Issues related to consent to sexual contact

Be aware of evidence that may be pertinent to the issue of whether the patient consented to the sexual contact with the suspect.  In the majority of sexual assaults, patients know the suspects. For example, according to the National Crime Victimization Survey, in 2002, 66.1 percent of rapes/sexual assaults involved offenders who were nonstrangers.[1] Most nonstranger suspects and many stranger suspects (if confronted by the criminal justice system) will claim that the patient consented to the sexual contact.[2] Consent claims typically stem from a lack of evidence and documentation concerning force and coercion. Thus, evidence and documentation of physical findings related to whether force or coercion was used against patients (e.g., findings that reveal injuries, drugs taken involuntarily, or signs of a struggle) are important in these types of cases. However, the absence of physical trauma does not mean that coercion/force was not used or prove that patients consented to sexual contact.[3] Also, some physical findings that suggest force are not necessarily indicative of a sexual assault. It is important to remember that if an investigation takes place, law enforcement officials will look for additional crime scene evidence that may help to overcome a claim of consent. 

[1] U.S. Department of Justice, Bureau of Justice Statistics, Criminal Victimization in the United States—Statistical Tables, http://www.ojp.usdoj.gov/bjs/abstract/cvusst.htm. 
[2] J. Archambault and D.K. Faugno, Overcoming a Consent Defense to Sexual Assault, Journal of Emergency Nursing, 27:204–208, April 2001. 
[3] L. Ledray, SANE Development and Operation Guide, 1998, p. 68.



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