This case is particularly important for our practice because we instruct experts for medico-legal reports. The case states that when preparing medico-legal reports doctors should not, and should not feel obliged, to reach conclusions about the possession of scarring which go beyond their own clinical expertise. The case also establishes that doctors preparing medico-legal reports for asylum seekers must consider all possible causes of scarring. Furthermore, where there is a presenting feature of the case that raises self-infliction by proxy as a more than fanciful possibility of the explanation for scarring, a medical report adduced on behalf of a claimant will be expected to engage with that issue. A judicial fact finder will be expected to address the matter in deciding whether on all the evidence the claimant has discharged the burden of proving that he or she was reasonably likely to have been scarred by torture against his or her will. A lack of correlation between the claimant’s account and what is revealed by the medical examination of the scarring may enable a medico-legal report to shed some clinical light on the issue of whether self-infliction by proxy is a real possibility.
Whilst the medical literature continues to consider that scarring cannot be dated beyond six months from when it was inflicted, there is some medical basis for considering in relation to certain types of cases that its age can be determined up to two years.