Experiences of the forensic medical exam after sexual assault: Qualitative thematic synthesis

ESR is the leading forensic science provider in Aotearoa New Zealand and provides laboratory testing for the evidential sexual assault kits that are produced during the forensic medical examination (FME) conducted by medical practitioners after sexual assault. Collaborative research is being undertaken to improve the system of FMEs including the processing of forensic samples and subsequent use of data. ESR social scientists conducted a literature review in early 2021 to inform this research, focusing on the experiences of patients and medical practitioners with the FME both in Aotearoa and internationally. The objectives were to highlight knowledge gaps and identify aspects that have the most impact on FME experience, particularly for patients.

The results highlighted the tension between the duel roles of a FME, which was to provide health and therapeutic care for the patient after sexual assault, and to collect forensic evidence for legal purposes. Most patients prioritised the healthcare purpose when consenting to a FME.The patients experience the FME as traumatic and invasive, and the behaviour of the practitioner had the biggest single impact on that experience.

Three recommendations were made for further investigation in the Aotearoa context: improving the FME documentation system so that health care and legal records can be separated; tracing the use and impact of the different forensic tests in subsequent legal processes so that the medical practitioners can keep the FEM to the minimum necessary; and supporting the ongoing professional development of medical practitioners with respect to conducting a FME after a sexual assault.