The University of Sydney Law School, Sydney, NSW, Australia.
Northern Sydney Local Health District, St Leonards, NSW, Australia.
Trauma Violence Abuse. 2024 Jan;25(1):663-679. doi: 10.1177/15248380231158606. Epub 2023 Mar 19.
We undertook a scoping review of published research literature that reported on adult sexual assault patients' experience of the physical examination component of the medical forensic examination (MFE). Eligible papers were those reporting data about the physical examination component of the MFE from the adult patient's perspective, published in the period January 2000 to March 2022 in peer reviewed journals and reports containing original research data published from a tertiary institution. Twelve papers were identified. The review identified a gap in the literature regarding the patient's experience of the physical examination component of the MFE. The existing literature is limited but suggests that some patients find the examination empowering and reassuring, restoring a sense of bodily control; however, for others it is an intrusive, violating experience that they endure. A more patient-centered sexual assault service appears to have a therapeutic value in itself, but more research is warranted as existing research is very limited and often from a proxy. In particular, more research on patients' self-reported experience of the MFE, including specific aspects of the examination and the experience of male and gender nonconforming victim-survivors, is needed. A better understanding, from the point of view of the patient, of the benefits of attending, may encourage victim-survivors to seek a health response and, possibly, report to police. It may also be time to assess the impacts of certain aspects of the forensic examination, rethink standard evidence collection processes, and consider enabling more acceptable options for victim-survivors including self-collection of intimate samples.
我们对已发表的研究文献进行了范围综述,这些文献报告了成年性侵犯患者对医疗法医检查(MFE)中体格检查部分的体验。合格的论文是那些从成年患者的角度报告 MFE 体格检查部分数据的论文,这些论文发表在 2000 年 1 月至 2022 年 3 月期间的同行评议期刊上,以及从三级医疗机构发表的包含原始研究数据的报告。共确定了 12 篇论文。该综述发现,文献中存在关于患者对 MFE 体格检查部分体验的空白。现有文献有限,但表明一些患者认为检查具有赋权和安慰作用,恢复了身体控制感;然而,对其他人来说,这是一种侵入性的、侵犯性的体验,他们只能忍受。一个更以患者为中心的性侵犯服务似乎本身就具有治疗价值,但需要进行更多的研究,因为现有研究非常有限,而且往往来自代理人。特别是,需要更多关于患者对 MFE 的自我报告体验的研究,包括检查的具体方面以及男性和非性别规范受害者幸存者的体验。从患者的角度更好地了解就诊的好处,可能会鼓励受害者幸存者寻求健康反应,并可能向警方报案。也许现在是评估法医检查某些方面的影响、重新思考标准证据收集过程并考虑为受害者幸存者提供更可接受的选择的时候了,包括自我采集亲密样本。