Making the decision to report

Where permitted by law, patients, not health care workers, should make the decision to report a sexual assault to law enforcement.  Health care workers in some jurisdictions are bound by law to report some or all forms of sexual assault, regardless of patients’ wishes.[1]  In the remaining jurisdictions, no report should be made without the consent of patients. (Exceptions typically include cases involving vulnerable adults and minors victimized by caretakers or other authority figures). All involved health care providers should be aware of the reporting requirements in the jurisdiction in which they work. 
 
In jurisdictions in which mandatory reporting by health care personnel is required, patients should be informed of the legal obligations of health care personnel, what triggers a mandatory report, that a report is being made, and the contents of the report. Patients should understand that even if health care personnel make a mandatory report, they are not obligated to talk with law enforcement officials or make a formal complaint themselves.[2]
 
Jurisdictions are encouraged to pay for forensic exams regardless of the level of cooperation of victims with law enforcement and the criminal justice process. Jurisdictions should conduct the exam and pay for exam costs without requiring patients’ involvement in the criminal justice system. Documentation and evidence collected could be invaluable to the investigation and prosecution if patients should report at a later date, which often occurs. Patients should also have the right to receive medical care for assault-related injuries and concerns, regardless of their decision to report and/or have evidence collected. 
 
Patients should be informed of the policies of the jurisdiction regarding whether the exam can be performed and paid for by a government entity if they elect not to report or are undecided about reporting. Also, they should be aware of jurisdictional and exam site policies on payment for medical care, if a report is made, no report is made, or no decision has yet been made on reporting.
 
[1] Some jurisdictions call for mandated reporting for some or all violent crimes, requiring health care workers to notify law enforcement in cases involving a gunshot or knife wound, strangulation/choking, or other serious bodily injury. They vary, however, in whether they require acts of sexual violence without serious physical injuries to be reported.
[2] Some victims may fear perceived consequences of reporting (e.g., retaliation by offenders; rejection by family members and friends; being discriminated against if they are males.) Victims may have these and other fears because they are from populations with differing sexual orientations or from racially or otherwise oppressed groups; inmates; or are being deported or refused citizenship (in the case of recent immigrants and refugees). Some recent immigrants or refugees may fear law enforcement because of past experiences of oppression by authorities in their countries of origin. In addition, many victims are not willing to deal with the humiliation, loss of privacy, and negativity they perceive would accompany reporting, an investigation, and prosecution. If an intimate partner or a family member committed the assault, victims may also be concerned about the consequences of prosecution on their families (e.g., loss of income, employment, profession, attorney fees, and childcare costs) and being blamed for “tearing the families apart.” Incest victims may be deterred from reporting because offender registries might indirectly identify them.


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