Background: Sleep deprivation is a prevalent method of psychological torture. However, difficulties in documentation have meant that it is not adequately appreciated by courts and other quasijudicial institutions such as UN treaty bodies. Method: This paper aims to review the legal literature on deprivation of sleep, the definition, and prohibition of torture and ill-treatment, and its health impacts. A number of texts were identified and analyzed based on contextual relevance: criminal justice processes as well as medical literature on health impacts. The texts were identified via a search of key legal and health databases using the search terms “sleep deprivation,” “sleep adjustment,” and “sleep regulation.” These texts were limited to English-language journal articles, NGO reports, court-cases and UN documents since 1950. They were then analyzed for their approaches to conceptualizing sleep deprivation from the perspective of assessing “severe pain and suffering” and the “diminishment of mental capacity”. Results/Discussion: Sleep deprivation is an ill-defined and, in turn, poorly documented method of torture, particularly when prolonged or inflicted in combination with othermethods (e.g., threats) and conditions (e.g., disruptive environment or time of day). More nuanced legal principles, informed by medical evidence, are lacking. Applying these principles would sharpen its conceptualization.

Background: Fear is a central dimension of torture and cruel, inhuman and degrading treatment (hereafter ‘other ill-treatment’), particularly as a part of verbal or non-verbal threats. Adjudicators and policy-makers have grappled, arguably at a greater depth than with other methods of psychological torture, with the circumstances in which fear-based methods amount to torture or other ill-treatment. The pursuit of non-coercive standards of police interrogation has further underscored the need to better distinguish the prohibited from the permitted. Upon this background, this article reviews the existing jurisprudential and social scientific literature in formulating a lens through which fear-inducing methods could be better functionally conceptualised. Method: This article has identified, through systematic full-text search of databases, texts with keywords ‘threat’, ‘fear’, ‘coercion’, ‘intimidation’, ‘distress’, ‘anguish’ and ‘psychological pressure’. The identified texts, limited to English-language journal articles, NGO reports, court-cases and UN documents from 1950 to date, were then selected for relevance pertaining to conceptual, evidentiary and legal critique provided therein. Discussion: Whilst it is broadly recognized that the deployment of fear to inflict violence can amount to torture, methods of threats or coercion are not adequately conceptualized particularly at the lower end, i.e. routine interrogational torture. Here, principles pertaining to the legitimate use of force and minimum level of severity are used as functional guidelines to distinguish the prohibited from the permitted. The power, practice and proximity of state authorities to harm necessarily qualify threats as real, immediate and credible and therefore torturous.

Background: Psychological torture is deployed to break and obliterate human resistance, spirit and personality, but it is rarely afforded sufficient attention. Deficiencies in conceptualising, documenting and adjudicating non-physical torture mean that it is frequently left undetected and uncontested by the public, media and the courts, bolstering impunity for its perpetrators. A review of the current literature to map conceptual and evidentiary shortcomings from an inter-disciplinary perspective is therefore warranted. Method: The relevant texts were identified through a systematic full-text search of databases, namely HeinOnline, HUDOC, UNODS and DIGNITY´s Documentation Centre, with the keywords `psychological torture´, `mental pain and suffering´, `severity´, `humiliation´, `interrogation techniques´, and `torture methods´. The identified texts, limited to English-language journal articles, NGO reports, court-cases and UN documents from 1950 to date, were then selected for relevance pertaining to conceptual, evidentiary, technological and ethical critique provided therein. Results/Discussion: Evidential invisibility, subjectivity of the suffering, and perceived technological control are the primary ways in which psychological torture methods are designed, and how they manage to evade prosecution and consequently be perpetuated. Cognisant of the need for further research, pertinent questions highlighting the need to develop approaches, sharpen standards and use a medical/psychological/legal interdisciplinary approach are suggested.

That international law progressively recognises and prohibits emergent forms of torture and related ill-treatment has become widely accepted in the anti-torture discourse. The premise that torture's techniques and contexts change is taken to shape juridical recognition, representation and response. Authoritative international treaties, such as the UN Convention Against Torture, the European Convention on Human Rights and the Inter-American Convention to Prevent and Punish Torture, are therefore deemed ‘living instruments’ – influenced by social and scientific change as channelled through the doctrine of dynamic interpretation. This article argues, however, that these premises are not sufficiently empirically grounded and, far from faithfully reflecting social and scientific changes, invoke critiques around the ideological and epistemological registers of advocates and adjudicators. Taking scholarship on dynamic interpretation and forms of state violence which do not leave overt physical marks as paradigmatic entry points, this article problematises torture's juridical conceptualisation and contextualisation through a critical theoretical lens.

This Protocol originates from a joint projectregarding documentation of psychologicaltorture initiated by the Public Committeeagainst Torture in Israel (PCATI),REDRESS and DIGNITY - DanishInstitute against Torture (DIGNITY) in2015 after the Copenhagen Conferenceon Psychological Torture. The project is avehicle to establish a common understandingbetween health and legal professions asto how to best ensure the most accuratedocumentation of psychological torture.Historically, sleep deprivation has beenused for different objectives but, primarily,to cause stress and duress for the purposeof extracting information and confessions.Detention centers with poor conditions isanother context in which sleep deprivation,as a consequence of sleep disruption, takesplace. This is often due to overcrowding,insufficient or no mattresses, and poorconditions of transportation between thecourts and detention facilities.The aim of the Protocol is to improvedocumentation of sleep deprivationused in such settings (most often duringinterrogation) and therefore to clarify thefacts of the case so that stronger legal claimscan subsequently be submitted to local andinternational complaints mechanisms.The Protocol has been developed basedon a methodology involving: compilationand review of legal and health knowledgeon sleep deprivation, also in non-torturecontexts; drafting by first author; discussionin the group of international experts;1 pilot-1 The group includes the following experts andorganizations in addition to the authors of thisProtocol: Nora Sveaass, Nimisha Patel, BrockChisholm, Ahmed Benasr, REDRESS (RupertSkilbeck and Alejandra Vicente), Freedom fromTorture (Angela Burnett and Emily Rowe),testing by PCATI; and evaluation by thethree organizations and the group of experts.Despite generic elements of sleepdeprivation, the context in a specific countrywill determine many aspects of the factualsituation. Each context differs and as suchthis Protocol could serve as a guideline or achecklist of elements to be considered in aspecific context.We hope that this Protocol will assistin the discussions between the variousstakeholders and provide guidance on whatcan be documented and how to documentsleep deprivation.