Author
As part of the general information provided to applicants for international protection, which is given in connection with the lodging of their application, the applicants are also informed of the possibility to obtain a medical examination aimed at identifying signs of persecution or serious harm.
Usually it is the applicant who provides medical reports indicating possible ill treatment in the past. The MoI, however, can obtain medical records upon its own request if the applicant provides consent to it. Usually the medical examination and report are paid for out of public funds, as all asylum seekers are covered by public health insurance.
There are no criteria set in the law indicating when a medical examination for the purpose of drafting a medical report should be carried out. The MoI rarely initiates medical examinations of the applicants on its own motion.
Medical reports are usually taken into account when assessing the credibility of the applicant’s statements. However, authorities do not always give medical evidence sufficient weight, especially if the reports show psychological problems.
The SAC recently found that the MoI had failed to properly consider an applicant’s vulnerability, mental health condition, memory problems and medication, all of which directly affected her ability to perceive events and recount them coherently and consistently.[1] The applicant had repeatedly informed the authorities that she suffered from anxiety, depressive symptoms and suspected undiagnosed ADHD, and she submitted medical documentation, including a psychiatrist’s report confirming treatment with high doses of antidepressants and anxiolytics. Despite this, the MoI did not adequately assess how her mental health might impact the credibility and detail of her testimony—particularly during a seven-hour interview, which would challenge even a healthy person’s concentration. The Court emphasised that if an applicant claims memory problems, authorities cannot dismiss these claims without proper medical grounds. Mental health issues other than ADHD could account for such difficulties, and this must be investigated rather than presumed . The judgment also referred to earlier case-law holding that mental disorders (e.g., schizophrenia) may significantly impair an applicant’s ability to provide a coherent, chronological and detailed account of events. In such cases, authorities must obtain an expert medical evaluation to understand how the applicant’s condition may affect their statements.[2]
Medical reports are rarely based on the methodology laid down in the Istanbul Protocol. There is a problem of lack of training of the medical personnel on the Istanbul Protocol. The Czech R epublic has been repeatedly criticised by the UN Committee Against Torture (CAT) for its inadequate identification of presumed victims of torture and for failing to ensure training of medical personnel and state officials on the Istanbul Protocol. In its concluding observations on the sixth periodic report from 2018, the CAT specifically recommended that the Czech Republic, in relation to asylum seekers, ‘ take all necessary measures to develop and implement a standard procedure for the identification and protection of persons in vulnerable situations, including victims of torture and ill-treatment’. [3] In this context, the CAT recommends ensuring that the Istanbul Protocol becomes an essential part of training for all healthcare professionals and other state officials involved in working with persons deprived of liberty. Similar concerns and recommendations regarding training on recognising signs of torture or other ill-treatment were already raised by the CAT in its earlier observations from 2012, when it rejected the State’s assertion that the physical and psychological symptoms of torture are so specific that an experienced doctor does not require specialised training.[4]
[1] SAC, judgement No 7 Azs 212/2024 – 58, 21 February 2025, available in Czech here, sec. 11 – 12.
[2] SAC, judgement No 5 Azs 156/2023‑32, 18 September 2023, available in Czech here.
[3] Committee Against Torture, Concluding observations on the sixth periodic report of Czech Republic, CAT/C/CZE/CO/6, 2018, available here, paras 38–39.
[4] Committee Against Torture, Concluding observations of the Committee against Torture, Czech Republic, CAT/C/CZE/CO/4-5, 2012, available here, para 18.