Health and Justice: Experiences of the forensic medical examination after sexual assault

Abstract

Sexual assault is a chronic problem around the globe, and those who choose to report a sexual assault are faced with further traumatic experiences within the justice system. There are many points at which these experiences could be improved, to support the complainant through the process. This qualitative evidence synthesis focused on the forensic medical examination (FME) as a point for potential improvement. Literature that focused on patient and medical practitioner experiences of the FME were reviewed and analyzed for themes that might suggest ways in which the FME process could be made better from the patient’s perspective. Three themes were identified. One related to the tension between the dual aims of the FME, of providing therapeutic healthcare and evidence for police investigation and prosecution. For the patients, these dual aims needed to be seen as healthcare first and forensic evidence as a secondary decision. The second theme was around the experience of the FME as traumatic, and the need for specialist training for practitioners was affirmed. Although women practitioners were preferred, the behavior and skills of the practitioner was more important. Their practice needed to be trauma-informed and patient-centered. The third theme was around optimizing the FME in terms of collecting the evidence that would have the most impact on the subsequent police and judicial processes, depending on the situation. For this optimization, further research is needed to trace the linkages between evidence and justice outcomes.

Keywords

• Sexual assault
• Sexual violence
• Forensic medical examination
• Patient experiences
• Thematic synthesis
• Qualitative