Medico-legal assessment of physical abuses in asylum cases: a multidisciplinary role for multiform issues

With increasing migratory flows, forensic assessment of physical and psychological abuse plays an essential part for the proper functioning of humanitarian asylum procedures. Among professionals involved with vulnerable migrants, clinical forensic practitioners identify and assess injuries related to physical abuse and correlate them with the victims' narrative. The present study assesses the importance of a multidisciplinary approach to the final assessment of scars, analysing its impact on the medico-legal evaluation of asylum seekers who suffered physical abuse. A retrospective study was conducted on all cases of asylum seekers evaluated at the Milan University Institute of Legal Medicine from 2008 to 2020 to investigate in which cases further investigations were needed and the outcome impacts of these investigations. Of the individuals examined, 92 asylum seekers were subjected to further forensic instrumental examinations (80.4%) and specialized medical consultations (33.7%). The most common indication for further investigation was for blunt shape forces in combination with other forces (38%), followed by blunt force injuries alone (34.8%). Radiography was the most widely used instrumental examination indicated to investigate injuries (90%) and the most frequent further consultation was odontological (17.4%). In 62 cases (47.7%) the presence of scars was confirmed by the identification of further skeletal and visceral lesions. The present research highlights the direct impact of a multidisciplinary, specialist approach on forensic consistency findings. This approach facilitated and improved the accuracy of clinical forensic evaluation in these highly sensitive cases, thereby reducing errors when assessing the presence of confounding factors, including those consequent from healing processes.