While there has been an increase in the number of international scholars investigating the forensic medical examination of rape and sexual assault victims, the extent to which their findings are generalisable outside of their country of origin is questionable. Nevertheless, scholars in different countries have used their peers' conclusions without considering local contexts.
An example of how jurisdictions' practices could problematise social scientists' analysis, concerns personnel: in North America, Forensic Nurses (FN) have routinely been employed as medical examiners for, at least, twenty years; in contrast, FNs are a novelty in the United Kingdom (UK). FNs are considered experts in the US and Canada and can provide opinion testimony to the court, this is not the case in the UK.
Forensic Nurses will be interviewed in Ontario and the UK about their training, their conduct of the forensic medical examination and their report. It is intended that such interviews will shed light upon the similarities and differences in practice between the UK and Ontario and provide tentative explanations for any noted differences, while also highlighting some of the difficulties Ontario-based FNs faced during their professional development in order to draw attention to some of the potential pitfalls for UK FNs.
Recruitment and Training In Ontario and the UK, recruitment procedures favoured nurses with previous experience in emergency medicine, gynaecology, or custody medicine. Training requirements in some Ontario centres included an extended apprenticeship fostering a non-judgment approach. Due to time constraints this was not universal, but efforts to assess nurses’ attitudes were employed elsewhere, including the UK, via a role-play exercise. Forensic nurses have to be flexible, often deciding whether to stay for hours after their shift. This was particularly distressing for nurses with other priorities, for example young families. This could potentially lead to burnout, resulting in nurses leaving the work. Expertise, Relevance and the Doctor/Nurse Relationship SANEs are not a priori deemed to be experts (a judge determines expertise on a case-by-case basis), and are often limited to providing statements of fact. SANEs are not keen to be involved with the legal process, preferring that their documentation serve as evidence. If expert evidence is required, a more experienced SANE provides it; their evidence does not concern the specifics of the case, but instead focuses on general evidence (the infrequency of physical injuries upon rape victims, for instance). It is currently convention in the UK that FNEs are similarly limited to evidence of fact, with doctors asked to provide evidence based upon the FNE’s report. Unlike the SANEs, doctors do provide opinion evidence. This situation creates anxiety amongst FNEs, as many doctors have criticised their introduction, arguing that nurses will not do a thorough job. In order to prove the thoroughness of their work, FNEs record everything mentioned during the examination, including any physical phenomena found upon the body. FNEs believe that they cannot draw conclusions about relevance and do not omit information. This practice is problematic as information generated from the forensic medical forms is disclosed to the defence and can then be used to undermine the complainant’s credibility during a trial. Recording everything in order to demonstrate thoroughness of work inadvertently provides prejudicial information about the complainant to the defence.
Contrary to earlier scholarship claiming that forensic medical examiners existed in a state of role-conflict, the study found that while Ontario nurses emphasised care over evidence-gathering, and FNEs the reverse, they made space and time for both. Rather than a role-conflict, scholars should instead see the forensic intervention as a medico-legal spectrum upon which practitioners move via their practice. The introduction of the colposcope has had minimum impact. SANEs’ infrequently use it, as it was often difficult to locate the machine. Future Research Having completed this preliminary study, I will further develop this research in two ways. Having founded the Comparative Analysis of Institutional Responses to Rape Network (CAIRRN) with colleagues from Canada and the United States of America, secondary analysis will be performed upon other members’ data in order to produce further comparative analysis. Secondly, a grant proposal will be prepared to investigate forensic intervention in inquisitorial jurisdictions in Europe.