Background

This national protocol was developed by the Office on Violence Against Women under the direction of the Attorney General pursuant to the Violence Against Women Act of 2000.[1] In developing the protocol, OVW reviewed existing protocols on sexual assault forensic examinations and consulted with national, State, local, and tribal experts on sexual assault. Experts were consulted from rape crisis centers; State and tribal sexual assault and domestic violence coalitions and programs; and programs for criminal justice, forensic nursing, forensic science, emergency room medicine, law, social services, and sex crimes in underserved communities.[2]

Starting in the summer of 2001, the Department of Justice (DOJ) began gathering information on resources, issues, and gaps related to sexual assault medical forensic exams. The first task was to identify and obtain relevant materials and data. Existing national and jurisdictional protocols on the exam and immediate multidisciplinary responses to sexual assault were sought,[3] as well as documents that analyzed jurisdictional response. Input was solicited on issues, gaps, and promising practices from numerous organizations, associations, and individuals representing disciplines involved in the response to sexual assault. In addition, numerous persons were contacted who could offer perspectives on particular issues related to the exam process. State sexual assault coalitions and/or State government agencies that oversee violence against women programs were also contacted to gain information on their activities concerning protocol development and training. In some States, data was obtained through discussions with sexual assault forensic examiners and coordinators of examiner programs or sexual assault response teams.

A series of forums was held in the summer and fall of 2002, calling upon practitioners and policymakers involved in victim advocacy, health care, forensic science, and criminal justice fields to assist in developing a national protocol. After a draft protocol for adult and adolescent victims was developed in early 2003, it was distributed to a wide array of individuals and organizations for their review and feedback.[4] Comments were first solicited from the individuals who were invited to the forums. Then input was sought from sexual assault survivors, as well as tribal sexual assault and domestic violence coalitions and local advocacy programs. Members of the National Advisory Committee on Violence Against Women also reviewed the draft and provided input. After several revisions of the document, feedback was solicited during the summer of 2003 from many national and State organizations and some local agencies that deal with sexual assault issues or serve diverse populations, as well as other individuals representing relevant disciplines. Comments received were incorporated into the document where appropriate. The finalized protocol will be reviewed periodically and revised as needed.[5]

Many of the provisions of this protocol are based on recommendations made by the consulted experts. Some of the recommendations are based on empirical research. Although research has been and continues to be done in many areas related to the medical forensic exam and was considered to the extent those involved in protocol development were aware, much more research needs to be done to provide support and validity to the exam process.

The national protocol recommends, rather than mandates, methods for conducting the medical forensic exam.[6] It serves as an informational guide to communities as they develop or revise their own protocols.[7] In no way does it invalidate previously established jurisdictional protocols, policies, or practices.


[1] The statutory requirement to develop this protocol can be found in Section 1405 of the Violence Against Women Act of 2000, Public Law 106-386. The statutory requirement also mandates the development of a national recommended standard for training for health care professionals performing these examinations, as well as related training for all health care students. These training standards will be created at a later date and, due to this fact, this protocol does not provide extensive training information.

[2] Such consultation was required under Section 1405 of the Violence Against Women Act of 2000, Public Law 106-386.

[3] Protocols reviewed varied in scope, focus, targeted audiences, and level of detail. Most addressed to some extent exam and evidence collection procedures, drug-facilitated assault, evidence integrity, and evaluation and care for STIs, HIV, and pregnancy. Some also addressed roles of involved responders, multidisciplinary coordination, reporting, crime lab testing, court testimony, issues related to victims’ needs, working with specific populations of victims, payment for the exam, and crime victims’ compensation.

[4] The scope of this protocol is limited to the sexual assault medical forensic exam of adult and adolescent victims. A separate protocol should be developed on child exams. Not only is child sexual victimization a complex topic in and of itself, but response to child victims can be considerably different from response to adult and adolescent victims.

[5] Future revisions will attempt to incorporate new research, advances in science and technology, and promising practices. Rather than depending solely on revisions to the national protocol for updated information, responders involved in the exam process are urged to stay informed of cutting-edge research, advances, and practices, and promote change to their jurisdictional protocols to reflect the most effective responses possible.

[6] The protocol has no regulatory purpose and is not intended to nor does it provide legal advice. (Statement adapted from the Hawaii State Sexual Assault Protocol for Forensic and Medical Examinations, Introduction, 1999.)

[7] Those involved in the development of this protocol strove to create a document that addressed the many issues facing communities across the Nation related to the exam process. However, there may be instances where the document falls short of adequately addressing specific needs or challenges facing a jurisdiction or a specific population of victims. See appendix A on customizing protocols for ways that jurisdictions can address these limitations when they are developing/revising their own protocols.