Child sexual abuse: The significance of the history and testifying on non-confirmatory findings

Background: Despite numerous studies and publications, there is still a common expectation that a medical assessment can confirm or rule out child sexual abuse (CSA). The truth is that CSA can never be ruled out and can seldom be confirmed on clinical grounds. Aim: The objective of this article was...

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Main Authors: Johanna M. Kotzé, Hanneke Brits
Format: Article
Language:English
Published: AOSIS 2019-06-01
Series:African Journal of Primary Health Care & Family Medicine
Subjects:
Online Access:https://phcfm.org/index.php/phcfm/article/view/1954
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author Johanna M. Kotzé
Hanneke Brits
author_facet Johanna M. Kotzé
Hanneke Brits
author_sort Johanna M. Kotzé
collection DOAJ
description Background: Despite numerous studies and publications, there is still a common expectation that a medical assessment can confirm or rule out child sexual abuse (CSA). The truth is that CSA can never be ruled out and can seldom be confirmed on clinical grounds. Aim: The objective of this article was to suggest which aspects to consider when the expert medical witness in a CSA case needs to explain why CSA can seldom be confirmed and can never be ruled out. The importance of a sound medical and medico-legal history was discussed because the history was generally the only positive ‘finding’ of the assessment of children who have possibly been abused. Method: Authoritative sources were used to support the explanation of reasons for an absence of corroborative clinical findings in CSA, as defined by the World Health Organization. The authors structured the individual sections by providing a background on which to base the testimony. They then summarised the clinical forensic significance of the information which should be offered in the courts and which should reflect on the court records, to be taken into account in the eventual decision, which will be made by the court. Results: A guideline was provided for answering questions frequently posed to the expert witness in child abuse cases where there were no positive findings. Conclusion: A structure for the explanation of reasons for a normal clinical examination when evaluating children who may have been sexually abused may reduce the discomfort of medical witnesses and improve the quality of expert medical testimony.
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spelling doaj.art-b2e978191fb64399b4d2d763ccba44c32022-12-22T03:45:50ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362019-06-01111e1e710.4102/phcfm.v11i1.1954628Child sexual abuse: The significance of the history and testifying on non-confirmatory findingsJohanna M. Kotzé0Hanneke Brits1Department of Forensic Medicine, University of the Free State, Bloemfontein, South Africa; and, Department of Family Medicine, University of the Free State, BloemfonteinDepartment of Family Medicine, University of the Free State, BloemfonteinBackground: Despite numerous studies and publications, there is still a common expectation that a medical assessment can confirm or rule out child sexual abuse (CSA). The truth is that CSA can never be ruled out and can seldom be confirmed on clinical grounds. Aim: The objective of this article was to suggest which aspects to consider when the expert medical witness in a CSA case needs to explain why CSA can seldom be confirmed and can never be ruled out. The importance of a sound medical and medico-legal history was discussed because the history was generally the only positive ‘finding’ of the assessment of children who have possibly been abused. Method: Authoritative sources were used to support the explanation of reasons for an absence of corroborative clinical findings in CSA, as defined by the World Health Organization. The authors structured the individual sections by providing a background on which to base the testimony. They then summarised the clinical forensic significance of the information which should be offered in the courts and which should reflect on the court records, to be taken into account in the eventual decision, which will be made by the court. Results: A guideline was provided for answering questions frequently posed to the expert witness in child abuse cases where there were no positive findings. Conclusion: A structure for the explanation of reasons for a normal clinical examination when evaluating children who may have been sexually abused may reduce the discomfort of medical witnesses and improve the quality of expert medical testimony.https://phcfm.org/index.php/phcfm/article/view/1954child sexual abuseexpert medical witnesssexual assaultnon-confirmatory signsnormal examination
spellingShingle Johanna M. Kotzé
Hanneke Brits
Child sexual abuse: The significance of the history and testifying on non-confirmatory findings
African Journal of Primary Health Care & Family Medicine
child sexual abuse
expert medical witness
sexual assault
non-confirmatory signs
normal examination
title Child sexual abuse: The significance of the history and testifying on non-confirmatory findings
title_full Child sexual abuse: The significance of the history and testifying on non-confirmatory findings
title_fullStr Child sexual abuse: The significance of the history and testifying on non-confirmatory findings
title_full_unstemmed Child sexual abuse: The significance of the history and testifying on non-confirmatory findings
title_short Child sexual abuse: The significance of the history and testifying on non-confirmatory findings
title_sort child sexual abuse the significance of the history and testifying on non confirmatory findings
topic child sexual abuse
expert medical witness
sexual assault
non-confirmatory signs
normal examination
url https://phcfm.org/index.php/phcfm/article/view/1954
work_keys_str_mv AT johannamkotze childsexualabusethesignificanceofthehistoryandtestifyingonnonconfirmatoryfindings
AT hannekebrits childsexualabusethesignificanceofthehistoryandtestifyingonnonconfirmatoryfindings