The effect of the medico-legal evaluation on asylum seekers in the Metropolitan City of Milan, Italy: a pilot study

Abstract

In the present-day situation, the clinical forensic documentation of an asylum seeker's narrative and his or her examination, together with the physical and psychological findings, may have very important effects on the outcome of the request for political asylum. Since 2012, the Municipality of Milan, the University Institute of Legal Medicine, and other institutions have assembled a team with the task of examining vulnerable asylum seekers and preparing a medical report for the Territorial Commission for International Protection (Prefecture, Ministry of Interiors), who will assess the application. We compared medico-legal reports and outcomes of 57 cases which were evaluated by the Commission after having undergone a medico-legal evaluation through the Istanbul Protocol criteria and examined, in particular, which medico-legal variables seem associated to the outcome. The results show that forensic assessment seems to have a significant and interesting correlation with the final assessment given by the Commission. For example, the higher the level of consistency, according to the Istanbul Protocol, the more frequently protection is granted. These data show how important clinical forensic medicine can be in such scenarios and how the presence of clinical forensic experts should be encouraged in such evaluations, as has been recently enshrined in Italy in the guidelines of a Ministerial Decree of April 3rd, 2017 for the assistance and the rehabilitation as well as the treatment of psychiatric disorders in refugees and asylum seekers who have undergone torture, rape, and other severe forms of psychological, physical, or sexual violence.

“Better than having no evaluation done”: a pilot project to conduct remote asylum evaluations for clients in a migrant encampment in Mexico

“…The acceptance of remote evaluations – especially those conducted in other countries -- in immigration courts as equal or nearly-equal means of clinician assessment may potentially have domestic and global ramifications. Asylum evaluations are highly relevant for asylum and immigration proceedings in all refugee-receiving countries and in fact such evaluations are being conducted, and their impact and effectiveness studied, in multiple countries, including the UK [ 14 ], Italy [ 15 ], and the Netherlands [ 16 ]. The international standard used as a reference for asylum evaluations around the world is the UN Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, also known as the “Istanbul Protocol” (IP) [ 17 ].…”

Tortures alleged by migrants in Italy: compatibility and other medicolegal challenges

“…The literature based on the forensic assessments of subjects who allegedly suffered torture acts is rather scarce [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. It is therefore so difficult for the medicolegal or forensic specialists to acquire a specific knowledge and experience in the field that the matter of the evaluation of the physical signs of torture is still considered a challenging area of forensic medicine [21].…”

Sexual assault and abuse committed against family members: An analysis of 1342 legal outcomes and their motivations

“…Cases with observed multiple types of lesions, especially if registered in multiple anatomical areas, were characterized by conviction, probably because they suggest a greater violence of the assailant, as previously seen when examining motivations sustaining the assignment of humanitarian protection to asylum seekers [27]. Actually, a higher number of convictions were registered in cases where the victim had clinical documentation produced by a general emergency room or a specific anti-violence service (as in the case of SVSeD), suggesting the importance that objective medical examinations may have.…”