91 treatment, if this is the case. 433 Thus, forensic doctors must take steps to notify possible abuse to the corresponding authorities or, if this entails foreseeable risks to health care professionals or their patients, to authorities outside the immediate jurisdiction. 434 In addition, the State must provide the necessary guarantees to ensure that, if a medical forensic examination supports the possibility that acts of torture or other cruel, inhuman or degrading treatment have been perpetrated, the detainee is not returned to the place of detention where this occurred. 435 259. In this regard, the Court notes that, despite the evident progressive deterioration in Gladys Espinoza’s physical condition, revealed by the four physical examination performed on her in April and May 1993 (supra para. 167), the forensic doctors who examined her did not report the existence of signs of torture to any authority and, on each of those occasions, Gladys Espinoza was returned to the same DINCOTE officials who had perpetrated the said torture and cruel, inhuman and degrading treatment against her. 260. The Court has established that the State must ensure the independence of medical and health care personnel responsible for examining and providing assistance to detainees so that they may perform the necessary medical examinations freely, respecting the norms established for the practice of their profession. 436 Thus, the Court considers that “professional independence requires that, at all times, health care professional act in accordance with the fundamental goal of medicine, which is to alleviate suffering and anguish, and to avoid harm to the patient, despite any circumstance that could counteract this.” The obligation of independence requires that doctors should have full freedom to act in the interests of the patient, and means that doctors must use the best medical practices, whatsoever the pressure to which they may be subject, including possible instructions from those employing them, prison authorities or security forces. In this regard, the State is obliged to abstain from, in any way, obliging doctors to compromise their professional independence. Even though it is not sufficient to indicate that a doctor is a State employee to determine that he is not independent, the State must ensure that his contractual conditions grant him the necessary professional independence to issue his clinical opinions without pressure. The forensic doctor also has the obligation to be objective and impartial when assessing the person he is examining. 437 261. The Court has indicated that, in principle, the burden of proving the facts on which his or her arguments are based corresponds to the plaintiff; however, it has emphasized that, contrary to domestic criminal law, in proceedings on human rights violations, the State’s defense cannot rest on the plaintiff’s impossibility of providing evidence when it is the State that controls the 433 Cf. Istanbul Protocol, supra, para. 71. 434 Cf. Istanbul Protocol, supra, para. 73. Similarly, see also: Argentine Criminal Code, article 144(2), Available at: http://www.infoleg.gov.ar/infolegInternet/anexos/15000-19999/16546/texact.htm; National Mental Health Act of Argentina, art. 29, Available at: http://www.msal.gov.ar/saludmental/images/stories/info-equipos/pdf/2013-0926_ley-nacional-salud-mental.pdf; Medical Ethics Code of Bolivia, art. 52, Available at: http://snis.minsalud.gob.bo/ documentacion/normativas/CODIGODEETICAYDEONTOLOGIAMEDICA.pdf; Code of Criminal Procedure of Chile, art. 84, Available at: http://www.leychile.cl/Navegar?idNorma=22960; Criminal Code of Colombia, amended by Law 1121 of 2006, art. 441, Available at: http://www.alcaldiabogota.gov.co/sisjur/normas/Norma1.jsp?i=22647, among others Similarly, see: International Council of Nurses, Nurses’ role in the care of detainees and prisoners, 1998, Available at: http://www.icn.ch/images/stories/documents/publications/position_statements/A13_Nurses_Role_Detainees_Prisoner s.pdf. 435 Cf. Istanbul Protocol, supra, para. 126. 436 Cf. Case of Bayarri v. Argentina. Preliminary objection, merits, reparations and costs. Judgment of October 30, 2008. Series C No. 187, para. 92. See also, Istanbul Protocol, supra, paras. 56, 60, 65 and 66, and Committee against Torture, General Comment No. 2: Implementation of article 2 by the States Parties, UN Doc. CAT/C/GC/2, para. 13. 437 Cf. Istanbul Protocol, supra, paras. 57, 61, 67 and 71. In this regard see the amicus curiae presented by Women’s Link Worldwide and the Legal Clinic of the Universidad de Valencia of April 15, 2014 (merits file, folio 1422).