


25.3: Pharmacological Torture

  • Torture is one of the most important preventable causes of psychological morbidity.

  • Torture by definition creates a severe form of psychosomatic distress because of the person’s lack of control over the basic bodily function.

  • Anxiety, depression, phobia, sleep disturbance, headache, post-traumatic stress disorder (PTSD), psychosexual problems, psychosomatic problems, convulsion, psychotic disorders, suicidal tendencies, and personality changes, are some of the psychological sequela.

Medicolegal and Ethical Aspects of Torture

  • Torture and Human Rights

    • Human rights standards have been established regarding the health professional’s role in torture and participation in the death penalty.

  • Torture and Forensic Experts

    • The single most important threat to the human rights of individuals comes from the forensic medical examiner that frames medical judgment to serve state or powerful third-party interests.

    • The forensic medical examiner should disclose the confidential report to the proper authority and it is for the benefit of that individual.





MA

Chapter 25: Torture and Medical Profession

25.1: Torture

  • Torture — any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as:

    • Obtaining from him or a third person information or a confession,

    • Punishing him for an act he or a third person has committed or is suspected of having committed,

    • Intimidating or coercing him or a third person, or for any reason based on discrimination of any kind; when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.


25.2: Methods of Torture

Physical Torture

  • Asphyxial torture: This is usually done by suffocating the individual.

  • Beating: Using rods, sticks, chains, cables, or other objects beating is done on various parts of the body from head to toe, including genitals.

  • Cold torture: Pouring the thin streams of ice cold water on the nude body or sensitive parts of the body, making the person stand on or walk barefooted or lie down on the ice block, or locking naked in an extremely cold air-conditioned room are some of the techniques adopted here.

  • Ear torture: This comprises hitting the ears with open palms continuously, which will create a rupture of the eardrum/tympanic membrane, causing severe pain and bleeding from the ear resulting in deafness.

  • Electrical torture: Applying electrical shock by electrodes oversensitive parts such as nipples, genitals, oral cavity, anal canal, armpits, etc.

  • Heat torture: Burning using cigarette butts, cigars, hot iron rods, or flames over the sensitive and concealed parts of the body.

  • Irritant torture: Here an irritant like chilly paste/ powder, is applied to the eyes or other delicate parts of the body, especially genitalia.

  • Keeping a person in an abnormal position: The abnormal position could be standing or sitting or lying supine or prone or on one side or crouched with the tying of hands and feet also.

  • Mutilation: This is an extreme degree of torture where multiple injuries are inflicted resulting in the mutilation of the parts of the body or total difficulty in establishing the identity of the person.

  • Pulling and/or twisting of nails/hairs/tongue/teeth/ breasts/genitalia, etc.: This is quite a painful procedure and may be practiced alone or together in combined form.

  • Roller torture: Comprises applying a roller over the parts of the body.

  • Suspension: Here a person is suspended either by hands/ feet for several minutes to hours.

Psychological Torture

  • Deprivation technique: This includes social deprivation, sensory deprivation, perceptual deprivation, sleep deprivation, nutritional deprivation, hygienic deprivation, and health service deprivation.

  • Coercion technique: Impossible choice/incongruent action, humiliation, threats, blind obedience to rules, and sexual torture are some of the types under this category.

  • Communication technique: Counter-effect technique, double blinding technique, disinformation, and distortion of perception and conditioning of new reflexes.

Sexual Torture

  • Sexual torture: It includes rape, penetration of the vagina/ anus by long neck bottles, wooden or metal rods, dildos/ artificial phallus, or such other objects, which can result in injuries or mutilation of the genitalia, causing impotence consequently.

  • Mutilation of the female genitalia

    • Female genital mutilation is a common and popular practice in some African countries and Egypt.

    • Thousands of young girls are subjected to this torture and mutilation in Egypt alone.

  • Gender bias torture especially sexual harassment of women in the workplace is now a hard reality.

    • This is the ultimate form of control, especially in a position of authority.

    • The fear of loss of job, hostility at work, and social stigma still prevent women from complaining about sexual harassment.

  • Post-traumatic stress disorder (PTSD) is more common in rapes, especially by strangers, of physical force being used, weapons being displayed, and injuries being sustained by the victim.


25.3: Pharmacological Torture

  • Torture is one of the most important preventable causes of psychological morbidity.

  • Torture by definition creates a severe form of psychosomatic distress because of the person’s lack of control over the basic bodily function.

  • Anxiety, depression, phobia, sleep disturbance, headache, post-traumatic stress disorder (PTSD), psychosexual problems, psychosomatic problems, convulsion, psychotic disorders, suicidal tendencies, and personality changes, are some of the psychological sequela.

Medicolegal and Ethical Aspects of Torture

  • Torture and Human Rights

    • Human rights standards have been established regarding the health professional’s role in torture and participation in the death penalty.

  • Torture and Forensic Experts

    • The single most important threat to the human rights of individuals comes from the forensic medical examiner that frames medical judgment to serve state or powerful third-party interests.

    • The forensic medical examiner should disclose the confidential report to the proper authority and it is for the benefit of that individual.