The importance of standardization in sexual violence cases for criminal trials

Sexual crimes cover acts that involve a sexual purpose and that are committed without the consent of the victim, and are crimes that aim all people, mostly women but also children and men, that cause many short- and long-term health problems [1; 2].

The management of sexual violence cases is a complex, demanding, delicate, long-term, multi-phase process that requires a multi-disciplinary approach. Ensuring that this process is permanent is only possible through detailed, accurate and objective documentation of the work. A high-quality forensic medical examination may potentially confirm and/or relieve the sexual assault victims’ concerns, minimize their trauma and support their recovery. Additionally, the collected evidence may help reveal the material truth during the criminal investigation, leading to the execution of criminal sentences and the prevention of further sexual violence [3].

It is also reported that the victims’ ability to reach medical assistance and being examined in an early period is important in terms of collecting bodily findings and evidential samples, and that especially the first 72 hours are critical [4]. Furthermore, it is noted that taking the victim who reaches medical assistance under protection and beginning rehabilitation in an early period may reduce the destructive effects of the sexual violence incident [5].

Sexual violence victims are beyond ordinary forensic cases and are seen as patients whose psychological, medical and forensic needs have to be considered [6]. Genito-anal findings observed in sexual abuse/assault cases are being reevaluated and reclassified in parallel with the changes and advances in imaging technologies. Therefore, in order for legal procedures to function regularly and correctly, the examination of sexual abuse/assault cases and the presentation of the results should be carried out by competent experts. Sexual abuse cases have to be examined and the results prepared in centers that have the necessary equipment and consultation capabilities, where experienced specialists who received the necessary training are present, multispectral colposcopes and supporting staining methods are used and photo-documentation is performed [7; 8; 9; 10].

Since the examination is also considered traumatic for the victim, it is very important to conclude the examination in a victim-oriented approach, in the shortest possible time, completely and carefully in order to avoid repeated traumas. Many countries have their own protocols in the area of sexual violence based on the cultural structure of the society, socio-demographic features of the victims, their potential needs, operational arrangements of healthcare centers, and legal conditions [11].

There is no routine training provided for healthcare professionals who work with sexual abuse/assault victims in our country, nor a common protocol or standardization throughout the country. The lack of a common language for sexual violence is reported to cause confusion of meanings in the examination and evaluation process, differences in reports in addition to loss of rights and an increase in the intensity of short- and long-term effects of trauma on the victim [3; 5]. Gener- ally, we believe that the main objective should be the use of a country-wide shared guide in order to protect the rights of all parties involved in the claim during the judiciary process, minimize the error margin, prevent the loss of evidence, ensure that healthcare professionals don’t miss any steps in this complicated process, use a common language while preparing the report outline, contents, finding interpretation and results, and the standardization of reports.

The justice mechanism is based on identifying and punishing the perpetrator. Although it exists in legislation, prevention-protection efforts towards “children in need of protection” and the measures necessary for the recovery and healthy development of the victim are not adequately implemented in practice, and the long-term follow-up and treatment requirements of sexual violence victims are neglected. Therefore, the views of all specialties that are necessary to examine and evaluate the case should be requested, and our reports should contain the measures that the child’s welfare requires, pressuring the system to activate the necessary mechanisms.

The examination and evaluation of sexual violence victims are carried out in different institutions and conditions, by healthcare workers of varying experience and expertise, with varying examination procedures, and the inconsistencies in the reports that are prepared may cause difficulties in the protection of the legal rights of the people involved, and disruptions in the judiciary process. Therefore, it is reported that the primary objective in sexual abuse/assault cases should be the use of current technology and laboratories and ensuring standardization in reporting [3].