Recommendations at a glance for jurisdictions and individuals responding to sexual assault victims to facilitate victim-sensitive reporting practices:
- Except in situations covered by mandatory reporting laws, patients, not health care workers, make the decision to report a sexual assault to law enforcement
- Inform patients about reporting consequences.
- As a result of VAWA 2005, many jurisdictions have implemented alternatives to standard reporting procedures.
- Promote a victim-centered reporting process.
Many sexual assault victims who come to health care facilities or other exam sites for the medical forensic
exam choose to report the assault to law enforcement. Reporting provides the criminal justice system with
the opportunity to offer immediate protection to the victim, collect evidence from all crime scenes, investigate the case, prosecute it if there is sufficient evidence, and hold the offender accountable for crimes committed.
Given the danger that sex offenders pose to the community, reporting can serve as a first step in efforts to
stop them from reoffending. Equally important, reporting gives the justice system the chance to encourage
victims to seek assistance to address their needs, identify patterns of sexual violence in the jurisdiction, and educate the public about such patterns. Service providers should discuss all reporting options with victims and the pros and cons of each, including the fact that delayed reporting may be detrimental to the
prosecution of an offender. Victims need to know that even if they are not ready to report at the time of the
exam, the best way to preserve their option to report later is to have the exam performed. Information should be provided in a language victims understand.
Some victims, however, are unable to make a decision about whether they want to report or be involved in
the criminal justice system in the immediate aftermath of an assault. Pressuring these victims to report may
discourage their future involvement. Yet, they can benefit from support and advocacy, treatment, and
information that focuses on their well-being. Recognizing that traumatic injuries heal and evidence on their
bodies is lost as time passes and that they may report at a later date, victims can also be encouraged to
have the medical forensic exam conducted. Victims who are recipients of compassionate and appropriate
care at the time of the exam are more likely to cooperate with law enforcement and prosecution in the future.
Except in situations covered by mandatory reporting laws, patients, not health care workers, 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 officials2. States are required, as a condition of eligibility for STOP Violence Against Women Formula Grant funds, to allow victims to receive examinations and to have the examinations paid for regardless of the level of participation of victims in the criminal justice process. Documentation and evidence collected could be invaluable to the investigation and prosecution if patients should report at a later date, which often occurs. Patients 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, although the state is not required to pay for medical care.
Jurisdictions need to consider the challenges of storing evidence in cases where victims go through the
medical forensic exam but opt not to participate with the criminal justice process. In some communities, it is a challenge to find adequate space to hold evidence in cases where a report has not been made. For more information on this topic, see B.6. Evidence Integrity.
In addition, under VAWA 2005 as a condition of STOP Formula Grant funding, states must also certify that
law enforcement officers, prosecutors, and other government officials do not ask or require victims of sex
offenses to submit to polygraph exams or other truth telling devices as a condition for proceeding with the
investigation or prosecution of the offense.
Inform patients about reporting consequences.
Prior to making a decision about reporting, patients need information about issues related to reporting. For example, they should be informed of the following:- The process of reporting the sexual assault to law enforcement and the information that will typically be requested from the victim
- Procedures dealing with reporting in the jurisdictional protocol for immediate response to sexual assault.
- Whether health care personnel are mandated by law to report the assault.
- The fact that the report will trigger an investigation. Depending upon the results of the investigation, the case may be referred to the prosecutor, and the prosecutor may file charges.
- The purposes of the exam and how documented injuries as well as evidence gathered could be used during investigation and prosecution.
- Types of evidence (beyond that found on patients) that may be gathered during an investigation3
- The fact that delays in reporting, especially extended ones, can result in loss of evidence and may negatively affect the ability of the criminal justice system to investigate and prosecute a case.4
- Practices regarding prosecution of sexual assault victims for unrelated criminal charges.
- The right to accept or decline exam procedures and the possible consequences of declining.
- The right to copies of any communication or report issued to law enforcement and procedures for accessing such data.
- Policies related to payment for the exam, evidence collection, and medical care, whether or not a report is made.
- Policies on collecting/holding evidence in cases where patients are undecided about reporting, and, if evidence can be collected with no report, the amount of time they have to make a reporting decision.
| Table of Contents | Reporting to Law Enforcement- VAWA 2005 |
1 Some jurisdictions mandate 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. Health care personnel should be aware that these reporting laws may come into conflict with military policy allowing for restricted reporting for victims in the military. 2 Some victims may fear possible 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 gender identities, or they are from racially or otherwise oppressed groups; they are inmates; or they fear 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 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. 3 For example, other evidence may be found on the suspect’s bodies and clothing, at the locations of actual assaults, and locations victims went to immediately after the assaults. 4 Prompt reporting can facilitate a thorough investigation. Collecting evidence from patients is but one piece of investigative information gathering. Other investigative activities may include, but are not limited to, identifying and collecting evidence from all crime scenes; identifying, apprehending, and interviewing suspects; interviewing witnesses (both eyewitnesses and persons to whom victims initially disclose); obtaining search warrants as needed (e.g., to search for drugs that might have been used to facilitate an assault or for evidence used during an assault such as clothing, ropes, or condoms). Investigative activities depend on the specifics of each case.