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What Constitutes a High-Quality, Comprehensive Medico-Legal Affidavit in the United States Immigration Context?

This fact sheet summarizes the findings of the first published multi-sectoral consensus-building exercise on medico-legal affidavits in the U.S. immigration context. Medico-legal affidavits are underpinned by an expert medical evaluation which can objectively contextualize trauma and corroborate accounts of abuse; they are a critical component in immigration proceedings where somebody is seeking protection on the basis of said trauma or abuse. However, the lack of existing validated guidelines has led to inconsistencies in clinical evaluations’ format, structure, and content, causing confusion for practitioners and adjudicators alike. Drawing on expertise from adjudicators, attorneys, and clinicians, this Physicians for Human Right (PHR) research therefore aimed to pinpoint what experts viewed as the most crucial aspects of medico-legal asylum evaluations and their accompanying affidavits. By using a modified Delphi approach to collect and synthesize expert opinions, a consensus was reached on the defining features of a high-quality, comprehensive evaluation. The study identified seven key areas that were most agreed upon by participants, which serve as a foundation for future efforts to standardize and enhance the overall quality and consistency of medico-legal reports.

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