What is a Medical Forensic Exam?
Moving Away From “Rape Kits”
While “rape kit” is often heard in the media and on television crime shows, this term is not trauma-informed or supportive to an individual in crisis. It also does not fully encompass the spectrum of care given in a medical forensic exam and may discourage individuals who do not identify with the term “rape” from seeking medical care.
“Medical forensic exam” is a broad term used for specialized medical care following a disclosure or suspicion of sexual assault. There are many aspects of care that may or may not be included in the exam. Care (or medical actions) is determined by the patient’s history, choices, and risks versus the benefits from a medical standpoint.
“Evidence collection” is one action that may or may not be appropriate within a medical forensic exam. If it is appropriate, and the patient consents, a sexual assault evidence collection kit may be used to collect evidence. If a sexual assault evidence collection kit is utilized, it is given to law enforcement for storage and/or testing.
These terms more accurately encompass the spectrum of sexual violence, as well as the comprehensive care received during a medical forensic exam. However, it is not uncommon for survivors to use the term “rape kit” and it is important that professionals are able to provide accurate education about the medical forensic exam and evidence collection.
There are specialized programs in the State of Colorado called Sexual Assault Nurse Examiner (SANE) programs or Forensic Nurse Examiner (FNE) programs. These programs employ forensic nurses who receive specialized and extensive training in trauma, working with patients who have experienced sexual assault, the requirements of evidence collection, and how to provide expert testimony. We strongly encourage you to refer your clients to a SANE or FNE program if they tell you they would like to seek medical care.
Why is it important to encourage survivors to seek medical care at one of the SANE or FNE programs in the state, if possible? Nurses in these programs are trained to understand the difficulty survivors can have seeking help, and they understand the effects such a traumatic experience can have on them. They can speak with them confidentially about what happened and talk with them about their options and how they can help. Speaking with one of these nurses (or any medical provider) should not trigger a call to law enforcement unless they want the medical provider to call. If a survivor chooses for law enforcement to be called, they also don’t have to speak with them or give them their name.
Who authorizes a medical forensic exam and when can they be performed? Survivors cannot be refused a medical forensic exam (MFE) if they want one and law enforcement does not authorize its use. Most MFEs are best performed within seven days of the assault if the survivor would like to have evidence collected. The MFE does more than collect potential evidence from the survivor’s body. So, even if the assault occurred more than seven days ago, it is always a good idea to encourage survivors to seek medical care from a trained practitioner who can support them and help them understand their options.
What happens during the medical forensic exam? During the exam, the nurse will ask a survivor about what happened and collect any potential evidence from their body. This process can take a few hours and it moves at a pace that is comfortable for the survivor. The nurse will explain each step to them before they do it, and survivors can agree to or decline any part of the exam they don’t like. The evidence collected is stored in an envelope (the “kit” or “sexual assault evidence collection kit”) and given to law enforcement. Whether law enforcement is given a survivor’s contact information is determined by the type of report a survivor chooses.
Part of your role as an advocate can be to ensure a law enforcement officer does not try to speak with a survivor of sexual assault until the survivor has been fully informed of their reporting options and made their own choice about next steps. Do this respectfully as many law enforcement officers are there to help and some may not know all the laws if they don’t work sex assault cases very often. Know the Colorado laws providing these rights to survivors so you can provide this information, if requested. Since survivors have a right to report anonymously, if they make contact with a law enforcement officer before knowing this, then this right is lost.