Victims of sexual offences: medicolegal examinations in emergency settings

The aim of the study was to present some data concerning the examinations of victims of sexual offences in emergency settings conducted by medicolegal examiners of the Lisbon Department of the National Institute of Legal Medicine (NILM) over a two-year period (2002-2003). The study was based on 352 alleged victims of sexual offences referred by investigating police authorities and physicians working at hospital emergency rooms. Examination records were reviewed and data collected according to the extended medicolegal protocol adopted by NILM, which includes sociodemographic variables, and medical and laboratory findings. The results show that examinations in emergency settings represented about 43% of the total examinations of victims of sexual offences, 44% of them being performed at hospital emergency rooms. Victims' ages ranged from a minimum of 93 days to a maximum of 86 years. The mean age was 17.5 years. Females represented about 92% with a large over-representation of those aged from 0 to 19 years (61% of the total). Victims were mainly girls of school age (36%) or under 6 years old (25%). Offenders were male, referred to mainly, as acquaintances/neighbours (32%), friends (24%) or cohabiting family members (20%), a large majority belonging to the victim's social or family circle (85%). Of the examinations requested as "urgent cases" only 61% were reported as having occurred within 72h prior to the examination. Traumatic lesions on the whole body were found in only 28% of the cases, while findings on the genitalia and/or the anus were present in 31%. Medical and laboratory findings were in accordance with some sort of sexual offence in 34% of the cases. Our findings show the great heterogeneity of the victims, with a high proportion of children as well as the interplay between examination requests in emergency settings and the need to define more accurate criteria and proceedings for legal authorities and physicians who are usually the first line of intervention before specialists in legal medicine.