Medico-Legal Examination of Rape Survivors
Forensic Medicine: Clinical Procedure & Ethics
1. Pre-Examination Essentials
- Consent: Informed, written consent is mandatory. If the survivor is a minor or incapacitated, follow specific legal guidelines for proxy consent.
- Trauma-Informed Approach: The examination must be non-coercive, sensitive, and conducted in a private setting to prevent re-traumatization.
- Emergency Care: Prioritize stabilizing life-threatening injuries before initiating the forensic examination.
2. Systematic Examination Steps
| Step | Focus Area |
|---|---|
| History | Record time, place, nature of the act, threats used, and post-incident actions (bathing/changing clothes). |
| General | Assess general physical state, clothing status, and signs of recent struggle. |
| Regional | Detailed examination of breasts, inner thighs, perineum, and genitalia (look for abrasions/tears). |
| Evidence | Collection of swabs (vaginal, oral, anal), fingernail scrapings, and hair samples for DNA/serology. |
3. Key Forensic Pearls
- Prophylaxis: Must offer Post-Exposure Prophylaxis (PEP) for HIV, emergency contraception (ECP), and antibiotics for STI prevention within the recommended time window.
- “Two-Finger Test”: This practice is scientifically invalid and ethically prohibited; its use to determine “habituation” is outdated and legally discouraged.
- Documentation: Use standardized forensic forms. Every injury must be measured, described, and ideally photographed (with permission).
- Chain of Custody: All collected samples must be labeled, sealed, and handed over to authorities with a documented chain of custody to ensure legal admissibility.