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Referral of Sexual assault victims (rape/sex abuse). Accident & Emergency deptt GTB hospital. SEXUAL OFFENCES Natural offences: Rape; Incest Unnatural offences: Sodomy; Tribadism; Bestiality; Buccal coitus Sexual abuse of children. 2.

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Referral of Sexual assault victims (rape/sex abuse)


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referral of sexual assault victims rape sex abuse

Referral of Sexual assault victims(rape/sex abuse)

Accident & Emergency deptt

GTB hospital

slide2
SEXUAL OFFENCES

Natural offences: Rape; Incest

Unnatural offences: Sodomy; Tribadism; Bestiality; Buccal coitus

Sexual abuse of children

2

slide3
All patients male or female are received in main casualty
  • Female patients are refd to deptt. of Gynecology and Obs. for further management.
  • Male victims – are taken care of in main casualty.
slide4

DUTIES OF REGISTERED MEDICAL PRACTITIONER TOWARDS STATE

Consent

Confidentiality

Maintenance Of Records

Collection And Preservation Of Samples

steps in specific cases
STEPS IN SPECIFIC CASES

IN RAPE CASE

Inform the police

After taking consent, medicolegal examination and treatment given

Samples for examination of blood, stains, semen, swabs, sweat, hair, nails etc preserved, sealed, labeled and sent to police under proper receipt

Issue medicolegal certificate and send report as early as possible

5

slide6

EXAMINATION OF PERSON ACCUSED OF SEXUAL ASSAULT

Section 53A CrPC

  • Brought by police written and signed request
  • Details of examination findings
  • Sample preservation –Clothing/Blood/Semen sample/Pubic hairs
  • for DNA profiling
  • Opinion
  • Age determination

Consent not required

steps in specific cases7
STEPS IN SPECIFIC CASES

IN RAPE CASE

THE CrPC 2005 AMENDMENT:

Some mandatory points for examination:

examined within 24 hrs after taking proper consent

Always examined in presence of female

Note the time of start and the time of end

Always state reasons for all conclusions

It is necessary to keep samples for examination of blood, stains, semen, swabs, sweat, hair, nails, DNA etc as required

7

child abuse suspected victims of sexual assault abandoned children
Guidelines laid down by hon’ble court

A detailed description of assault/abuse history is mentioned

In case of girl victim medical examination preferably by a female doctor

As far as practical –psychiatrist help made available to victim

Report prepared as early as possible

Parents/ guardian whom child trust allowed to be present

In case of results of examination are likely to be delayed the same mentioned

Emergency medical treatment/prophylaxis against STD provided when necessary/HIV testing after window period

After examination child permitted to wash up and provide fresh clothing if clothing is taken as evidence

Samples Preserved according to guidelines –SAFE [Sexual abuse Forensic Evidence] Kit provided in Govt. hospitals

CHILD ABUSE/ SUSPECTED VICTIMS OF SEXUAL ASSAULT/ABANDONED CHILDREN
slide9

MEDICAL EXAMINATION OF VICTIMS OF SEXUAL ASSAULT

Section 164A of CrPC

  • Examination only by female registered medical practitioner

in case of female victims

  • Without delay
  • Consent -documented
  • Note down particulars
  • Complete history
  • Examination – Genital examination and injuries:
  • Standard protocols and guidelines
  • Preserve samples-DNA profiling
  • Emergency Contraception if required
  • Treatment /prophylaxis as required
  • Opinion
where
Where?

Specified area is defined for all such cases

Emergency Department is the area where males victims MLC is prepared

but

sometimes may be in wards after detection of new findings

slide11

COLLECTION AND PRESERVATION OF SAMPLES

Gastric lavage/ vomitus in poisoning cases

Blood in alcoholic/poisoning cases/drug abuse or for DNA test

  • Clothes in assault/injury/fire-arm/burn cases
  • Nail clippings in assault/rape cases
  • Vaginal swabs/public hair in rape cases
  • Swabs in un-natural sexual offence cases
preparation of medicolegal report
PREPARATION OFMEDICOLEGAL REPORT

Medicolegal report (MLR) prepared immediately after the examination of a medicolegal case is done

It is prepared in duplicate, preferably with a ball-point-pen, in a clear and legible handwriting

Cutting/ overwriting etc avoided as much as possible and all corrections properly initialed

Abbreviations of any sort avoided

12

consent in medico legal cases
Consent in Medico legal cases

CONSENT FOR MEDICOLEGAL EXAMINATION TO BE TAKEN IN WRITTEN IN ALL CASES

Exception : Cases brought by police being arrested on charge of committing an offence

Person below 12 years/unsound mind- consent of guardian is to be taken.

slide14

Information is given only to I.O. or any

person designated by I.O.

If the I.O. gives requisition for any clarification regarding certain points mentioned in the report given, answer is given in writing.

DOCTORS MAINTAIN CONFIDENTIALITY IN ALL MLC CASES

important issues
Important issues
  • Psycho- social support to the victims
  • Need to adjust them in families
  • Foster families /care homes
  • Police protection to the victims/ family members
issues of abused boys
Issues of Abused Boys
  • Stigma of homosexuality
  • Loss of freedom
  • Expected male role
    • deal with problems alone
    • don’t be so sensitive
    • be strong
    • allegiance