Writing Medical Certificates in Cases of Sexual Violence

The doctor often led to the recognition of violence whose victims may be afraid to complain to the competent authorities, especially when it comes to vulnerable populations (refugees, prisoners, civilian victims of war, etc.). In this situation, the doctor will want to know if it is an isolated act of violence or large scale (systematic rape for example).

To sexual violence, the doctor is obliged to write a forensic certificate in favor of the victim, regardless of the country where he practices.

This certificate is individual (for the benefit of the victim or their beneficiaries) and confidential (it belongs to medical confidentiality). Examples of certificates presented below relate to sexual violence, but the approach is the same forany other form of intentional violence.

All medical certificates must contain:

– The identity of the signatory physician.

– The identity of the victim (except for the certificate sent to the UNHCR or the ICRC without consent of the victim, see below).

– Full date and time of the examination.

– The statements of the victim by taking his words.

– The findings of the clinical examination.

– The nature of the charges or examinations.

– A conclusion (if possible with a duration of ITT and providing a PPI).

Notes:

• The name of the victim (except for the certificate sent to the UNHCR or the ICRC without consent of the victim, see below), the doctor’s name and signature, and the date of the examination must appear on each page.

• A personal copy is given to the victim for possible legal use.

Keep a copy of the medical certificate (or, if applicable, the reportable 1 in the folder with an archive status allowing subsequently authenticate the certificate given to the victim.

That the practitioner should not do:

– Repeat the words of the victim to his own account.

– Conclude by calling itself the offense and designating the author, this is within the judiciary.

– Assume the absence of sexual assault when clinical examination shows no damage.

Examples of medical certificates for children and for adults.

With the consent of the victim, the doctor sends a registered copy of the certificate:

– UNHCR (to the protection officer exclusively) if the victim is a refugee or displaced, so that protective measures can be taken against him;

– The ICRC in the case of a victim of a conflict or an inmate.

Without the consent of the victim, the doctor may send a copy of the certificate to the UNHCR or the ICRC, but without revealing the identity of the victim (actually, the information “full name, street address” should not appear).

1* The declaration to justice for sexual violence against children under 15 years is in principle compulsory, unless the declaration contains a risk of aggravating the injury to the child. Examine each situation case by case.