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Tokyo declaration 1975
1. TOKYO DECLARATION
OF 1975
BY
DR. GURSIRAT S. KHOKHAR
JUNIORRESIDENT
DEPT.OFFORENSICMEDICINEANDTOXICOLOGY
GOVT. MEDICALCOLLEGE, AMRITSAR
2. DECLARATION OF TOKYO
The Declaration of Tokyo is a set of
international guidelines for physicians
concerning torture and other cruel, inhuman
or degrading treatment or punishment in
relation to detention and imprisonment,
which was adopted in October 1975 during
the 29th General assembly of the World
Medical Association, and later editorially
updated by the WMA in France, May 2005 and
2006. It declares torture to be “contrary to the
laws of humanity”.
3. • The policy states that doctors should refuse to
participate in, condone, or give permission for
torture, degradation, or cruel treatment of
prisoners or detainees. According to the policy,
a prisoner who refuses to eat should not be fed
artificially against his will, provided that he or
she is judged to be rational.
4. PREAMBLE
• It is the privilege of the medical doctor to practice medicine in
the service of humanity, to preserve and restore bodily
and mental health without distinction as to persons, to comfort
and to ease the suffering of his or her patient. The utmost
respect for human life is to be maintained even under threat,
and no use made of any medical knowledge contrary to the
laws of humanity.
• For the purpose of this Declaration, torture is defined 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
5. DECLERATION
1-- The physician shall not countenance, condone or participate in the
practice of torture or other forms of cruel, inhuman or degrading
procedures, whatever the offense of which the victim of such
procedures is suspected, accused or guilty, and whatever the
victim's beliefs or motives, and in all situations, including armed
conflict and civil strife.
2-- The physician shall not provide any premises, instruments,
substances or knowledge to facilitate the practice of torture or
other forms of cruel, inhuman or degrading treatment or to
diminish the ability of the victim to resist such treatment
3-- When providing medical assistance to detainees or prisoners who
are, or who could later be, under interrogation, physicians should
be particularly careful to ensure the confidentiality of all personal
medical information. A breach of the Geneva Conventions shall in
any case be reported by the physician to relevant authorities.
6. CONT.
4--The physician shall not use nor allow to be used, as far as he or
she can, medical knowledge or skills, or health information
specific to individuals, to facilitate or otherwise aid any
interrogation, legal or illegal, of those individuals.
5--The physician shall not be present during any procedure during
which torture or any other forms of cruel, inhuman or
degrading treatment is used or threatened.
6--A physician must have complete clinical independence in
deciding upon the care of a person for whom he or she is
medically responsible. The physician's fundamental role is to
alleviate the distress of his or her fellow human beings, and no
motive, whether personal, collective or political, shall prevail
against this higher purpose.
7. CONT.
7--Where a prisoner refuses nourishment and is considered by the
physician as capable of forming an unimpaired and rational
judgment concerning the consequences of such a voluntary
refusal of nourishment, he or she shall not be fed artificially. The
decision as to the capacity of the prisoner to form such a
judgment should be confirmed by at least one other
independent physician. The consequences of the refusal of
nourishment shall be explained by the physician to the prisoner.
8--The World Medical Association will support, and should
encourage the international community, the National Medical
Associations and fellow physicians to support, the physician and
his or her family in the face of threats resulting from a refusal to
condone the use of torture or other forms of cruel, inhuman or
degrading treatment.
8. MEDICAL CODES ON TORTURE
• UNIVERSAL DECLARATION OF HUMAN
RIGHTS (1948)
• INTERNATIONAL AGREEMENT OF CIVIL AND
POLITICAL RIGHTS (1966)
• DECLARATION ON THE PROTECTION OF ALL
PERSONS FROM TORTURE AND OTHER CRUEL
INHUMAN OR DEGRADING TREATMENT OR
PUNISHMENT– DECLARATION OF TOKYO
(1975)
9. Cont.
• STATEMENT BY THE INTERNATIONAL UNION OF
PSYCHOLOGICAL SCIENCE(1976)
• PRINCIPLES OF MEDICAL ETHICS(1982)
• DECLARATION OF HAWAII WORLD PSYCHIATRIC
ASSOCIATION(1983)
• WORLD CONFERENCE ON HUMAN
RIGHTS(1993)
• HUMAN RIGHTS ACT(1993)
10. DEFINITION
A, 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
YEILD INFORMATION, TO MAKE A
CONFESSION OR FOR ANY OTHER REASON.
11. HISTORICAL EVIDENCES OF TORTURE
• Torture was frequently employed during
the Middle Ages to punish criminals and
extract confessions. Hundreds of devices
were used including The Rack and The
Chair.
• Some common modes of torture employed
during that time are……………
12. The Spanish Tickler
• The victim was naked and
tied making him or her
completely defenseless.
Then the torturers began
the (sometimes public) act
of mutilating the victim.
They often began with the
limbs and slowly moved
into the chest, back, neck
and finally the face.
13. Judas Cradle
• The triangular-shaped end of the judas
cradle was inserted in the victim's anus
or vagina. This torture could last,
depending on some factors discussed
below, anywhere from a few hours to
complete days.
The time it took someone to die varied
enormously from individual to individual.
Torturers would sometimes add weight to
the victim's legs as to increase pain and
hurry the victim's death. Other torturers
would place oil on the device which
increased pain considerably.
This device was rarely, if at all, washed.
If the victim did not die quickly enough,
or their painful execution was
interrupted, they would invariantly die
from an infection.
14. Coffin Torture
• The victim was placed inside the "coffin".
Torturers were well-known for forcing
overweight victims into the device, or even
making the "coffin" slightly larger than
normal to make the victims more
uncomfortable.
The period of time a victim was to be kept
inside the coffin was determined by his or
her crime. Very serious crimes, such as
blasphemy, were punished by death inside
the coffin where the victim was to be kept
inside under the sun with animals eating his
or her flesh.
15. The Wheel Torture (Breaking Wheel)
• The device consists of a large wooden wheel with many spokes. The
victim's limbs were tied to the spokes and the wheel itself was slowly
revolved. Through the openings between the spokes, the torturer
usually hit the victim with an iron hammer that could easily break the
victim's bones. Once his bones were broken, he was left on the wheel to
die, sometimes placed on a tall pole so the birds could feed from the
still-living human.
16. Thumbscrew Torture
• The victim's fingers were placed
inside the instrument and slowly
crushed as the torturer turned
the handle on top. This method
was primarily used to extract
confessions as it was both
painful and very lasting.
• The same instrument was also
used to crush victim's toes.
17. The Rack Torture
• The torturer turned the handle causing the ropes
to pull the victim's arms. Eventually, the victim's
bones were dislocated with a loud crack. If the
torturer kept turning the handles, some of the
limbs were torn apart, usually the arms.
• Sometime this method was limited to dislocating
a few bones, but the torturer often went too far
and rendered the legs or arms (sometimes both)
useless. In the late Middle Ages, some new
variants of this instrument appeared. They often
had spikes that penetrated the victim's back - as
the limbs were pulled apart, so was his spinal
cord increasing not only the physical pain, but
the psychological one of being handicapped at
best.
18. The Rat Torture
• The victim was completely restrained
and tied to the ground or any
horizontal surface. A rat was then
placed on his stomach covered by a
metallic container. As the container
was gradually heated, the rat began
to look for a way out - through the
victim's body.
Digging a hole usually took a few
hours of agonizing pain for the
victim. This almost invariantly
resulted in death.
19. Saw Torture
• The victim was tied to an inverted
position. This had several "benefits":
first, it assured sufficient blood
diverted to the brain, second, it
slowed down the loss of blood and
third, it humiliated the victim.
• While some victims were cut
completely in half as a symbolical
gesture, most had only up to their
abdomen cut, this was done to
prolong the time of death.
25. THE DEPRIVATION TECHNIQUE
• SOCIAL DEPRIVATION TECHNIQUE/SOLITARY
CONFINEMENT
• SENSORY DEPRIVATION (blind folding/sham
torture)
• PERCEPTUAL DEPRIVATION
• SLEEP DEPRIVATION
• NUTRITIONAL DEPRIVATION
• HYGIENIC DEPRIVATION
• HEALTH SERVICE DEPRIVATION
26. THE COERCION TECHNIQUE
• IMPOSSIBLE CHOICE/ INCONGRUENT
TECHNIQUE
• HUMILIATIONS
• THREATS
• BLIND OBEDIENCE OF RULES
• SEXUAL TORTURE (undressing, insertion of
foreign bodies in external genitilia, mutilation
of external genitilia, rape)
27. THE COMMUNICATION TECHNIQUE
• COUNTER-EFFECT TECHNIQUES
• DOUBLE BLINDING TECHNIQUES
• DISINFORMATION/ FALSE INFORMATION
• DISTORTION OF PERCEPTIONS
• CONDITIONING OF NEW REFLEXES
28. REASONS FOR TORTURE
• TO SPREAD TERROR IN SOCIETY OR COUNTRY
• TO DESTROY A PERSONALITY
• TO TAKE REVENGE
• TO GET TESTIMONY INCRIMINATING OTHERS
32. SOCIAL EFFECTS
• SOCIAL STIGMA
• LOSS OF JOB / EMPLOYMENT
• REJECTION FROM FAMILY AND SOCIETY OR
COMMUNITY
• ANTI-SOCIAL BEHAVIOUR
• REVENGE
• DRUG ADDICTIONS
33. MANAGEMENT OF TORTURE VICTIMS
• Avoid reminding torture episodes
• Treatment should simultaneously include
Physical and Psychological therapy
• Treatment should include the victim and his
family
• Social condition and personal social service
should be included in treatment
34. INJURY PATTERNS AND AUTOPSY
FINDINGS IN VICTIMS OF TORTURE
• GENERAL FINDINGS
scars
bruises
lacerations
multiple # in different stages of healing
• BEATING
hemorrhages in soft tissues
aseptic necrosis of palms and soles
scarring or rupture of Tympanic membrane
35. Cont.
bruises over abdomen
bruises over palms and soles
injuries over back and buttocks
sub-scalpal hematoma
cerebral cortical atrophy
skull #
• SUSPENSION
bruises and scars over wrists and ankle joint
specific PM lividity patterns, edema on
dependent parts.
36. Cont.
• NEAR SUFFOCATION
fecal matter or urine in and around
mouth, oesophagus, trachea, larynx.
petichiae over lungs
• SEXUAL ABUSE
STDs
genital injuries
37. Cont.
• FORCED POSTURE
dependent edema
perineal or scrotal hemotomas
petechiae over dependent limbs
• BITE MARKS
• VITEROUS HUMOUR FOR ELECTROLYTE
ABNORMALITIES FOR DEHYDRATION
38. TORTURE AND ITS ASPECT IN INDIA
• All cases of torture should be reported to police.
Sec 340and 342– Wrongful confinement and
punishment for 6 mnts.
• Sec. 330 IPC- voluntarily causing hurt for the purpose
of extorting confession or information or to compel
restoration of property is punishable with
imprisonment up to seven (7) years.
Sec. 331 I.P.C - voluntarily causing grievous hurt, for
the purpose of extorting confession or information
or to compel restoration of property is punishable
with imprisonment up to ten(10) years.
39. CONT.
• Sec. 339 IPC and 341 IPC- Wrongful restraint. Imprisonment
up to one (1) month.
• Human Rights Act, 1993, in India, also curbs the violation of
any human rights, including any torture.
1. The District Magistrate and SP of police, have to report
within 24 hours to National Human Rights Commission,
cases of rape, custodial death / torture.
2. P.M. in custodial death or alleged torture – video filming
has to be done and the cassette has to be sent to be sent to
commission. The PM report should be submitted in twenty
four (24) hours.
3. Information of arrest has to be given to the victim’s
relatives/friends
40. TORTURE DAY
• The United Nations International Day in
Support of Victims of Torture – 26 June is
held annually on 26 June to speak out against
the crime of torture and to honor and support
victims and survivors throughout the world.
