IPAT Medical-Evidence Engagement and Rebuttal of the International Protection Act 2015 s.28(6) Presumption

1) Introduction

G.M. v The International Protection Appeals Tribunal and Anor (Approved) [2026] IEHC 525 is a High Court judicial review decision in which Bradley J. refused to quash an International Protection Appeals Tribunal (“IPAT”) determination affirming the refusal of both a refugee declaration and subsidiary protection.

The applicant (G.M.), a subsistence farmer from Zimbabwe, claimed fear of serious harm from his uncle, said to be a local healer/witch doctor. A central factual feature was an alleged ritual attack in 2009/2010 in which the uncle sedated the applicant and removed his right testicle. The applicant relied heavily on a Spirasi Medical Report (28 March 2024) describing physical scarring and psychological symptoms consistent with depression and PTSD.

The judicial review focused on two alleged legal errors:

  • Medical-evidence/PTSD issue: whether IPAT failed to adequately consider the Spirasi report (including PTSD) when criticising the applicant’s later narrative as vague.
  • Threats/reasons/s.28(6) issue: whether IPAT failed to properly consider alleged death threats and failed to apply s.28(6) of the International Protection Act 2015 (as amended) and/or failed to give adequate reasons under s.46(6).

Bradley J. rejected both grounds, concluding that IPAT assessed the claim with “vigilance and care” and gave adequate reasons for rejecting a forward-looking risk despite accepting the 2009/2010 harm.

2) Summary of the Judgment

The High Court held:

  • IPAT did engage with the Spirasi report and indeed accepted the core alleged traumatic event (the testicle removal) on the balance of probabilities; it was entitled to find the applicant’s account of later violence/threats vague and lacking detail.
  • The court distinguished authorities where tribunals either disregarded medical evidence or made credibility findings in a manner that suggested expert evidence had not been “weighed in the mix”.
  • IPAT gave adequate reasons meeting s.46(6) and the general “middle ground” standard for reasons discussed in Connelly v An Bord Pleanála and Mallak v Minister for Justice Equality & Law Reform.
  • IPAT correctly applied s.28(6): although past serious harm was accepted (triggering the presumption), IPAT identified “good reasons” why repetition was unlikely—particularly the absence of credible evidence of further violence over a prolonged period of co-residence and the absence of pursuit when the uncle allegedly knew the applicant’s later location.

Relief was refused; the matter was listed for mention regarding costs.

3) Analysis

3.1 Precedents Cited (and How They Shaped the Outcome)

(a) Deference, presumptions, and the limits of judicial review

  • MPBK v IPAT [2020] IEHC 450: Bradley J. relied on the cluster of general propositions (presumption of validity; JR not an appeal; weight is for the decision-maker; no entitlement to discursive narrative). These propositions underpinned the court’s approach: the applicant needed to show a legal error, not merely contest the assessment of credibility or the weight given to evidence.

(b) Presumption that submissions/material were considered

  • G.K. v Minister for Justice [2002] 2 I.R. 418 (“G.K.”) and Rana & Ali v The Minister for Justice [2024] IESC 46 (“Rana & Ali”): These authorities supported the proposition that where a decision-maker states that all material has been considered, a challenger must point to an evidential basis to infer the contrary. This was important to the “second issue”, where IPAT expressly listed the material relied upon (including the Spirasi report) and stated it had been “fully assessed”.

(c) Treatment of medical reports (Spirasi and similar)

  • I.R. v Minister for Justice [2009] IEHC 510; [2015] 4 I.R. 144 (“I.R.”): Cited for the principle that, absent a legal error, the weight given to medical reports is for IPAT.
  • CM (Zimbabwe) v The IPAT [2018] IEHC 35: Used to reinforce that a tribunal may consider a Spirasi report but not in the manner most favourable to an applicant; evaluation remains quintessentially for the tribunal.
  • M.E. v. Refugee Appeals Tribunal [2008] IEHC 192: Quoted via CM (Zimbabwe) for the “quintessentially a matter for the Tribunal Member” approach to weighing evidence.
  • A.T. (DRC) v The Minister for Justice and Equality & Ors [2015] IEHC 479: Distinguished; that case involved failure to engage with the Spirasi report or provide reasons for rejecting it—unlike here where IPAT quoted and relied on the report and accepted key aspects.
  • BAC (Botswana) v The IPAT [2024] IEHC 297: Distinguished on its sequencing/context concerns (credibility finding arguably formed before expert evidence was considered, and expert evidence rejected). Bradley J. found neither concern applied.
  • N v The IPAT and Ors [2026] IEHC 121 (“N”): A significant comparator. In N, the court quashed IPAT for failing to “weigh in the mix” the corroborative value of psychiatric evidence relevant to memory issues and the applicant’s account of persecution. Bradley J. contrasted the present case: IPAT accepted the main traumatic event and explicitly stated it considered the psychological impact and the Spirasi findings.
  • H.E. (DRC) [2004] UKIAT 00321 (via MPBK): Emphasised that medical reports can identify condition and record history but cannot conclusively prove how injuries were inflicted—helpful in keeping the Spirasi report in its proper evidential role.

(d) Reasons, transparency, and statutory structure

  • H & A v IPAT & Ors [2025] IECA 203: Cited for the structure of s.46 and the requirement that IPAT communicate decisions and reasons under s.46(6).
  • Connelly v An Bord Pleanála [2018] IESC 31; [2021] 2 I.R. 752 (“Connelly”) and Mallak v Minister for Justice Equality & Law Reform [2012] 3 I.R. 297; [2012] IESC 59 (“Mallak”): These cases framed the adequacy-of-reasons analysis. Bradley J. applied the “middle ground” concept and the functional rationale for reasons (fairness, ability to challenge, meaningful review).

(e) s.28(6) presumption and “good reasons” rebuttal

  • N.U. v IPAT & Ors [2022] IEHC 87, I.L. v IPAT & Anor [2021] IEHC 106), G.G. v IPAT & Ors [2025] IEHC 625: Used to explain that s.28(6) creates a rebuttable presumption: past persecution/serious harm is a “serious indication” of future risk unless there are “good reasons” it will not be repeated.
  • I.U. v IPAT & Anor [2026] IEHC 360 and M.Y. v IPAT [2022] IEHC 345: Cited for the practical significance of s.28(6) (a “significant” presumption in the applicant’s favour) and the concept of onus shifting to the decision-maker to show “good reasons” against repetition.

(f) “Vigilance and care” (EU law analogy)

  • Case C-756/21, X v IPAT: The applicant argued, by analogy, that IPAT must apply “vigilance and care” when performing the assessment. Bradley J. accepted the standard as a touchstone but concluded IPAT met it on the facts.

3.2 Legal Reasoning

(A) Engagement with the Spirasi report and PTSD: acceptance of core harm did not compel acceptance of all later narrative

A key feature of this case is that IPAT accepted the gravamen of the medical corroboration: it accepted, on the balance of probabilities, that the applicant was sedated and his testicle removed for ritual purposes. IPAT quoted the Spirasi conclusion that the scrotal lesion was “highly consistent” with the account (Istanbul Protocol para. 418(c)).

The dispute therefore narrowed to whether IPAT was obliged, because PTSD symptoms were recorded, to treat later vagueness (about subsequent violence/threats) as medically explained and thus not credibility-damaging. Bradley J. held IPAT was entitled to its view because:

  • The Spirasi report’s narrative focus was the 2009/2010 trauma and its aftermath; it did not suggest a general inability to recount post-2009/2010 events.
  • The report’s PTSD discussion did not expressly establish that the applicant fell within the “inability to recall important aspects of the trauma” dimension (as contrasted with other symptom clusters).
  • IPAT did not disregard psychological effects; it recorded that it bore in mind “the psychological impact” and the scar evidence, but still found the later account lacking detail, and found long co-residence without serious harm undermined a forward-looking fear.

The High Court’s approach reflects a disciplined distinction between:

  • Corroboration of an injury/condition (which may support that something happened), and
  • Inference about perpetrator intent and future risk (which remains a tribunal assessment drawing on the overall chronology and plausibility).

(B) Alleged death threats and adequacy of reasons: reasons were traceable and sufficient

The applicant argued IPAT failed to properly consider threats and failed to give a reasoned decision under s.46(6). Bradley J. treated this primarily as an adequacy-of-reasons/engagement issue, addressed through:

  • IPAT’s explicit inventory of documents relied on, including Spirasi, and its statement that all information was “fully assessed” (invoking the G.K./Rana & Ali presumption absent contrary evidence).
  • IPAT’s detailed analysis of the post-2009/2010 period (paras 4.4 to 4.7) and the forward-looking fear section (paras 5.1 to 5.3), which expressly set out why repetition was not reasonably likely.
  • The “middle ground” standard from Connelly: IPAT did more than provide a perfunctory conclusion; it identified specific evidential deficits (timing, continued residence, lack of concrete post-2009/2010 harm, and lack of pursuit in Nkayi).

Importantly, the court accepted that the applicant’s references to threats existed in the record (IPO notes, s.35 interview, appeal background), but held that IPAT’s treatment—finding a lack of credible evidence of serious attempts to harm/kill after 2009/2010 and finding the oral evidence scant—was a permissible engagement and adequately explained.

(C) Section 28(6): triggering the presumption is not the end of the analysis

The judgment provides a practical illustration of how s.28(6) operates when a past serious harm finding is made. IPAT accepted the past harm (testicle removal), expressly recognised that this engaged s.28(6), and then articulated “good reasons” why it would not be repeated, including:

  • Prolonged continued co-residence (approximately six years) without credible evidence of further serious violence.
  • The act being characterised as a ritualistic procedure without evidence of continuing interest to inflict further ritual harm.
  • When the uncle allegedly learned of the applicant’s location in Nkayi, there was no evidence of pursuit despite the uncle’s ability to travel.

Bradley J. found this to be a correct application of s.28(6): the presumption can be rebutted where the tribunal identifies and explains concrete reasons, grounded in the evidence and chronology, why repetition lacks a reasonable likelihood.

3.3 Impact

  • Medical evidence in credibility analysis: The decision reinforces that acceptance of medical corroboration of a traumatic event does not compel acceptance of all downstream narrative elements (such as later threats/violence), particularly where the medical report does not establish that PTSD symptoms materially impaired the applicant’s ability to provide detail about later events.
  • “Weigh in the mix” remains fact-sensitive: By distinguishing N v The IPAT and Ors [2026] IEHC 121, the judgment suggests that quashing risk increases where expert psychological evidence is directly relevant to the specific credibility deficits relied upon (e.g., memory inconsistency), whereas here the tribunal accepted the core event and explained why later vagueness mattered.
  • s.28(6) rebuttal template: The case gives a clear example of what may constitute “good reasons” to consider past harm will not be repeated: extended periods without repetition, absence of pursuit, and a plausible account of why the past harm may have been situational rather than ongoing.
  • Reasons challenges face the G.K./Rana & Ali presumption: Where IPAT states it considered all material and gives a structured explanation, a reasons-based challenge will likely require a concrete basis to infer that key representations were ignored rather than simply contested on substance.

4) Complex Concepts Simplified

  • Judicial review is not an appeal: The High Court does not re-decide the protection claim; it checks legality (procedural fairness, rationality, proper engagement with evidence, correct legal tests).
  • Weight of evidence: Even where evidence exists (e.g., a medical report), the tribunal usually decides how persuasive it is—unless it misdirects itself legally or fails to engage with it.
  • Spirasi/Istanbul Protocol consistency language: Findings such as “highly consistent” indicate an injury could have been caused as alleged and that few other causes exist. It does not automatically prove the identity, motive, or future intent of an alleged perpetrator.
  • s.28(6) rebuttable presumption: If someone has already suffered persecution/serious harm (or direct threats), that is a strong indicator of future risk. But the tribunal can rebut it by giving “good reasons” why it will not happen again (based on evidence and logic).
  • Adequacy of reasons (“middle ground”): A decision need not read like a court judgment, but it must explain enough so the affected person can understand why they lost and can decide whether to challenge it.

5) Conclusion

[2026] IEHC 525 affirms a pragmatic, evidence-led approach to (i) how IPAT must engage with medical/psychological reports and (ii) how the s.28(6) presumption operates in practice. The High Court accepted that IPAT can (and sometimes should) accept a medically corroborated past harm, yet still reject a forward-looking risk where it identifies coherent, record-based “good reasons” against repetition—such as long non-recurrence, limited credible evidence of continuing threats, and lack of pursuit when opportunity allegedly arose.

The judgment also underscores that reasons challenges under s.46(6), particularly where IPAT explicitly states it assessed all documentation, must confront the G.K./Rana & Ali presumption and demonstrate a real basis to infer non-engagement rather than a mere disagreement with outcome.