Who does and doesn't get a sexual assault evidence kit in hospital?

Sexual assault survivors seeking care in northwestern Ontario hospitals are not always treated equally. Patients who were intoxicated during the assault or while seeking treatment after the fact face greater difficulty accessing sexual assault evidence kits (SAEKs), according to a new study published in the journal Violence Against Women this summer.Despite the fact that in Ontario, hospitals are legally obligated to provide access to SAEKs to anyone who is in need of one, free of charge, but 40% of hospitals in Canada either don't have them or lack staff trained to use them.SAEKs are used to collect DNA evidence and document injuries. They do not treat the harms sustained from the assault, the study noted. Rather, they are forensic tools for gathering evidence that could potentially be used in legal proceedings. After conducting qualitative interviews with healthcare providers working at hospitals in northwestern Ontario, the authors identified three major sociocultural barriers to accessing SAEKs in rural communities: being Indigenous, police involvement and stigma pertaining to alcohol use.Survivors who experience more than one of these factors simultaneously have an even harder time accessing a SAEK, the authors noted.Patients who were intoxicated during the assault or while seeking treatment were often dismissed as unreliable. Further, patients were seen as more credible if they arrived at the hospital with police support. However, if they arrived under custody, they were often thought to be exaggerating or lying about their assault.And Indigenous patients are often discredited and subjected to racist assumptions.“From the interviews that we did, it seems that the person most likely to be viewed as credible and blameless, and to therefore receive a kit, is a white woman who was sober when assaulted, who doesn’t know the perpetrator, and who calls police for help,” co-author Kathleen Rice, professor in McGill University’s Department of Family Medicine, said in a news release.These barriers also restrict access to sexual assault care more broadly, which typically includes emotional support, emergency contraception, testing for STIs, medical treatment of injuries and follow-up care, safety planning and risk assessment and counselling.“This runs counter to how healthcare providers are supposed to provide care in this situation,” the authors wrote.“Not only are they not supposed to offer different levels of care depending on their moral assessment of the patient, but it is also not their responsibility to determine whether an assault took place. They are not supposed to withhold care based on whether they believe an assault survivor’s claims, yet our data suggest that some rural healthcare providers do precisely that.”Underpinning this differential treatment is the concept of an “ideal” sexual assault victim.“Those who fall outside that ‘ideal victim’ stereotype risk facing disbelief or discriminatory care,” Rice added.The study authors called on hospitals to work with sexual assault nurse examiners to develop “resource-specific protocols.” “Who decides to use a SAEK? Survivors should have the ultimate say in this decision, and it should be an informed one,” the authors wrote.“There should be full transparency as to what the forensic examination will entail, and also what the legal proceedings may be if the survivor chooses to report the assault.”The authors also questioned whether emergency departments, where many survivors seek post-assault care, are the best setting for the administering of SAEKs. While emergency rooms have the advantage of 24-hour service, they expose survivors to biases and misguided assumptions that impact the care, or lack of care, that they receive.“The carousel-like movements of emergency departments do not appear to meet the needs either of assault survivors or care providers,” the authors wrote.

Who does and doesn't get a sexual assault evidence kit in hospital?

Register for free access or login.

Related Topics

Business Topic