Magalhães Teresa, Ribeiro Cristina Silveira, Jardim Patrícia, Vieira Duarte Nuno
Instituto Nacional de Medicina Legal, I.P., Portugal.
Acta Med Port. 2011 Mar-Apr;24(2):339-48. Epub 2011 May 20.
The public nature of child abuse crime (domestic violence, maltreatment and sexual crimes) implies the opening of a criminal enquiry as soon as facts likely to be considered as such are known. Professionals who suspect of these cases are considered mandatory reporters as is the case of health care professionals. The work with abused children and youth involves several courses of action between institutions, namely as to the starting procedures to follow in case triage, reporting of suspicion, diagnosis and preservation of evidence for penal purposes, as well as to the protection of the victim(s), all of which still lack a clear definition in Portugal. Several professionals often take part simultaneously in these early procedures and it is crucial that their own personal intervention be articulated with one another's. With the aim of promoting that adequate articulation between the professionals and the acting services, technical orientations to be followed have to be established, namely as far as the articulation between the medicolegal services and the health care services are concerned. These orientations should aim at: ruling the reporting of the occurrence in good time; guarantee an appropriate collection of evidence; guarantee good medical procedures in medical exams and evidence collection; avoid repetition of exams of the victims, preventing secondary victimisation and cross-contamination of child report. Based on the internationally accepted rules for the matter and taking into consideration the Portuguese reality, namely in legal terms, the authors made a proposition concerning the procedures for the intervention in such cases that are herewith presented and were approved as General Recommendations for the Examination in Cases of Suspicion of Domestic Violence, Maltreatment or Sexual Crime Against Children by the National Institute of Legal Medicine, in January 2010. These were later confirmed by the Specialty College of Legal Medicine of the Medical Board Association.
虐待儿童犯罪(家庭暴力、虐待和性犯罪)的公开性质意味着一旦知晓可能被视为此类犯罪的事实,便会展开刑事调查。怀疑此类案件的专业人员被视为强制报告人,医疗保健专业人员亦是如此。与受虐待儿童和青少年开展工作涉及机构间的多项行动流程,即在病例分诊、怀疑报告、诊断以及为刑事目的保存证据等方面应遵循的起始程序,还有对受害者的保护,而这一切在葡萄牙仍缺乏明确界定。数名专业人员常常会同时参与这些早期程序,关键在于他们各自的个人干预行动要相互协调。为促进专业人员与相关服务机构之间的适当协调,必须确立应遵循的技术指导方针,尤其是在法医学服务与医疗保健服务的协调方面。这些指导方针应旨在:及时规范事件报告;确保适当收集证据;在医学检查和证据收集过程中保证良好的医疗程序;避免对受害者进行重复检查,防止二次伤害以及儿童报告的交叉污染。基于国际上对此事公认的规则,并考虑到葡萄牙的实际情况,尤其是法律层面的情况,作者就此类案件的干预程序提出了一项建议,现予以呈现,并于2010年1月被国家法医学研究所批准为《怀疑家庭暴力、虐待或性犯罪侵害儿童案件检查的一般建议》。这些建议后来得到了医学委员会协会法医学专业学院的确认。