Intended for healthcare professionals

Student Careers

How to care for survivors of torture

BMJ 2004; 328 doi: (Published 01 April 2004) Cite this as: BMJ 2004;328:0404150
  1. Caroline Jewels, fifth year medical student1,
  2. Helen Maguire, fifth year medical student1,
  3. Brian Fine, general practitioner2,
  4. Carol Cheal, general practitioner3
  1. 1Guy's, King's, and St Thomas's School of Medicine, London
  2. 2Brockwell Park Surgery, London SE24 9AE
  3. 3Well Park Surgery, London SE26 6JQ

All doctors in the United Kingdom can expect to see patientsat some stage in their career who have been tortured. Caroline Jewels, Helen Maguire,Brian Fine, and Carol Cheal discuss how to identify and support survivors of torture

Imagine you are a junior doctor in east London. Your next patient comes in complaining of chronic back pain. You ask more questions about the history of the pain, and he breaks down into tears. He goes on to explain that he is seeking asylum in the United Kingdom. He fled his country, where he had been held captive and tortured for six months. How do you react to this information? What do you say to him? How will you treat his pain? What support will you provide him with? How do you cope yourself?

What is torture?

The World Medical Association defines torture as “the deliberate, systematic, or wanton infliction of physical or mental suffering by one or more persons, acting alone or on the orders of any authority, to force another person to yield information, to make a confession, or for any other reason.”1 The United Nations condemns any medical professional being involved in any form of torture unless their involvement is to evaluate, protect, or improve the detainees' physical and mental health. The British Medical Association's policy is that medical ethics prohibit any involvement by doctors in torture and that doctors in countries where torture does not occur have a responsibility to help colleagues in countries where it does.2

Methods of torture

Torture is often used to get information or a confession, to punish, to take revenge, or to create terror and fear within a population. Some common methods of physical torture include beating, electric shocks, stretching, submersion, suffocation, and burns. Common methods of …

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