Алгоритм дії лікаря при фіксації сексуального насильства під час збройних конфліктів та воєнного стану в Україні

Abstract

The purpose of the study was to analyze and generalize recommendations regarding the actions of medical workers when documenting the facts of sexual violence and providing medical and psychological assistance to persons affected by sexual violence related to the armed conflict in Ukraine. Results and discussion. As a result of the international armed conflict on the territory of Ukraine, caused by the aggression of the Russian Federation, a large number of crimes against the civilian population were recorded. At the present time, one of the difficult challenges of society is sexual violence in the conditions of armed conflict. Sexual violence during an armed conflict is not only a criminal offense, but also a violation of international humanitarian law and human rights. According to the United Nations, the facts of sexual violence in wartime are difficult to detect and investigate. Responding to sexual violence in armed conflict requires coordination of international and national institutions and an interdisciplinary approach to providing legal and medical assistance, social and psychological support to victims of sexual violence during armed conflict. The modern tool for combating violence against women and preventing violence against women is the Istanbul Convention. An important aspect is that the right of victims of sexual violence during armed conflicts to appeal to state bodies, human rights organizations, medical workers, psychologists for help is a personal decision of each victim. A victim of sexual violence in the context of an armed conflict has the right to receive qualified free medical care. Medical assistance to persons affected by conflict-related sexual violence is provided in health care facilities as needed at all levels of medical care, both outpatient and inpatient. The purpose of providing medical assistance to the victim is to overcome the negative consequences and effects of conflict-related sexual violence on the physical and psychological health of the victim. The injured person has the right to freely choose a health care facility, a doctor, and a method of treatment in accordance with the doctor's recommendations. Medical assistance to persons affected (or likely to be affected) by conflict-related sexual violence is provided in accordance with the Protocols for the provision of medical assistance. When seeking medical help from victims or their legal representatives, medical workers must record their complaints (appeals), collect anamnesis, conduct a medical examination with an assessment of the condition of a victim of conflict-related sexual violence and, if necessary, additional instrumental and laboratory examination and measures to prevent the consequences of sexual violence. Conclusion. We recommend an algorithm of actions for medical professionals in cases of recording and documenting the fact of conflict-related sexual violence. In order to prevent psychological traumatization of the victim, it is recommended to use modern methods of recording (photographing, video recording) during the collection of anamnesis and subsequent examination of the victim in order to enable the parties to the criminal proceedings/court to use the obtained data. It is emphasized that the timely conduct of forensic medical examinations in order to detect the presence of injuries with the subsequent recording of the facts of the conflict-related sexual violence will help the side of the criminal proceedings/court to take effective measures of a criminal or other nature against the offender