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What you should know about Hospital Procedures

If you have been sexually assaulted, there may be medical concerns that arise both immediately following the assault and much later. If you were sexually assaulted recently, it is a good idea to go to a doctor to get checked out for possible injuries or complications. It is important to seek emergency medical care as soon as possible to begin coping with the complex emotional issues surrounding rape. 


 

You may choose to access either a public or a private hospital based on your comfort. Neither can deny providing care to you. It is also not necessary to have reported to the police before you go to the hospital. As per section 357C of the CrPC (Criminal Law Amendment Act 2013), hospitals (both public and private) are required to provide immediate free treatment to survivors of sexual assault. Refusal to provide medico legal examination and treatment is punishable by imprisonment for up to 1 year as per section 166B IPC. This examination can be performed by any registered medical practitioner. 


The health system has a medico legal role as well as a therapeutic role to play.


- Therapeutic role of a doctor entails provision of immediate medical aid and psychological first aid. Medical aid comprises of treating bruises, wounds, bleeding, provision of antibiotic to prevent infections, assessment for sexually transmitted diseases including HIV, providing emergency contraception, assessing pregnancy in case there is delayed reporting to health facility among others.


- The medico legal role includes seeking detailed history pertaining to the incident, conducting a through head to toe examination; collecting relevant evidence and interpreting the medical evidence. A friend, family member, or crisis counselor may be present during the physical examination if you wish.  Vaginal/Anal Swabs, fingernail scrapings and clippings, pubic and head hair samples, and blood and saliva samples are usually obtained. These samples are labeled, packaged, and sealed, along with your clothing and any other evidence. This evidence will be given directly to a police officer or stored in a secure and locked location to ensure that no one tampers with this evidence.


- The doctors should not mention details about old tears of the hymen, laxity/size of the introitus, irrelevant obstetric history (such as past abortions, past contraceptive practices), and habituation to sexual intercourse, in the medical examination report. (Section 146 Indian Evidence Act)


- The document submitted by the doctor as expert witness in the court should contain the narrative of the incident in the survivor%u2019s words; details of any evidence taken, details of injuries, and health consequences suffered, time lapse between assault and examination and interpretation of findings. (As per section 164ACrPC)


- Interpretation of medical findings by the examining doctor must take in to account the activities undertaken by you that could have led to the loss of evidence (e.g. bathing, urination, changing clothes, douching), threats given to you, restraints used, intoxication, and also nature of sexual assault in itself.


- Rape(Section 375 IPC) and sexual assault (POCSO Act 2012) are legal terms and hence, are the mandate of courts and therefore it is not for the doctor to decide.


- You have a right to receive a copy of the medical report from the hospital, free of cost. 




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