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    Sexual Assault

    Uploaded by

    HongMing
    This document discusses procedures for dealing with cases of sexual assault as emergency doctors. It outlines the requirements for a case to be considered criminal, including needing a police report and officer present. It also notes the need to get consent from victims, especially those under 18, and cautions doctors to avoid providing too many specific details to victims' reports that could cause problems later. The document then covers examining victims for injuries from rape, penetration, and assault; types of specimens that should be collected based on the freshness of the case; and the three elements - physical, consent, and mental - that must be proven for an offence.

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    Sexual Assault

    Uploaded by

    HongMing
    316 views2 pages
    This document discusses procedures for dealing with cases of sexual assault as emergency doctors. It outlines the requirements for a case to be considered criminal, including needing a police report and officer present. It also notes the need to get consent from victims, especially those under 18, and cautions doctors to avoid providing too many specific details to victims' reports that could cause problems later. The document then covers examining victims for injuries from rape, penetration, and assault; types of specimens that should be collected based on the freshness of the case; and the three elements - physical, consent, and mental - that must be proven for an offence.

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    Sexual Assault

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    This document discusses procedures for dealing with cases of sexual assault as emergency doctors. It outlines the requirements for a case to be considered criminal, including needing a police report and officer present. It also notes the need to get consent from victims, especially those under 18, and cautions doctors to avoid providing too many specific details to victims' reports that could cause problems later. The document then covers examining victims for injuries from rape, penetration, and assault; types of specimens that should be collected based on the freshness of the case; and the three elements - physical, consent, and mental - that must be proven for an offence.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    316 views2 pages

    Sexual Assault

    Uploaded by

    HongMing
    This document discusses procedures for dealing with cases of sexual assault as emergency doctors. It outlines the requirements for a case to be considered criminal, including needing a police report and officer present. It also notes the need to get consent from victims, especially those under 18, and cautions doctors to avoid providing too many specific details to victims' reports that could cause problems later. The document then covers examining victims for injuries from rape, penetration, and assault; types of specimens that should be collected based on the freshness of the case; and the three elements - physical, consent, and mental - that must be proven for an offence.

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    Sexual Assault

    One of the jobs of emergency doctors is to deal with sexual assault.


    For cases to be investigated, must need police report.
    Requirements to be a criminal medico-legal case:
    Police report number, police form, police officer present (for arrest offences grievous hurt,
    unnatural offence, rape), consent, police photographer (if need to take photos as evidence
    forensics physician may take photos for documentation)
    Consent from patient - >18 years old, if <18 years old need to get consent from
    guardian/parents/police/protector from the welfare office
    Patient history given to the police, there may be discrepancies -> will cause problems during
    cross-examination by the lawyers -> dont give out specific time/place/date/names/things that
    happened too long ago etc, but do report what happened
    Victim reactions
    Patients demeanor was patient crying etc at the time of presentation
    Rape sexual intercourse between a man and a woman without her consent -> false
    presence, force/threats, fraud (spiking drinks) will make the consent void even if the victim
    has consented
    Sexual intercourse with a girl under 16 is an offence -> statutory rape
    Sexual intercourse with a mentally incapable/mentally subnormal/retarded -> unable to judge
    and give informed consent, or mentally ill/psychiatrc person -> rape
    Sharp weapon injuries -> incised etc
    Lacerations injuries due to blunt trauma
    Chopped wound subset of incised wound
    Defense injury extensor, forearm
    Stab wound sometimes with hilt-guard abrasion, fish tail edge = sharp edge of the weapon
    (2 fish tails = double sharp edge), depth indicates length of weapon
    Refer victims of rape for genital exam by O&G specialists
    Type of specimen depends on cold and fresh case
    Fresh acute - <120 hours in Penang -> must be seen by a doctor within 1 hour -> take
    swabs
    Cold non-acute - >120 hours -> arrange for doctor appointment the next day -> no swabs
    taken
    3 elements of offence
    Must prove penetration proof of anal/vaginal penetration to show injuries of the genitals
    and surrounding area of the genitals
    Must prove lack of consent when the patient is 16 years old, if consented can it be false
    consent?
    The intention of the accused person in sexually penetrating without consent -> not so
    important
    Physical, consent and mental elements!

    Hymen can be torn in non-sexual acts


    Penetration
    Anus in sodomy penetration of the anus through the anal verge
    Penis tip of penis no need erected penis to penetrate -> even someone with impotence
    can be charged for rape
    Vagina introduce the penis beyond the labia majora
    Eg -> if tip of penis enters labia majora = penetration due to blunt object penetration
    abrasions, bruises, lacerations, redness, swelling
    If in young children, infant no need penetration -> signs of injury eg bruises are enough
    Cribiform hymen in adolescence
    Tulip hymen pre-puberty children to adolescents
    In victims who never delivered, can use Foley Catheter insert catheter with balloon not
    expanded, inflate the balloon -> stretch hymen from behind to look for any tear -> look for
    partial tears etc
    Continually reinsert to the floor, suck fluids through the catheter -> swab = vaginal swab
    Vaginal speculum only if hymen is torn, not used even if partially torn as it can cause
    further tear
    Sodomy is more difficult to be proven
    Acute type, non-acute, habitual anoreceptive (regularly sodomised), combination acute in
    habitual anoreceptive victim
    Acute findings differ from habitual findings!
    >120 hours cold usually no findings
    No hymen, pooping can also cause anal mucosa injuries, harder to penetrate anus if victim
    does not consent unless the person use lubricants because external sphincter is voluntary
    Toluidine blue not for young children as can cause irritation
    Normally used to show anal injuries

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