Page 381 - Learnwell EVS
P. 381
ctical advice for writing medical certificates in the event of sexual violence
Writing medical certificates in the
event of sexual violence
Phy sicians are often the first to be confronted with the consequences of violence. V ictim s
are som etim es afraid to report to th e auth orities concerned , particularly wh en th e
population affected is vulnerable (refugees, prisoners, civilian victim s of war etc.). In such a
situation, the phy sician should try to d eterm ine if the event was isolated or part of larger
scale violence (e.g. sy stem atic rape).
Faced with sex ual violence, the phy sician is obliged to com plete a m ed ical certificate for the
benefit of the victim , irrespective of the country in which (s)he is practising.
Th e certificate is individual (for th e benefit of the ind ivid ual or th eir beneficiaries) and
confidential (it falls with in professional confid entiality ). Th e ex am ples of certificates
presented in th e following pages are written for sexual violence, but th e approach is the
sam e for all forms of intentional violence.
All medical certificates must include:
– The id entity of the signing phy sician.
– The id entity of the victim (ex cept for certificates passed on to HCR or to ICR C without the
consent of the victim, see below).
– The com plete d ate and the tim e of the ex am ination.
– The statem ent of the victim in his/her own words.
– The find ings of the clinical ex am ination.
– The sam ples taken and the ex am inations carried out.
– A conclusion (includ ing, if possible, the length of Total Tem porary Incapacity (TTI) and
anticipated Partial Perm anent Incapacity (PPI)).
Notes:
•The nam e of the victim (ex cept for certificates passed on to HCR or to ICR C without the
consent of the victim, see below), the nam e of the phy sician and his/her signature, as well
as the d ate of the ex am ination m ust appear on each page.
•A copy containing the victim ‟s nam e is given to the victim for future legal use. Keep a copy of
the m ed ical certificate (or, if the case should arise, of the m and atory 1report ) in the patient
record , archived to allow future authentication of the certificate given to the victim .
What the practitioner should not do:
– R ephrase the word s of the victim as the practitioner‟s own.
– End orse the id entity of the aggressor nor the nature of the crim e, this m ust be left to the
legal authorities.
– Conclud e th at th ere was no sex ual violence in th e absence of lesions on clinical
ex am ination.
Examples of medical certificates for adults and children (see following pages).
With the consent of the victim, the phy sician gives a copy of the certificate containing the
victim ‟s nam e:
– to HCR (to th e protection officer only ) if th e victim is a refugee or d isplaced , so that
protection m easures m ay be put in place for the ind ivid ual;
– to ICR C if the victim is a victim of war or a prisoner.
Without the consent of the victim, the phy sician m ay give a copy of the certificate to HCR or
ICR C, but without revealing the id entity of the victim (concretely , the sections “fam ily nam e,
first nam e and precise ad d ress” should not appear).
1 In principle, legal reporting of sexual violence against children under 15 years is mandatory. The only exception
is if there is a risk that reporting may further harm the situation of the child. Consider each case individually.
322
Writing medical certificates in the
event of sexual violence
Phy sicians are often the first to be confronted with the consequences of violence. V ictim s
are som etim es afraid to report to th e auth orities concerned , particularly wh en th e
population affected is vulnerable (refugees, prisoners, civilian victim s of war etc.). In such a
situation, the phy sician should try to d eterm ine if the event was isolated or part of larger
scale violence (e.g. sy stem atic rape).
Faced with sex ual violence, the phy sician is obliged to com plete a m ed ical certificate for the
benefit of the victim , irrespective of the country in which (s)he is practising.
Th e certificate is individual (for th e benefit of the ind ivid ual or th eir beneficiaries) and
confidential (it falls with in professional confid entiality ). Th e ex am ples of certificates
presented in th e following pages are written for sexual violence, but th e approach is the
sam e for all forms of intentional violence.
All medical certificates must include:
– The id entity of the signing phy sician.
– The id entity of the victim (ex cept for certificates passed on to HCR or to ICR C without the
consent of the victim, see below).
– The com plete d ate and the tim e of the ex am ination.
– The statem ent of the victim in his/her own words.
– The find ings of the clinical ex am ination.
– The sam ples taken and the ex am inations carried out.
– A conclusion (includ ing, if possible, the length of Total Tem porary Incapacity (TTI) and
anticipated Partial Perm anent Incapacity (PPI)).
Notes:
•The nam e of the victim (ex cept for certificates passed on to HCR or to ICR C without the
consent of the victim, see below), the nam e of the phy sician and his/her signature, as well
as the d ate of the ex am ination m ust appear on each page.
•A copy containing the victim ‟s nam e is given to the victim for future legal use. Keep a copy of
the m ed ical certificate (or, if the case should arise, of the m and atory 1report ) in the patient
record , archived to allow future authentication of the certificate given to the victim .
What the practitioner should not do:
– R ephrase the word s of the victim as the practitioner‟s own.
– End orse the id entity of the aggressor nor the nature of the crim e, this m ust be left to the
legal authorities.
– Conclud e th at th ere was no sex ual violence in th e absence of lesions on clinical
ex am ination.
Examples of medical certificates for adults and children (see following pages).
With the consent of the victim, the phy sician gives a copy of the certificate containing the
victim ‟s nam e:
– to HCR (to th e protection officer only ) if th e victim is a refugee or d isplaced , so that
protection m easures m ay be put in place for the ind ivid ual;
– to ICR C if the victim is a victim of war or a prisoner.
Without the consent of the victim, the phy sician m ay give a copy of the certificate to HCR or
ICR C, but without revealing the id entity of the victim (concretely , the sections “fam ily nam e,
first nam e and precise ad d ress” should not appear).
1 In principle, legal reporting of sexual violence against children under 15 years is mandatory. The only exception
is if there is a risk that reporting may further harm the situation of the child. Consider each case individually.
322
