OBJECTIVE Know how to complete a medical certificate Know when to decide to collect forensic evidence Know how to collect forensic evidence and how to support or facilitate this MEDICAL CERTIFICATE ID: 1048428
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1. 6. MEDICAL CERTIFICATE AND FORENSIC EVIDENCE COLLECTION
2. OBJECTIVEKnow how to complete a medical certificateKnow when to decide to collect forensic evidenceKnow how to collect forensic evidence and how to support or facilitate this
3. MEDICAL CERTIFICATETHE MEDICAL CERTIFICATE: Is a document by the health care provider of the survivor’s story in their own words and a description of the injuries.Is a confidential medical document, an element of proof and a piece of material evidence available if a survivor decides to pursue a legal case. Should be given directly to the survivor. The survivor has the sole right to decide whether and when to use this document. May be handed over to legal services or protection organizations ONLY with the explicit agreement of the survivorMust be safely, securely stored at the health facility
4. MEDICAL CERTIFICATEThe medical certificate should NOT include a requirement or tick-box to indicate whether or not rape has occurred. The absence of injuries does NOT indicate that sexual violence did not occur, and should not lead to the conclusion that no sexual violence took place. While the health-care provider may document the description of the incident and examination, it is not their job to determine whether a rape has occurred.
5. WHAT IS FORENSIC EVIDENCE?Forensic evidence may also be collected to help the survivor to pursue legal redress where this is possible and if they wish to do so.
6. WHEN SHOULD FORENSIC EVIDENCE COLLECTION BE DONE? ONLY WHEN:The survivor wants to report the case to the policeForensic evidence can be collected, stored and analyzed should be gatheredThe survivor has come within 7 days after the rapeTrained health care provider is available
7. WHEN SHOULD FORENSIC EVIDENCE COLLECTION BE DONE? DO NOT COLLECT EVIDENCE:if the survivor chooses not to have evidence collected. Respect their choice. that cannot be processed or will not be used for legal action.if the violence is not considered a crime under the relevant lawsif the survivor has presented more than 7 days after the incidentif you are not trained to do so
8. SPECIMEN COLLECTION SHOULD BE GUIDED BYThe survivor’s wishesThe type of sexual abuse and the history, the ACCOUNT of the assault guides what specimens to collect The time that has passed since the incidentWhat the survivor has done after the incident (bathed, change of clothes, drank/eaten)Accessibility of labs and their capacity to process evidence
9. WHAT SPECIMENS TO COLLECT?HEALTH (PATHOLOGY) VERSUS LEGAL (FORENSIC) SPECIMENS Some pathology specimens may have forensic importance (for example, evidence of STIPathology specimens diagnose or monitor a condition Forensic specimens for legal purposes
10. WHAT SPECIMENTS TO COLLECT?PHOTOGRAPHS: to document injuries. CLOTHING: including underwear.Specimens where BIOLOGICAL MATERIAL may have been DEPOSITED: skin, hair, mouth, vagina and anus for analysis for sperm, seminal fluid or DNA ANALYSIS if availableFOREIGN MATERIAL that may corroborate the survivor's story.BLOOD, HAIR OR URINE for toxicology testing
11. TIME FRAME FOR SPECIMEN COLLECTIONAfter a certain time or activity following the rape, not all evidence can be collectedMAXIMUM TIMES for collecting evidence after assault:SKIN, including bite marks__________72 HOURSMOUTH__________12 HOURSVAGINA __________UP TO 5 DAYSANUS __________ 48 HOURSURINE (toxicology) 50 ml__________ UP TO 5 DAYSBLOOD (toxicology) 2 × 5 mL samples_______________ UP TO 48 HOURS In tubes containing sodium fluoride and potassium oxalateFOREIGN MATERIAL ON OBJECTS (condom/clothing)__________________ UP TO 48 HOURS In tubes containing sodium fluoride and potassium oxalate
12. STORAGE OF FORENSIC EVIDENCE“GIVE THE SAMPLES AND EVIDENCE TO THE POLICE AFTER MAINTAINING CHAIN OF CUSTODY (WITH THE CONSENT OF THE SURVIVOR)”Carefully LABEL, STORE AND RECORD chain-of-custodyDOCUMENT information about specimenDRY AND PACKAGE samplesLabel each evidence sample.Pack each piece of evidence in a different paper envelope.Label and seal the envelope
13. VIDEO - INTRODUCTION TO FORENSIC EVIDENCE COLLECTIONCOLLECTING FORENSIC EVIDENCE DOCUMENTING THE SURVIVORS HISTORYCOLLECTING EVIDENCE BEFORE THE PHYSICAL EXAMCOLLECTING EVIDENCE DURING THE PHYSICAL EXAMCOLLECTING EVIDENCE FROM THE EXTERNAL GENITALIA AND ANUSCOLLECTING EVIDENCE FROM THE VAGINA AND RECTUMPREPARATION, STORAGE AND DISSEMINATION OF EVIDENCERELEASE OF EVIDENCETHE IMPORTANCE OF FORENSIC EVIDENCE
14. ACTIVITY - FORENSIC EVIDENCE COLLECTION
15. KEY MESSAGESCollect forensic evidence only when all four conditions are metSeparate consent is needed for a forensic examinationThe assault history guides forensic evidence collectionTime elapsed and activities undertaken after the incident determines whether evidence can be foundStorage that avoids contamination, labelling and detailed documentation are essentialHealth care providers may need to provide testimony. They cannot conclude whether evidence points to rape. That is for the courts to establish.