Sexual Assault Complainants Research Articles

When Privacy is Not Enough: Sexual Assault Complainants, Sexual History Evidence and the Disclosure of Personal Records

How can the rights of sexual assault victims be balanced against the rights of the accused in a sexual assault case? Sexual assault remains one of the most under-reported crimes in Canada, largely due to the invasion that results once a sexual assault is reported. Distrust of the criminal justice system continues to deter reporting. Recent amendments to the Canadian Criminal Code aim to protect sexual assault complainants by regulating the introduction of sexual history evidence and third-party records, such as counselling and therapy. However, courts in Canada have increasingly used a standard based on privacy law lo interpret these provisions. Does privacy law serve as a useful framework by which to evaluate this legislation? This article explores the gendered issues of privacy law, challenges the privacy approach to the sexual assault provisions of the Criminal Code, and explores a more balanced alternative.

Emergency care for complainants of sexual assault

Dr Wiese and his colleagues (February 2005 JRSM1) provide a reasonable overview of sexual assault examination practice in emergency departments. They are incorrect, however, in coupling Australia with the USA in the use of specially trained sexual assault nurse examiners. Sexual assault forensic services throughout Australia are almost exclusively provided by doctors, most of whom have training and experience in this field. At present there is no move to transfer such services to forensic nurse examiners, except in circumstances where there are significant difficulties in the availability of medical practitioners, as is found in rural and remote parts of Australia. The authors are most accurate when implying that sexual assault services (and indeed all forensic services) should be provided by practitioners with specialist qualifications or training. The implementation of forensic nurse examiners in rural and remote Australia will proceed only after specialist training in the appropriate fields.

Emergency care for complainants of sexual assault

Sexual assault in the UK is common. The British Crime Survey (2000) estimated that 61 000 women in England and Wales had been raped in the preceding year and found that this is the crime that women fear most.1 Most women and virtually all men who have been sexually assaulted keep their painful experience to themselves and do not disclose it to police or healthcare services.2 Those vulnerable individuals miss out on the prevention and treatment of sequelae such as sexually transmitted infections, genital injuries and other trauma, unwanted pregnancies, and psychological morbidity—while their assailants avoid prosecution and may go on to assault others. Even when sexual assault is reported to the police, conviction rates are low. In the year 2002, the police recorded 9723 female rapes. Only 2651 assailants were proceeded against and a mere 572 cases ended in a conviction.3 Service improvements that encourage complainants of sexual assault to seek help for themselves and provide the forensic evidence needed by the prosecution to secure a conviction are therefore clearly desirable.

Beyond Belief?

This article reviews issues concerning perceptions of women’s credibility in the context of police responses to sexual assault complainants. It is based on both quantitative and qualitative data drawn from detailed analysis of police rape and sexual assault files. Particular attention is paid to identification of the principal factors affecting police perceptions of rape complainants, addressing such issues as demeanour, intoxication and concealment. Problems arising from the misinterpretation of significant ‘cues’ are identified, and consideration given to possible ways in which miscommunication between rape complainants and police officers occurs. The article argues that many rape complainants must still battle to gain credibility in the eyes of some police investigative officers, and that stereotypically based judgements continue to impact negatively on police perceptions and decision making. The overall aim of the article is to prompt critical, constructive evaluation of police culture and practice in order to enhance the quality of police responses to victims of sexual violence and abuse.

The Haven: a pilot referral centre in London for cases of serious sexual assault

Objective Several schemes have been reported to improve treatment of rape and to encourage reporting. The development of a comprehensive forensic and follow up service for complainants of sexual assault is described, and activities of the first year are reviewed. Design Retrospective review of case records of complainants examined in The Haven. Setting Department of Sexual Health in a London teaching hospital. Sample All case records, 676 complainants, from the first year of cases seen in The Haven. Methods Description of setting up a service in partnership between the National Health Service and the Metropolitan Police, called The Haven. Analysis of a standardised proforma used for case records. Results Mean age of complainants is 26 years (range 11–66); 6% were male. Assailant was categorised as a stranger in 52% of cases; attack involved physical violence in 50% of cases; 24% of victims had genital injuries; 39% had other physical injuries. Immediate care given at time of forensic examination included 30% of women receiving emergency contraception and 5% of clients receiving post-exposure prophylaxis against HIV. Fifty-five percent of clients returned for a sexual health screen and/or counselling. Thirty-one percent received screening for sexually transmitted infections and 12% were diagnosed with one or more infections. Conclusions Requirements following sexual assault include forensic examination, first aid, postcoital contraception, prevention and management of sexually transmitted infections and psychosocial support. Provision of these services within a sexual health setting is feasible.

The Haven: a pilot referral centre in London for cases of serious sexual assault

Several schemes have been reported to improve treatment of rape and to encourage reporting. The development of a comprehensive forensic and follow up service for complainants of sexual assault is described, and activities of the first year are reviewed. Retrospective review of case records of complainants examined in The Haven. Department of Sexual Health in a London teaching hospital. All case records, 676 complainants, from the first year of cases seen in The Haven. Description of setting up a service in partnership between the National Health Service and the Metropolitan Police, called The Haven. Analysis of a standardised proforma used for case records. Mean age of complainants is 26 years (range 11-66); 6% were male. Assailant was categorised as a stranger in 52% of cases; attack involved physical violence in 50% of cases; 24% of victims had genital injuries; 39% had other physical injuries. Immediate care given at time of forensic examination included 30% of women receiving emergency contraception and 5% of clients receiving post-exposure prophylaxis against HIV. Fifty-five percent of clients returned for a sexual health screen and/or counselling. Thirty-one percent received screening for sexually transmitted infections and 12% were diagnosed with one or more infections. Requirements following sexual assault include forensic examination, first aid, postcoital contraception, prevention and management of sexually transmitted infections and psychosocial support. Provision of these services within a sexual health setting is feasible.

Drug-facilitated sexual assault

Jason Payne-James and Deborah Rogers (July 2002 JRSM1) draw wider attention to a report2 identifying that many complainants of sexual assault have high concentrations of alcohol in their blood. In a Home Office report it was recommended that, when psychoactive drugs are involved, a clinical psychologist should testify as to the effects of the drug and that a toxicologist would be able to give evidence as to the complainant's behaviour against that of typical reactions to the drugs in question3. In the UK clinical psychologists are not necessarily trained in substance misuse and may never have seen an acutely intoxicated patient in a forensic setting as part of their practice. Thus clinical psychologists who are not specialists in addiction may not be able to advise investigators or provide evidence in court on the effects of drugs. Most toxicologists, except for a few who are medically qualified, cannot comment expertly on the clinical effects of drugs on an individual, although they may give helpful general advice on the effects of drug metabolites and level of toxicity. In many cases the forensic physician who has attended the complainant shortly after the incident and who has taken a detailed history and performed a full examination will be the person in the best position to assist the court with an informed opinion, based on the objective results of an appropriate clinical examination, as to whether or not the complainant is intoxicated at the time of presentation. Furthermore his/her clinical findings will inform the analytical toxicologist's approach to the samples submitted to the laboratory. The opinion of a competent forensic physician as to which substances may have caused the signs exhibited and symptoms described by the complainant may be invaluable to the investigators and to the court, before the laboratory results have become available or in those cases where the complainant has presented too late for useful toxicological results to be obtained. Clear recommendations have been issued to forensic physicians when called to examine complainants of sexual assault4 as well as for the toxicological investigation of such assaults5,6.

Will any woman do?

Assumptions are often made that women police officers will respond more sympathetically to rape complainants than their male colleagues. In the research study presented here, 48 women complainants of rape and sexual assault expressed their views of the extent to which they considered the gender of the interviewing officer to be important and commented on the ways in which the men and women involved with their case interacted with them. The results showed that, overall, genderper sewas not the determining factor of complainant satisfaction. Professionalism, warmth and sensitivity were the qualities most desired and these were not exclusively associated with gender. This suggests that not only is it possible for some male officers to be sensitive victim interviewers, but also that being female does not automatically denote possession of the key attributes required for victim interviewing. Some rape complainants, however, expressed a strong preference for women officers. This places the onus on the police not simply to provide a woman officer – the “any woman will do” scenario – but to ensure the availability of trained and experienced women and men officers.

Colonization through Disclosure: Confidential Records, Sexual Assault Complainants and Canadian Law

This article explores the Canadian experience of widened access to sexual assault complainants' private records. It dissects legal developments from the mid-1990s, when the Canadian Supreme Court established a liberalized disclosure regime in the landmark O'Connor decision. A legislative reform passed in 1997 that sought to establish a stricter regime was recently upheld and at the same time weakened by the Supreme Court in Mills. The article contends that access to complainants' records stands as a critical example of how a liberal legalistic discourse of sexual assault is extending its hegemony by colonizing and silencing, in particular, feminist and therapeutic discourses. At issue is the relative status of legal 'Truth' and dissonant and emergent feminist narratives, as well as our ability to understand and speak about sexual violation outside of the narrow confines of law.

Physical aspects of alleged sexual assaults.

The medical evidence, detailing the physical findings, is just one component in the investigation of serious sexual assault and it is not for the doctor alone to determine the veracity of an allegation. This paper has described some of the factors which limit the quality and value of the medical evidence. Potential ways to rectify the problems are: 1. A requirement that all doctors who examine complainants of sexual assault should have undergone basic theoretical and practical training and be required to continue their education by attendance at update meetings and participating in peer review groups. 2. Large-scale, well-designed research projects which relate the physical findings to the outcome of the case. 3. Routine colposcopic assessments with photo-documentation of the genital examinations of all complainants of serious sexual offences. 4. Pretrial debate amongst medical experts.

Sexual assault on women and girls in the District of Columbia.

This article presents a comprehensive report of forcible rape in the District of Columbia from September 15 1965 through June 30 1968. 1/2 of the 3000 complainants of alleged sexual assault were brought to medical attention almost all female. About 85% were nonwhite much higher than their representation in the population; ages ranged from 1-88 with the highest number at age 14; incidents varied from forcible and attempted rape through statutory rape to child molestation. Preexisting conditions at examination included pregnancy gonorrhea and syphilis. 4 females who had probably been raped died as a result of physical abuse prior to examination. Of the 18 patients hospitalized with severe injuries 6 were children with vaginal or perineal laceration; 50 patients required emergency room surgery or other treatment. Of 1000 referrals made by nurses to clinics and private physicians for reexamination 63% were completed. Of the 9 who became pregnant 7 were aborted; there were 3 new cases of syphilis 1 lymphopathia venereum and 58 of gonorrhea; 18 with a history of emotional disturbance were returned to treatment; follow-up revealed 53 women and girls with new emotional disturbances 42 of whom were brought to treatment; 7 patients were still under psychiatric supervision 18-24 months after the assault. It is suggested that initial medical examination should be done by a gynecology or pediatrics resident or staff member away from the emergency area and with attention to the emotional component. Follow-up examination should reevaluate the patient as a whole person.(AUTHORS MODIFIED)