Medical evidence in asylum applications: Medical versus legal approaches

• Published in: Journal of forensic and legal medicine 2023-07, Vol.97, p.102553-102553, Article 102553
• Main Authors: Sadana, Annum, Gérard, Sasha Elisabeth, Tang, Ashley, Pardee, Lisa, Sher, Olivia, Foote, Ali, Ades, Veronica
• Format: Article
• Language: English
• Subjects: Asylum; Expert Testimony; Humans; Medical affidavit; Post-traumatic stress disorder; Refugees; Trauma
• ISSN: 1752-928X; 1878-7487
• DOI: 10.1016/j.jflm.2023.102553

The purpose of this narrative review is to elucidate the ways the clinicians working on forensic medical evaluations can engage with asylum proceedings. We compare the legal and medical perspectives on different aspects of forensic medical evidence, asylum evaluations, and asylum applications. As asylum seekers must demonstrate a well-founded fear of persecution in order to receive asylee status, legal and medical professionals often need to collaborate in asylum cases. Although significant evidence has demonstrated that an objective expert medical opinion can support asylum claims, few studies have analyzed how the medical professional's role complements or is at odds with the goals of the legal system. This review summarizes and compares key aspects of the medical and legal perspectives on trauma, credibility, autobiographical memory, and medical evidence to better comprehend the role that medical professionals can play in writing medical affidavits for asylum applications. We dissect legal misconceptions surrounding trauma and the consequences of such misunderstandings and make recommendations for medical evaluators who are working in a forensic capacity. •Legal professionals evaluate credibility based on demeanor and the presentation of a clear narrative in asylum applications.•Clinicians evaluate the consistency of forensic evidence with the alleged trauma in asylum applications.•Medical and legal professionals differ in their understanding of trauma symptoms.•The legal community has a limited understanding of the long-term effects of trauma and prioritizes physical evidence over psychological evidence.•Clinicians can educate the legal community about the psychological impact of trauma on memory and narrative consistency.