The term adult sexual assault, as used in this section,
applies to all such offenses (sexual assault is a criminal act) against
persons who are 18 years of age and over, and not married to the alleged
perpetrator. Sexual assault against children under the age of 18, and
those incidents that occur within a marital relationship should be
referred to the Family Advocacy Program and should be handled as child
sexual abuse or spouse abuse (OPNAVINST
1752.2 and BUMEDINST 6320.70). Sexual
harassment is covered by
SECNAVINST 5300.26.
Family Advocacy Representative
The assessment of sexual abuse is a complex process involving many
professionals including law enforcement, a family advocacy representative
(FAR), and medical personnel. Coordination of the assessment is often
difficult and confusing. Navy instructions direct family advocacy
representatives (FAR) to take the lead role. The FAR is always the
first person to contact in a sexual abuse case as mandated by Navy
instruction. Most state statutes also require reporting to civilian
authorities.
Considerations
All victims of sexual assault will be given as much credibility as a
victim of any other crime: they shall be considered a victim of sexual
assault when any type of sex is forced on her or him through any type of
coercion, violent or otherwise, they shall be considered a victim of
sexual assault, regardless of her/his behavior at the time of the sexual
assault (e.g. fraternization, underage drinking, etc.), and they shall be
considered a victim of sexual assault regardless of the assailant's
relationship with the victim (e.g., boyfriend, acquaintance, co-worker,
etc.).
Role of the Physician
The medical officer must ensure appropriate law enforcement and command
notifications are made depending upon jurisdiction and per OPNAVINST 1752.1. This should
include providing the victim with options concerning her/his involvement
with investigative/legal personnel and possible consequences as outlined
in OPNAVINST 1752.1.
The primary role of the physician is to meet the needs of the victim and to
observe, describe, collect, and record findings. All victims of sexual assault
will be treated with fairness and respect. All medical personnel will ensure
the sensitive, coordinated, and effective management of sexual assault cases,
including access to a victim advocate program and appropriate counseling.
Sensitivity to the victim's emotional state is critical. Explain the
availability of victim advocacy services and notify the on-call victim
advocate, if desired by the victim.
The medical officer will conduct a medical examination and gather physical
evidence as soon as possible, (if the assault occurred within 72 hours of the
visit), paying particular attention to victim sensitivity and privacy. Allow
the victim to receive medical care and emotional support and / or
stabilization before detailed investigative interviews. A victim's written
consent is necessary for all medical procedures. This is contained within the
sexual assault kit. Sexual assault cases must be managed in compliance with
SECNAVINST 5520.3. If the assault occurred more than 72 hours before the
visit, the sexual assault kit does not need to be utilized; however a physical
exam should be conducted and appropriate medical care provided to address
pregnancy prevention (emergency contraception, STDs treatments, etc.), as well
as counseling services.
Collection of physical evidence is not required in all cases of sexual
assault, such as the case of a patient presenting for psychological assistance
several days post-assault. These individuals should be referred for
appropriate mental health counseling and should still be offered a physical
exam and medical care.
References
Revised by CAPT Glenna L. Tinney, MSC, USN, MED-32, Bureau of
Medicine and Surgery, Washington, D.C. (1999).
Approved for public release; Distribution is unlimited.