Expert medico-legal reports: The relationship between levels of consistency and judicial outcomes in asylum seekers in the Netherlands
Keywords:Asylum seekers, refugees, torture, legal medicine, post-traumatic stress disorder, Istanbul Protocol
Introduction: If asylum applicants need to prove that they have been persecuted in their home country, expert judgment of the psychological and physical consequences of torture may support the judicial process. Expert medico-legal reports can be used to assess whether the medical complaints of the asylum seeker are consistent with their asylum account. It is unclear which factors influence medical expert judgement about the consistency between an asylum seeker’s symptoms and story, and to what extent expert medico-legal reports are associated with judicial outcomes. Methods: We analysed 97 medico-legal reports on traumatised asylum seekers in the Netherlands. First, we evaluated the impact of trauma-related and other variables on experts’ judgments of the consistency of symptoms and story. Second, we evaluated the effect of experts’ judgments of symptom-story consistency on subsequent judicial outcomes. Results: Gender, receipt of mental health care and trauma-related variables were associated with symptomstory consistency. Positive asylum decisions were predicted by expert judgments about the presence of physical signs and symptoms of torture, and ill-treatment and their consistency with the refugee’s story, but not psychological symptoms. Conclusion: These results suggest that standardised procedures for the documenting of medical evidence by independent experts can improve judicial decision quality and the need to improve psychological and psychiatric assessments.
Bruin, R., Reneman, M., & Bloemen, E. (2006). Care Full, Medico - legal reports and the Istanbul Protocol in asylum procedures. Utrecht: Pharos, Amnesty International, Dutch Council for Refugees.
Cathcart, L. M., Berger, P., & Knazan, B. (1979). Medical examination of torture victims applying for refugee status. Can Med Assoc J, 121(2), 179-184.
European Court of Human Rights. (2010). CASE OF R.C. v. SWEDEN.
European Parliament. Council of the European Union. (2013). EUR - Lex. Access to European Union Law. Retrieved from http://eur-lex.europa.eu/legal-content/EN/NOT/?uri=CELEX:32013L0032
Furtmayr, H., & Frewer, A. (2010). Documentation of torture and the Istanbul Protocol: applied medical ethics. Med Health Care Philos, 13(3), 279-286. doi:10.1007/s11019-010-9248-1
Haagensen, J. O. (2007). The role of the Istanbul-Protocol in the uphill battle for torture survivors being granted asylum in Europe and ensuring the perpetrators pay. Torture, 17(3), 236-239.
Herlihy, J., & Turner, S. (2006). Should discrepant accounts given by asylum seekers be taken as proof of deceit? Torture Journal, 16(2), 81-92.
Herlihy, J., & Turner, S. (2013). What do we know so far about emotion and refugee law? Norther Ireland Legal Quarterly, 64(1), 47-62.
Herlihy, J., & Turner, S. W. (2007). Asylum claims and memory of trauma: Sharing our knowledge. The British Journal of Psychiatry. Vol.191 Jul 2007, pp. 3-4. https://doi.org/10.1192/bjp.bp.106.034439
iMMO. (2017). Institute for Human Rights and Medical Assessment. Retrieved from http://www.stichtingimmo.nl/?lang=en
Ingleby, D. (2005). Forced Migration and Mental Health Rethinking the Care of Refugees and Displaced Persons. Boston, MA: Springer Science + Business Media, Inc.
Jennissen, R. (2009). The Dutch migration monitor. Retrieved from https://www.cbs.nl/NR/rdonlyres/2C023D63-66E6-4E51-BFB5-D899B63B34B0/0/2012denederlandsemigratiekaartpub.pdf
Keten, A., Akcan, R., Karacaoglu, E., Odabasi, A. B., & Tumer, A. R. (2013). Medical forensic examination of detained immigrants: is the Istanbul Protocol followed? Med Sci Law, 53(1), 40-44. doi:10.1258/msl.2012.011090
Lustig, S. L., Kureshi, S., Delucchi, K. L., Iacopino, V., & Morse, S. C. (2008). Asylum grant rates following medical evaluations of maltreatment among political asylum applicants in the United States. Journal of Immigrant and Minority Health, 10(1), 7-15. doi:https://doi.org/10.1007/s10903-007-9056-8
McColl, H., Bhui, K., & Jones, E. (2012). The role of doctors in investigation, prevention and treatment of torture. J R Soc Med, 105(11), 464-471. doi:10.1258/jrsm.2012.120100
Migration, A. C. o., & Affairs. (2014). Traces of the past. Retrieved from http://www.acvz.org/publicaties/ACVZ_Advies_40-web.pdf
Oomen, J. (2007). Torture narratives and the burden of giving evidence in the Dutch asylum procedure. Intervention, 5(3), 250-255. doi: http://dx.doi.org/10.1097/WTF.0b013e3282f20246
Schulz, W. F. (2008). The future of human rights : U.S. policy for a new era. Philadelphia: University of Pennsylvania Press.
United Nations. Office of the High Commissioner for Human Rights. (2004). Istanbul Protocol : manual on the effective investigation and documentation of torture and other cruel, inhuman or degrading treatment or punishment (Rev.1 ed.). New York: United Nations.
Wallace, R. M., & Wylie, K. (2013). The Reception of Expert Medical Evidence in Refugee Status Determination. International Journal of Refugee Law, 25(4), 749-767. https://doi.org/10.1093/ijrl/eet046
Wilson-Shaw, L., Pistrang, N., & Herlihy, J. (2012). Non-clinicians' judgments about asylum seekers' mental health: how do legal representatives of asylum seekers decide when to request medico-legal reports? Eur J Psychotraumatol, 3. doi:10.3402/ejpt.v3i0.18406
How to Cite
We accept that some authors (e.g. government employees in some countries) are unable to transfer copyright. The Creative Commons Licence Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) covers both the Torture Journal and the IRCT web site. The publisher will not put any limitation on the personal freedom of the author to use material contained in the paper in other works which may be published, provided that acknowledgement is made to the original place of publication.