Soutoul J H, Robert M, Pierre F
Expert National Judiciaire, Gynécologue-Accoucheur, Maîtrise de Droit Privé et DEA.
Chir Pediatr. 1988;29(2-3):147-52.
In the emergency care of a young girl presumed to be a victim of sexual assault and the treatment of the lesions discovered in the perineum and vulvo-vaginal tract, the paediatric surgeon must take into consideration the medico-legal aspects of the file right from the first approach to this young victim. It would actually be damaging to her if a paediatric surgeon reconstituted the perineal tissues, vulva and vagina "ad integrum" without carefully describing the lesions observed and without, whenever possible, taking good quality photographs to be kept in the case file to support the evidence of sexual assault, if a criminal procedure is filed. Similarly, as a complement to this assessment of the initial lesions, the surgeon must be able to establish an anatomical and functional assessment of the vulvo-vaginal tract after healing, to enable the experts appointed by the court to determine the basis for compensation of bodily damages related to the sexual assault and the expenses entailed by further plastic operations required by the sequelae of the genital lesions. The bases for a pretium doloris, future aesthetic, sexual and obstetric damages should also be indicated in any certificate given to the patient's family or to the court experts. Thus, if the surgeon participates indirectly in demonstrating evidence of the crime subject to penal sanction, he can help the victim in her parallel civil court action for compensation of her bodily damages before the repressive jurisdiction.
在对一名疑似遭受性侵犯的年轻女孩进行急诊护理以及治疗会阴部和外阴-阴道区域发现的损伤时，小儿外科医生从首次接触这位年轻受害者起，就必须考虑到病历的法医方面问题。如果小儿外科医生在未仔细描述所观察到的损伤且未尽可能拍摄高质量照片留作病历存档以支持性侵犯证据（若提起刑事诉讼）的情况下，就“完全地”重建会阴组织、外阴和阴道，这实际上会对她造成伤害。同样，作为对初始损伤评估的补充，外科医生必须能够在愈合后对外阴-阴道区域进行解剖学和功能评估，以便法庭指定的专家能够确定与性侵犯相关的身体损伤赔偿依据以及生殖器损伤后遗症所需进一步整形手术的费用。在给患者家属或法庭专家的任何证明中，还应注明疼痛赔偿、未来美学、性功能和产科损伤的依据。因此，如果外科医生间接参与证明应受刑事制裁的犯罪证据，他可以在刑事司法管辖权之前，帮助受害者在平行的民事诉讼中要求赔偿其身体损伤。
