Open Access Research Article
ROLE OF MEDICAL PRACTIONERS IN CHILD SEXUAL ABUSE CASES BY: KANIKA UPADHYAYA
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Article Details
ROLE OF MEDICAL PRACTIONERS IN
CHILD SEXUAL ABUSE CASES
AUTHORED BY: KANIKA UPADHYAYA
Designation: Student (LLM) At Gujarat
National Law University
ABSTRACT
Rameeza Bi, Mathura, Nirbhaya, Geeta
Chopra—these names echo through walls of courtrooms and textbooks, as victims
of worst form of violation of human right—Sexual Abuse. It is appalling to note
that not just in adults, everyday newspapers and news channels are flooded with
news of rape and sexual abuse of small children from different parts of
country. Instead of bringing measurable changes in legislations and introducing
new legislations like POCSO, Child Sexual Abuse (CSA) has seen a rise. As we
delve deeper into lower conviction rates and requirement of evidences to prove
commission of rape, it is found that not just investigating officers but
medical practioners are also provided with elaborate guidelines to deal with
such sensitive cases. How is doctor’s role important in the justice
dispensation? Expert evidence of a
doctor plays a crucial role in determining the conviction or acquittal of the
Accused. This Article examines the statutory provisions and detailed guidelines
provided for medical practioners in Indian scenario and throws light on
shortcomings which need to be fulfilled in current scenario, by drawing a
comparison between statutory provisions and guidelines incorporated in USA and
UK.
Keywords: CSA, Consent, Medical
Examination, Survivor, Expert Evidence
INTRODUCTION
Children are world’s future. They
need utmost care and proper nurturing in order to develop into valuable human
assets. Often news channels and newspapers highlight plight of children who are
poor or were forced to migrate from their homeland due to variety of reasons,
living in sub human conditions. WHO, UNICEF alongside other international
organizations particularly focus on such vulnerable children in order to ensure
availability of decent food, clothing, shelter and education to them, which is
their basic human right? Apart from hunger, poverty, protection from war crimes
etc, another menace which is on rise related to children is sexual abuse. It’s
absolutely condemnable yet it is the gross reality that filthy minded
perpetrators target vulnerable children in order to satiate their lust. Reasons
for same cannot be accurately enumerated as it depends on intermingling of
various socio-economic-personal factors.[1]
What is further sickening is that in several cases the perpetrator himself or
herself is a minor or someone whom the victim already knew[2].
WHO defines Child Sexual Abuse as any sexual activity carried out by an adult
or a minor with a child who doesn’t comprehend the nature of such activity
owing to his/ her lack of maturity and hence inability to give consent for such
activities.[3] Child
Sexual Activities are alarmingly high particularly in developing Asian and
African nations. In India, child sexual abuse saw an approximate 50% surge
during the COVID lockdown as per data reported by child aid agencies,[4]while
recent NCRB data presents an average rate of 29%[5] in
matters of child sexual abuse which may actually be even higher, if non-
reported cases are taken into account.[6]
Even in developed nations like the USA, around 12-17% adolescent females[7]
have somewhere faced sexual abuse,[8] in
addition to the rampant sex trafficking and prostitution particularly among
illegal immigrants.[9] Child
Sexual Abuse has myriad disastrous consequences both physically and
psychologically[10],
probably extending for a lifetime, (especially if proper care and counselling
is not provided timely) in addition to social stigma attached to the offence.
This social taboo and fear of ostracisation is one of the primary reasons why
victims fail to openly speak about the injustice meted out to them.
Regarding the legal scenario,
suitable statutory amendments[11]
have been made periodically to widen the ambit of definition of rape[12]
and provide stringent punishments for rape or sexual assault committed by a
person in dominant/ authoritative position or if it is done with a child below
age of 12years.[13]
Nevertheless when provisions of Indian Penal Code 1860(hereinafter called
“IPC”) and Code of Criminal Procedure 1973 (hereinafter called “CRPC”) fallen
short of providing adequate relief to the child victim, Protection of Children
from Sexual Offences Act 2012 (hereinafter referred to as “POCSO”) was enacted
after much deliberation in order to nab the actual culprit and render justice
to victim effectively. A detailed analysis of POCSO Act depicts laudable
efforts of the legislature by introducing different categories of penetrative,
non penetrative sexual assault, using a child for pornographic or similar
purposes, separate special courts to proceed with such cases, increasing
quantum of punishment till death penalty, as per severity of the case in
addition to other elaborate guidelines for police officers and judicial
officers as to report the case while comforting and taking victim into
confidence, using child friendly measures both at the stage of investigation as
well as trial. Nevertheless the question arises that why there are such low
conviction rates?[14]
What about the doctor who was supposed to examine the victimized child or
otherwise himself turned out to be an abuser?[15]
This Article explores the role of medical practioners while dealing with child
sexual abuse cases.
MEDICAL
EXAMINATION OF THE VICTIM:
Right to health has been inferred as a part of
Right to life under Article 21 of the constitution.[16]
Further 2013 Criminal Law Amendment has expanded definition of Rape to any kind
of unwanted penetrative as well as non penetrative act which was done against
will.[17]
Survivors of Rape or Sexual Assault suffer severe physical and psychological
damage, which might have an indelible impact for life. Relevant Provisions in
CRPC,[18]
POCSO[19]
and IPC[20]
provide for medical examination of the survivor. Apart from this, detailed
guidelines[21] pertain
to medical examination, treatment; psychiatric counselling[22]
with other support and collection of relevant evidences in sexual abuse cases.[23]
The examination shall be conducted by
a government doctor or any registered medical practioners within 24 hours of
the incident (irrespective of complaint lodged with police[24]
or court or not)[25] in
presence of parent or any trustworthy individual, after taking due consent of
the child [26]or
someone who can validly consent on behalf of the child except the police
officer[27]
who brought the victim to the health centre.[28]
Interpreter or relevant expert’s assistance for taking consent shall be taken
for especially abled or survivors suffering from any other kind of disability.[29]
If disabled person is often sexually abused by close ones and is capable of
narrating chain of events himself/ herself, attempt must be made to take history
directly from such survivor (depends on the degree of disability).[30]
Proper documentation of consent given shall be made after explaining the child
or person giving consent the process of medical examination and consequent
sample collection.[31]
In case some immediate, lifesaving procedure is to be undertaken, consent might
not be taken, as per facts and circumstances.[32]
If the victim is a female, she should be examined by a female doctor or in
presence of a female attendant.[33]
It is the doctor’s responsibility to inform nearest police station having
jurisdiction about the incident and also ensure that the samples[34]
collected are properly packed, so that they reach medico- forensic experts in a
good condition, devoid of any damage, decay or deterioration.[35]
Doctor also needs to correctly get all the precise details of the incident from
the victim, with utmost care, in order to prevent revictimisation[36]and
ensure that confidentiality and privacy of the survivor is maintained.[37]Fine
distinction to be made while recording what actually happened and what might
have happened –i.e. about what victim himself or herself is uncertain. Details
of previous sexual history[38]
should be considered irrelevant.[39] It
is pertinent at the outset to make the victim comfortable and not push victim
in an insensitive manner to reveal intricate details of the abuse, it is to be
understood that such things take time.[40]
It is not to be presumed that absence of struggle marks imply that survivor in
any manner consented to sexual activity.[41]
Also no prior presumption of any sort of tutelage or false information being
fed to child survivor by parents/ person accompanying for examination shall be
made. Any conduct of the medical practioners or usage of coercion or undue
influence which is unwanted or not required for the purpose of medical
examination is illegal under Section 164A(7) Crpc.[42]
Two Finger Test is forbidden to be used as a means of medical examination.[43]
Psycho-social support and counselling alongside treatment of physical injuries
and other preventive medication as against sexually transmitted diseases or
unwanted pregnancy should be timely[44]
and adequately provided. Denial of providing appropriate treatment to victim
after receiving information about sexual abuse is punishable under Section 166B
IPC[45].
Also any reasonable suspicion of commission of sexual assault and not reporting
the same to the relevant police authorities is also a punishable offence.[46]
Apart from this additional guidelines have been laid for if victim belongs to
special group like transgender, LGBTQ, sex workers etc so that they are
encouraged to come forward and report matters of wrongdoing and that they won’t
be ridiculed or met with hostility because of their identity.[47]
If sexual abuse is the result of socio- economic- religious discrimination, it
shall be duly noted in the medical report. Medical Report shall also clearly
mention any other physical injuries sustained during or immediately after the
sexual assault as well as verbal threats made to the survivor.[48]
If a reasonable possibility of child survivor being unsafe in his/ her own
place, social worker shall be roped in for proper planning of providing
alternate accommodation to the survivor.[49]
Child Welfare Committee shall also provide for support during investigation and
trial.[50]
Positive atmosphere must be maintained for survivor’s rehabilitation, in order
to make him/her realize that their bodily integrity has been violated and the
wrongdoer shouldn’t go scot free, for which the survivor needs to have an open
and well informed communication with other stakeholders of justice system.[51]
Doctor deposing on matter of child sexual abuse must be well prepared regarding
facts and other significant information about the case so that a precise,
detailed testimony could be given, which in turn has a direct relation to
acquittal/ conviction and quantum of sentence.[52]
Not just doctors but schools and family too have an important therapeutic role
and hence they too need to train students regarding their privacy and security
alongside providing counselors in school, instead of covering up under the ruse
that children aren’t meant for discussions on physical intimacy.[53]
CCTV Cameras, toll- free helpline numbers are some other safeguards that should
be clearly made known to students as well as the staff and other
administrators.[54]
Parliament and Supreme Court have
made praiseworthy efforts to bring out elaborate guidelines for schools,
medical practioners, investigating officers emphasizing on their coordination
for widespread community knowledge and rehabilitation of the child victim.
However when the question of implementation comes, India still lags behind. It
is a sorry state that till today many schools and educational institutions
particularly in remote and rural areas of the country sheerly lack proper
infrastructure and counselling facilities. People living in such areas still
consider sex as a taboo and tend to spurn any sort of training or information
related to good touch and bad touch. Parents / guardians fearing societal
ostracisation or reprisal from perpetrator tend to cover up, instead of
reporting matter of child sexual abuse, believing this will tarnish their
reputation and destroy child’s future especially if it is a female child. They
instead believe they will sort out the matter between themselves specifically
if the perpetrator is a known person. Parents/ Guardian accompanying the victim
in several cases deny consent for medical examination and attempt to scurry
away, even if matter is reported, the whole process turns waste as without
consent, medical examination cannot be carried out unless some exceptional
situation exists. Doctors do strive to seek parents/ guardian’s/ survivor’s
cooperation citing injury to dignity being a legal crime, yet a flat refusal is
the upshot in many a cases fearing waste of time and resources due to lack of
confidence in the judicial system in addition to sullying of honour.
Survivors or their families even if
muster courage to report the matter to the police, in umpteen number of cases,
either police refuses to lodge an FIR on the ostensible reason of it being a
false complaint especially if it involves some influential person as an accused[55]
or drives the survivor away to go to the health centre in order to obtain
medical evidence of sexual abuse. Health Centers principally in rural areas
lack appropriate SAFE Kits[56]
and other evidence collection tools[57]
to examine victim and collect evidence. Medical practioners in such areas are
either totally uninformed or have some sort of bleak idea of existing statues
and guidelines, as a result mechanically treat survivor instead of sensitively
handling.[58] Many a
times they lack the pediatric expertise[59]
to examine such case and as a result the reports[60]
prepared by them are not reliable due to inaccurate findings.[61]
Samples coming from farther areas in several cases are not properly packed or
stored those results in damaging the quality of samples and incorrect
conclusions.[62] Doctors
provide expert evidence[63],
however many a times aren’t cross examined or tend to forget or get confused
among different cases and drift from their earlier statement in their court
testimony, which weakens the case of prosecution to a large extent.[64]
Privacy and confidentiality of the survivor is numerous cases is forgotten and
are examined in an utmost distressing fashion,[65]
further agonizing victim and his/her family.[66]
Suitable and sufficient counselling facilities are available only in a handful
of areas which is a major deterrent in survivor’s proper treatment and
recovery. It is provided for
transferring the survivor to appropriate shelter homes or any other suitable
accommodation after medical examination, in best interest of the child
survivor. However these shelter homes in some cases turn out to be those dark
dens of rampant sexual atrocities[67]
where an already traumatized victim is made to suffer same sexual torture
again.[68]
CCTV’s Doctors and police instead of being sympathetic, often collectively or
simultaneously ridicule victim, blaming him/ her for their own plight, asking
inappropriate, irrelevant questions under the guise of history taking and
preparing MLC Report which further pushes survivor into despair. This horrid
behaviour is often found in cases reported by LGBTQ Community or Sex Workers.
Some doctors don’t want to get into slow-paced, cumbersome trial and turn down
survivor by giving some excuse, though it is now punishable. Delay caused in
Medical Examination and making survivor and his/her family run from pillar to
post to gather evidences, leads to destruction of vital evidences and healing
of injuries[69] which
is [70]then
put in medical report as no sexual abuse could be observed.[71]
Negative opinions regarding rape or sexual assault commission or casual remarks
by doctors that they perceive that child is influenced by his/her family
/guardian and made to make false statements given utmost weightage[72]
by trial courts[73],
thereby acquitting Accused,[74]
giving them benefit of doubt.[75]
Now a day’s Courts themselves try to settle the dispute between survivor and
the Accused by coaxing both parties to enter into a compromise and eventually
compounding the gruesome offence.[76]
Both acquittal and compounding go against well settled principles provided in
medical[77]
jurisprudence[78] which
has been reiterated by the Apex Court in countless precedents[79]
that a ruptured hymen, semen presence or strict vaginal penetration isn’t
essential to constitute rape. A Survivor’s testimony is alone sufficient for
conviction though medical and other advisory evidences pinpoint otherwise.[80]
Medical evidences are opinion based / advisory in nature[81]
and hence survivor’s testimony doesn’t need any corroboration and should not be
viewed with suspicion as it is disparaging to survivor’s outraged modesty.[82] A
pertinent question arises here is that can someone’s dignity be measured in
monetary terms? How much money can absolve guilt of the perpetrator? In cases
where Accused marries survivor in guise of compromise, does such marriage
ensures stability and security to the survivor? Neither CRPC nor POCSO provides
for compounding of such grisly offences.
POSITION IN
USA:
History evinces incidents of child abuse since
ancient times but its seriousness was realized in 1962 with coinage of the term
“Battered Child Syndrome”.[83]
The first and foremost ramification succeeding this article was inclusion of
condition of mandatory reporting of child abuse. Guidelines for Medical
Practioners in child abuse cases are mostly similar as to what has been
provided in India. If child avows or vaguely hints at being sexually exploited,
the concerned child must be taken to local doctor and psychiatrist for
immediate treatment and further report the matter to police or child protection
units who shall take cognizance of the matter.[84]
Child survivors are encouraged to speak on the matter, making them comfortable
and assuring them that they were not responsible for the injustice meted out to
them.[85]Despite
its rare to find confirmed evidences of sexual abuse[86],
high quality infrastructure, trained counselors and timely intervention may
save the child survivor in the nick of time from long term depression or any
other physical-mental infirmity.[87] Given
the serious nature of the offence and the mental blockages the child survivor[88]may
face in articulating his/ her ordeal, the physicians are given specific
training to deal and counsel such patients as well as their families.[89]
Proper coordinated multidisciplinary approach is taken up between police,
physicians and other participants of the justice system to strongly keep the
viewpoints of the child survivor,[90]
state out his/ her requirements in order to take up the suitable course of
action.[91]
In order to prevent malicious health care workers to take advantage of
vulnerability of small children and demand sexual favours in return to the
trust reposed in them, stringent screening is done of physicians as well as
other nursing staff previous employment records and behavioural profile is
established at each organization where medico works, in order to identify any
physician who is engaged in horrible malpractice of sexual exploitation of
children or adolescents under the false show of treatment.[92]
The American Academy of Pediatrics
(AAP) with American Medical Association (AMA) [93]has
prescribed strict policies and parameters[94]
(e.g.: use of chaperons) for dealing with sensitive cases in addition to
periodic training and upgradation, which must be followed by entire medical
personnel of health facility ardently.[95]
Helpline Numbers can be contacted by child survivor or any of his family/
guardian to report any sort of unwanted physical interaction with the physician
or nursing staff which they have a reason to believe [96]falls
out of the purview of medical treatment required.[97]
Any history of familial violence or untoward physical discomfort in abdominal
or pelvic reigon, gynecologist or pediatrician do make it a point to screen
such patients for sexual violence and if they reasonably suspect the same, the
next step is to inquire about the same from alleged victim. If he/ she respond
in the affirmative, then provide immediate counselling sessions to relieve them
of their mental agony in addition to physical aid.[98]
POSITION IN
UNITED KINGDOM:
Recent surge in child sexual
exploitation (CSE)[99]led
to joint working and information sharing among government and independent
health groups in collaboration with government ministers in 2014-15.[100]
CSE is challenging both in terms of identification and treatment. Hence in
every case of STI, Drug abuse, Familial violence etc, screening for probable sexual
abuse is carried out. National Action Plan to Prevent and
Tackle Child Sexual Exploitation in Scotland has updated its definition of CSE
in 2016 in order to combat the menace more efficiently. [101]Adequate
treatment and mental counselling facilities are arranged for patients who are
indeed abused in their early years and are reeling under its aftermath at later
stages in life.[102]
Medical personnel’s training and initial assessment after induction[103]
to evaluate his performance while dealing with sensitive cases is given supreme
importance by the Royal Medical Society.[104]
Discouraging Myths and Fake rumors is an important step taken while negotiating
with children who are potential suspects of CSE, owing to their disturbed
physical- mental state.[105]
Even healed injuries are tested using instruments like magnifying colescope, in
order to refer any probable victim to requisite child welfare agencies, even if
it has been a while since the incident occurred.[106]Ireland
in its full fledged guidelines provides for examination of child suspected to
have undergone CSE shall be examined as per nature of injuries and behavioural
situation, but as far as possible include a senior pediatrician. In case there
is a dispute between team of doctors examining the child, the area of controversy
shall be outlined and refer the matter to senior practioners for his
suggestions and get a final opinion about the case.[107]
Detailed full body check-up is carried out including dental, orthopedic, CT
scan, nutritional status, signs of neglect [108]etc.
in order to find out any other injuries or issues which might be related to the
CSE.[109]
After a detailed study of laws and
guidelines pertaining to medical examination and evidence in India, USA and UK;
it can be observed that all 3 nations have attempted to put their best foot
forward in consonance with broad principles enunciated by WHO on child sexual
abuse. Challenges facing the victim are almost similar in all 3 jurisdictions.
Never the less difference arises on the point of execution of policies and guidelines.
A multi disciplinary approach, better health infrastructure, easy availability
of counselors who are well trained to take up cases of CSA and proper
coordination among various players of justice system as in case of USA and UK
could be observed rarely in case of India. US and UK understand that after
effects of CSA are much more gross and can result over a lifetime and keeping
this in view, they screen every suspect which might have a probable history of
abuse which is absent in India. This might be one of the reasons why much more
accurately cases are reported and taken care of in USA and UK. Full body
check-up as in case of Ireland instead of focusing upon obtaining DNA and other
forensic samples; sending adolescents and adults for counselling and giving
them aid as required for incident that happened with them as a child is missing
in case of India. CSA Survivor be examined by a trained gynecologist/
pediatrician/ physician who has received particular training to examine such
cases is lacking in Indian perspective. If doctor himself turns out to be
perpetrator, action can be taken against him as well. However this isn’t the
case in Indian scenario. Fine balance has to be drawn between what is essential
for medical examination and what can be reasonably construed as undesirable and
not required. Installing CCTV Cameras and surprise visits to shelter homes and
correctional accommodation in order to ensure safety of children who are kept
there for rehabilitation might curb the wrongdoings being carried out at such
places.
CONCLUSION:
CSA is a widespread barbaric jeopardy
that plagues the entire world as perpetrators are omnipresent. To tackle this
situation one stage of recognition and rule formation has been successfully
completed but some nations like India lag behind in process of implementation.
Periodic studies, suitable amendments, upgradation and maintenance of
infrastructure and human resources, public campaigns for mass awareness and
information sharing might curb this issue to a significant extent not just in
one’s own country but across the globe.
[1] Jyoti Belur and BB Singh: CSA and
Law in India: a Commentary:
https://crimesciencejournal.biomedcentral.com/articles/10.1186/s40163-015-0037-2
[2] Ibid
[3] Protection Of Children From Sexual Abuses: Decoding
The POCSO Act: https://legalserviceindia.com/legal/article-8225-protection-of-children-from-sexual-abuses-decoding-the-pocso-act.html
[4] Child Sexual Abuse in India: Alarming statistics,
lifelong impact, how to heal:
https://www.indiatoday.in/education-today/featurephilia/story/child-sexual-abuse-in-india-alarming-statistics-lifelong-impact-how-to-heal-2416285-2023-08-04
[5] S. Tyagi and S. Karande:
Child sexual abuse in India: A wake-up call:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8445113/
[6] Ibid
[7] By both stranger as well as known
person
[8] John Briere, Catherine Scott:
Principles of Trauma Therapy: Guide to symptoms, evaluation and treatment:
https://books.google.co.in/books?hl=en&lr=&id=VtjsAwAAQBAJ&oi=fnd&pg=PP1&ots=nRlqyfLKnC&sig=NPOext7IcyGwFaNxQklHl6D
[9] Ibid
[10] CSA in India: A systematic Review:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205086
[11] 1983 and 2013
[12] Mathura Trial: Tukaram Vs. State
of Maharashtra AIR 1979 SC 185
[13] Case Law regarding medical
evidence in relation to sexual violence: https://india.unfpa.org/sites/default/files/pub-pdf/casebook_26-12-2018_final.pdf
[14] Sentencing In Rape Cases: A
Critical Appraisal Of Judicial Decisions In India:
https://jstor-gnlu.refread.com/stable/pdf/26826588.pdf?refreqid=fastly-default%3A164f95f65a787a7a20de324a18d58702&ab_segments=0%2Fbasic_search_
[15] Child abuse carried out
under guise of medical treatment, report finds:
https://www.theguardian.com/uk-news/2020/dec/03/child-abuse-carried-out-under-guise-medical-treatment-inquiry-told
[16] In line with CEDAW, ICESCR and related
International Conventions
[17] Ibid
[18] Section 164-A Crpc
[19] Section 27 POCSO
[20] Section 92 IPC
[21] In line with WHO Guidelines
on reporting of child sexual abuse: Responding to children and adolescents who
have been sexually abused:
https://www.who.int/publications/i/item/9789241550147
[22] Dilip vs. State of Madhya Pradesh
(2013) 14 SCC 331
[23] SAFE ( Sexual Assault Forensic
Evidence) Kit to be used
[24] State of Karnataka vs. Manjanna
(2000) 6 Supreme Court Cases 188
[25] Medical Examination of Survivors /
Victims of Sexual Violence: A Handbook for Medical Officers:
https://india.unfpa.org/sites/default/files/pub-pdf/handbook_final_design.pdf
[26] Child with age of 12 years and
above : Section 89-90IPC
[27] Implementing POCSO Act 2012 in
schools: https://www.nipccd.nic.in/file/reports/pocso12.pdf
[28] Ibid: Parents or Guardian/ Child
Welfare Committee/Panel of Senior Doctors in Administrative Position
[29] Ibid
[30] Ibid
[31] Ibid
[32] Ibid: Section 92IPC
[33] Ibid
[34]
Section 164 A Crpc: DNA: necessary to collect alongside clothes worn at
time of incident and any other material evidences like semen, bodily fluids
etc.
[35] Supra
[36] Supra
[38] State of Punjab vs. Gurmeet Singh
[39] GUIDELINES & PROTOCOLS
Medico-legal care for survivors/victims of Sexual Violence:
https://main.mohfw.gov.in/sites/default/files/953522324.pdf
[40] Ibid
[41] Supra
[42] Supra
[43] Supra
[44] Section 357 Crpc and Rule 5 of
POCSO.
[45] Imprisonment of upto 1 year or
fine or both
[46] Section 19 POCSO: Five
things to know about the POCSO Act:
https://idronline.org/article/rights/five-things-to-know-about-the-pocso act/?gad_source=1&gclid=EAIaIQobChMIrsXPo96TgwMVxKlmAh3uZwMeEAAYASAAEgJ5N_D_BwE
[47] Supra
[48] Supra
[49] Chapter 5: POCSO 2012: Child
Welfare Home or any alternate accommodation
[50] Supra
[51] Supra
[52] Supra
[53] Supra
[54] Supra
[55] Hathras Gangrape Case: In
UP, Rape Survivors Struggle to Get Police to Register FIRs, Let Alone
Investigate Them:
https://thewire.in/women/uttar-pradesh-police-rape-fir-discrimination
[56] Guidelines for Forensic
Examination in Sexual Assault Case:
https://cghealth.nic.in/ehealth/2018/Instructions/Guide07092018.pdf
[57] Supra
[58] David L. Kerns, Donna L. Terman
and Carol S. Larson: The Role of Physicians in Reporting and Evaluating Child
Sexual Abuse Cases: The Role of Physicians in Reporting
and Evaluating Child Sexual Abuse Cases on JSTOR
[59] Ibid
[60] Clinical Practice
Guidelines for Child Sexual Abuse:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345137/
[61] Genital examinations for alleged sexual abuse of
prepubertal girls: findings by pediatric emergency medicine physicians compared
with child abuse trained physicians: https://www.sciencedirect.com/science/article/abs/pii/S0145213402004192
[62] Supra
[63] B.L. Chaudhary,, Raghvendra Kr:
Medical examination of child of sexual assault under the protection of children
from sexual offences (POSCO), act 2012:
https://www.academia.edu/36505517/Medical_examination_of_child_of_sexual_assault_under_the_protection_of_children_from_sexual_offences_POSCO_a
[64] Breaking Silence: CSA in India:
https://www.hrw.org/report/2013/02/07/breaking-silence/child-sexual-abuse-india
[65] GUIDELINES FOR MANDATORY REPORTING
IN CHILD SEXUAL ABUSE CASE:
https://nimhanschildprotect.in/wp-content/uploads/2021/11/Guidelines-for-Mandatory-Reporting-in-Child-Sexual-Abuse-cases.pdf
[66] Ibid
[67] Sexual
abuse at shelter homes: Existing mechanism not adequate to deal with problem,
says SC: https://economictimes.indiatimes.com/news/politics-and-nation/sexual-abuse-at-shelter-homes-existing-mechanism-not-adequate-to-deal-with
[68] How Apna Ghar Sexual Abuse Case
Unfolded: https://www.hindustantimes.com/india-news/all-about-rohtak-s-apna-ghar-sexual-abuse-case-the-horror-tales-and-how-it-unfolded/stor
[69] The 10 Biggest Legal Mistakes Physicians Make When
Dealing with Suspected Child Abuse and Suspected Sexual Abuse: https://seak.com/blog/uncategorized/10-biggest-legal-mistakes-physicians-make-dealing-suspected-child-abuse-suspected-sexual-abuse/
[70] May doctors refuse to treat rape
survivors in order to avoid having to give evidence in court?: (PDF) May doctors refuse to treat
rape survivors in order to avoid having to give evidence in court?
(researchgate.net)
[71] Supra
[72] In Absence Of Victim’s
Medical Report, Rape Accused Is Entitled To Get Benefit Of Doubt: Calcutta High
Court:
https://bnblegal.com/news/in-absence-of-victims-medical-report-rape-accused-is-entitled-to-get-benefit-of-doubt-calcutta-high-court/
[73] Hari Chand v State:
https://www.livelaw.in/delhi-hc-acquits-rape-accused-benefit-doubt/
[74] St State Of Himachal Pradesh
v Asha Ram, 2006 Cri.L.J. 139
[75] State V Rahul (2022)
[76] Kerala
High Court Enunciates Broad Principles For Compounding Of Sexual Offences
Against Women & Children Upon Compromise With Accused: https://www.livelaw.in/high-court/kerala-high-court/kerala-high-court-sexual-offences-quashing-compromise-with-accused-non-compondble
offences
[77] Parikh's Textbook of Medical
Jurisprudence and Toxicology
[78] Modi Textbook of Medical
Jurisprudence and Toxicology, 23rd Edition:
https://www.livelaw.in/pdf_upload/rajesh-vs-state-of-up-and-3-others-criminal-misc-bail-application-no-10336-of-2022-allahabad-high-court-474170.
[79] Madan Gopal Kakkad vs Naval Dubey
And another, 1992 SCR (2) 921
[80] State
v. Rehan, 2020 SCC OnLine Del 172, decided on 21-01-2020]...
[81] State of MP v Dayal Sahu (2005) 8 SCC 122
[82] Bharwada Bhoginbhai Hirjibhai Vs.
State of Gujarat, AIR 1983 SC 753
[83] C.
Henry Kempe: The battered-child syndrome. JAMA. 1962;181(1):17-24: https://journalofethics.ama-assn.org/article/why-1962-matters-history-clinicians-responses-abused-and-neglected-children/2023-02
[84] Responding To Child Sexual Abuse: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Responding_To-Child-Sexual-Abuse-028.aspx#:~:text=The%20examining%
[85] Ibid
[86] J E Myers: Adjudication of CSA
Cases: https://pubmed.ncbi.nlm.nih.gov/7804772/
[87] Dirk Huyer, MD: CSA and Family Physicians: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1479790/
[88] Child Abuse and Neglect: Are
Future Doctors prepared?:
https://www.sciencedirect.com/science/article/abs/pii/S1344622322000888
[89] Ibid
[90] DJ Besharov: Responding to
child sexual abuse: the need for a balanced approach:
https://pubmed.ncbi.nlm.nih.gov/7804761/
[91] Supra
[92] Protecting Children From
Sexual Abuse by Health Care Professionals and in the Health Care Setting:
https://publications.aap.org/pediatrics/article/150/3/e2022058879/189218/Protecting-Children-From-Sexual-Abuse-by-Health?autologincheck=redirected
[93] Time to End Physician
Sexual Abuse of Patients: Calling the U.S. Medical Community to Action:
https://link.springer.com/article/10.1007/s11606-019-05014-6
[94] Child safety and Well Being Clinical
Services: https://unmhealth.org/medical-professionals/child-abuse-response.html
[95] Ibid
[96] Sexual Abuse by Medical
Professionals:
https://www.rainn.org/articles/sexual-abuse-medical-professionals
[97] Ibid
[98] Adult Manifestations of Childhood
Sexual Abuse: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2011/08/adult-manifestations-of-childhood-sexual-abuse
[99] New guidance for physicians
to help tackle child sexual exploitation:
https://www.rcplondon.ac.uk/news/new-guidance-physicians-help-tackle-child-sexual-exploitation
[100] Ibid
[101] Child Sexual Exploitation A Guide
for Health Practitioners: https://www.pkc.gov.uk/media/39252/Child-Sexual-Exploitation-A-Guide-for-Health-Practitioners/pdf/Child_Sexual_Exploitation_-_A_Guide_for_Health_Practitio
[102] Ibid
[103] Child sexual abuse (CSA) forensic
medical examinations: INTERIM GUIDANCE REGARDING NUMBERS OF EXAMINATIONS AND THE
MAINTENANCE OF COMPETENCE:
https://fflm.ac.uk/wp-content/uploads/2021/03/ARCHIVED-CSA-Examinations-Interim-Guidance-Dr-B-Butler-Feb-2020.pdf
[104] Quality Standards for doctors
undertaking Pediatric Sexual Offence Medicine (PSOM):
https://fflm.ac.uk/wp-content/uploads/2021/03/ARCHIVED-Quality-Standards-for-doctors-undertaking-PSOM-Dr-Cath-White-and-Prof-Ian-Wall-April
[105] Coventry Safeguarding Children:
One Minute Guide Child Sexual Abuse For Paediatricians, Emergency Doctors, and
other Health Staff March 2022:
https://www.coventry.gov.uk/downloads/file/38420/child-sexual-abuse-guide-for-paediatricians-emergency-doctors-and-other-health-staff
[106] Supra
[107] Medical Assessment of
Alleged or Suspected Child Abuse:
https://www.proceduresonline.com/sbni/p_medical_assess.html
[108] Ibid
[109] Ibid
Article Information
ROLE OF MEDICAL PRACTIONERS IN CHILD SEXUAL ABUSE CASES BY: KANIKA UPADHYAYA
Authors: KANIKA UPADHYAYA
- Journal IJLRA
- ISSN 2582-6433
- Published 2024/01/04
- Issue 7
About Journal
International Journal for Legal Research and Analysis
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- ISSN 2582-6433
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