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Editorial article
Human trafficking victims: An emerging reality in forensic medicine
Víctimas de trata de seres humanos: una realidad emergente en medicina forense
Elena Canoa,
Corresponding author
mfcarod@gmail.com

Corresponding author.
, Anna Mateua, Antonia Bertomeua, Alexandre Xifróa,b
a Unitat de Valoració Forense de Víctimes de Tràfic d'Essers Humans, Institut de Medicina Legal i Ciències Forenses de Catalunya, Departament de Justícia, Drets i Memòria, Barcelona, Spain
b Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="p0005" class="elsevierStylePara elsevierViewall">Trafficking in human beings &#40;THB&#41; is the trade in persons for the purpose of exploitation for profit&#44; using means such as force&#44; fraud&#44; deception&#44; threat&#44; or physical or psychological violence &#40;sometimes extreme&#41; to retain them&#44; in any of the stages in which this activity takes place&#58; recruitment&#44; travel-transit &#40;including receipt or harbouring&#41;&#44; and exploitation&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a> These actions seriously violate the fundamental rights and freedoms of the victims&#44; which can have far-reaching physical&#44; mental&#44; sexual&#44; reproductive&#44; and psychosocial consequences&#46;<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a></p><p id="p0010" class="elsevierStylePara elsevierViewall">Since 2010&#44; the Spanish Criminal Code has included the crime of THB and its 3 fundamental elements in Article 177 bis&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> The specialised Prosecutor&#39;s Office for Trafficking in Human Beings and Immigration plays a very significant role in driving legal proceedings for this crime&#44; which has resulted in the specialised assessment of victims as emergent practice in forensic medicine&#46; The dimension of this practice is not measured in quantitative terms&#44; as the volume of victims requiring forensic medical assessment is not significant if we consider the volume of interventions in other types of crime&#46; The dimension&#44; in this case&#44; has to be measured qualitatively by what the forensic examination can contribute&#44; not only for the benefit of judicial procedure&#44; but also as a way of recognising the survivor&#39;s experience&#44; as a necessary step for their recovery&#46; In 2017&#44; the Forensic Medical Council published the Forensic Medical Protocol for the assessment of victims of trafficking&#44;<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a> highlighting the importance of the forensic examination and the basic principles for conducting it&#46; The results of 2 investigations conducted at the Institute of Legal Medicine and Forensic Sciences of Catalonia &#40;IMLCFC&#41;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a> provide an approach to this practice&#44; the first investigation to be conducted from a forensic medical perspective in our immediate environment&#46;</p><p id="p0015" class="elsevierStylePara elsevierViewall">The most common forensic medical intervention is to characterise the consequences that the victim may have suffered&#44; either temporarily or permanently&#44; to any aspect of their health&#46;<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a> It also involves identification of the factors &#40;especially those related to the presence of any disability&#41; which underlie the vulnerability that traffickers are going to exploit&#46; Finally&#44; any circumstances that may influence their testimony&#44; or how attendance at trial may affect their current state&#44; need to be identified&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">Less frequently&#44; the forensic practitioner will be required to participate urgently in the police process of extracting victims from the network&#46; This intervention will serve to document the general condition of the victims at that precise moment&#44; from weight and nutritional status to hygiene status&#44; or the presence of acute injuries&#44; so as to later correlate these findings with the conditions in which the victim was kept&#44; whatever the stage of trafficking in which they were found&#46;</p><p id="p0025" class="elsevierStylePara elsevierViewall">THB primarily affects women and girls&#46;<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a> In our experience&#44; the procedures that most frequently required forensic evaluation were related to sexual exploitation and the predominant victim profile was a young&#44; foreign woman with a cultural background very different to our own&#46; Therefore&#44; in the forensic approach to these victims&#44; we consider it necessary to apply a broad perspective&#44; from a victim-centred approach and based on knowledge of the impact of the trauma so that we can adjust our assessment to the concrete and specific situation of the survivor&#46; This approach must be based on training and awareness of human rights so that those that have been violated can be detected&#44; with a gender perspective to identify the vulnerability factors that underlie the disproportionate impact of trafficking on women and girls&#44; and with a cross-cultural perspective to recognise factors specific to the survivor&#39;s culture that will influence both their vulnerability and the clinical expression of the psychological impact&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">THB is a changing activity that adapts and exploits the means at its disposal&#44; and has the capacity to easily develop forms of exploitation beyond sexual&#44; begging&#44; or forced labour&#44; exploitation in the form of forced marriage&#44; or organ procurement for transplantation&#46; Moreover&#44; it is not uncommon for victims to be subject to more than one type of exploitation&#46; In the field of forensic medicine&#44; we must consider exploitation for forced criminality&#59; this could be considered the fourth most frequent type of exploitation&#44; after sexual exploitation&#44; forced labour&#44; and begging&#44; and it is essential to highlight that&#44; in this case&#44; most victims are men and&#44; above all&#44; children &#40;68&#37; of detected victims&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a></p><p id="p0035" class="elsevierStylePara elsevierViewall">In the case of exploitation for forced criminality&#44; the victim is forced to commit criminal acts such as crimes against property or drug trafficking offences &#40;including the production of cannabis crops&#41;&#46;<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a> In these cases&#44; the victim&#44; in addition to the network&#44; can also become a victim of the justice system if they are arrested&#44; tried&#44; and convicted precisely for having committed these acts&#44; in contravention of the provisions of Directive 2011&#47;36&#47;EU&#44;<a class="elsevierStyleCrossRef" href="#bb0055"><span class="elsevierStyleSup">11</span></a> Article 8&#44; and the aforementioned 177 bis of the Spanish Criminal Code&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a></p><p id="p0040" class="elsevierStylePara elsevierViewall">This latter form of exploitation places forensic medicine professionals in a privileged position to detect potential victims &#40;in forensic medical assistance to persons in custody or in psychiatric evaluations of persons accused of these types of crimes&#41;&#44; when&#44; duly trained and qualified&#44; we are able to identify the indicators of trafficking and record them&#46; This is a decisive first step&#44; when we become aware that there is no stereotypical victim in this situation and that victims will not always be women&#44; nor will they necessarily have been subjected to sexual exploitation&#44; but&#44; in fact&#44; they may be presented to us as &#8220;criminals&#8221;&#46;</p><p id="p0045" class="elsevierStylePara elsevierViewall">THB&#44; therefore&#44; presents medical professionals with an important challenge&#44; which requires raising awareness and specialised training to incorporate the specific requirements requested by the Courts in assessments and&#44; above all&#44; to identify and adapt to the circumstances of the survivors&#44; minimising re-victimisation&#46; For these reasons&#44; with a broad perspective and from accumulated experience&#44; in 2022&#44; the Institute of Legal Medicine and Forensic Sciences of Catalonia created the first Forensic Assessment Unit for Victims of THB&#46;</p></span>"
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Article information
ISSN: 24454249
Original language: English
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