Adolescent Health & Medicine

Biography

Marianne has completed MB ChB at the University of the Free State, Bloemfontein, South Africa and Dip For Med (SA) Clin at the Colleges of Medicine of South Africa. She is affiliated with the Departments of Forensic Medicine and Family Medicine, Free State University. She is also involved with training in Clinical Forensic Medicine for the Free State Department of Health. She is running a service for the clinical forensic assessment of children who have possibly been sexually abused. She has vast experience as expert medical witness in child sexual abuse cases. Her publications focus around practical aspects of evaluation in rape cases, child sexual abuse cases and clinical forensic documentation.

 

Abstract

Perpetrators of child sexual abuse are commonly acquitted based on wrong facts. Expert medical witnesses play a major role in the explanation of medical findings. Health care providers may experience a perceived responsibility to prove that child sexual abuse has taken place. In truth, the function of an expert medical witness is to educate the courts and to introduce reliable medical knowledge to other professionals in court and thus complement the search for the truth. From the side of the courts, there still exists an expectation that child sexual abuse can be confirmed or ruled out by means of a medical evaluation. Experience shows that the question most frequently asked to an expert medical witness is to explain why the absence of confirmatory clinical signs does not exclude child sexual abuse. The aim of the presentation is to provide the basic knowledge and understanding expert medical witnesses need to step into the witness box with confidence and explain medical principles scientifically in a language understandable to people outside the medical field. The explanation of normal findings in child sexual abuse cases range over a basic knowledge of evaluation protocol; understanding of relevant aspects of acknowledged definitions, criminology, the way children express themselves, physiology and insight into the part a clinician plays in the complete investigation of child sexual abuse. The presentation introduces the examination protocol and moves on to explain why a normal or non-specific clinical evaluation does not negate child sexual abuse. The focus is on the sexual abuse of prepubertal children but touches on the sexual abuse and rape of adolescents. A brief summary of the interpretation of normal and abnormal clinical findings conclude the presentation. The presentation aims to equip health care providers to support the courts efficiently in child sexual abuse cases.