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
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.

DUTIES OF REGISTERED MEDICAL
PRACTITIONER TOWARDS STATE
1.
2.
3.
4.
Consent
Confidentiality
Maintenance Of Records
Collection And Preservation Of Samples
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
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 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
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?
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
COLLECTION AND PRESERVATION OF SAMPLES
•
•
•
•
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
Gastric lavage/ vomitus in poisoning cases
Blood in alcoholic/poisoning cases/drug abuse or
for DNA test
PREPARATION OF
MEDICOLEGAL REPORT

Medicolegal report (MLR) prepared immediately
after the examination of a medicolegal case is
done

It is prepared in duplicate, preferably with a ballpoint-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 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.
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

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
Stigma of homosexuality
 Loss of freedom
 Expected male role

 deal
with problems alone
 don’t be so sensitive
 be strong
 allegiance
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