Examination for the late physical after effects of torture

This paper describes the experience of doctors at the Medical Foundation for the Care of Victims of Torture, London, in documenting torture as recounted by survivors, mostly refugees from one of 63 countries, and in writing medico-legal reports to support their asylum claims. More than 2000 new patients are seen each year and 500 reports written. Few patients are seen in the acute phase; many not until 10 years following their torture. Patterns of torture practised in different countries are described, with the resulting physical signs. Methods of history-taking and examination are discussed, with emphasis on the detection of subtle forms of torture, recognition of deception and encouragement of full disclosure.