A forensic sexual assault evaluation is incomplete without photographs. If a chart is limited to written documentation of injury (via words or diagram), there is no forensically sound ability to have peer-review, supervision, or a second opinion in a legal setting.
Photography in Sexual Assault Assessments
- Taking photographs of areas of the patient reported to be involved in the assault are standard of care in the medical forensic examination process.
- These photographs can supplement the medical forensic history, evidence documentation, and physical findings.
- The presence of quality photographs affords the opportunity for objective second opinion reviews and peer review.
- Photographs should not be used to interpret subtle and/or nonspecific findings like redness that are not noted on exam documentation.
- Medical providers should have the proper experience and training to take these photographs.
- Any photographs taken by nonmedical personnel should include only the head and extremities and should not document findings on the torso or genital region.
- Examiners should be familiar with equipment operation and be educated on forensic photography in sexual assault cases.
- Photographic equipment should be used that can clearly document the level of injury.
- Patients should understand the purpose of photography in forensic evidence collection, the extent to which photographs will be taken and procedures that will be used, potential uses of photographs during investigation and prosecution (especially anogenital images if taken), and the possible need to obtain additional photographs following the exam.
- Take initial and follow-up photographs if injury is noted on the original exam, or if injiru suspected and has not demonstrated itself yet (such as an emerging bruise).
- There is no evidence base to support the use of alternate light sources (ALS) to diagnose bruises despite limited current regional practice (especially in cases of attempted strangulation).
- Properly identify/label photographs following hospital protocols (for example – print the patient’s name, date of exam, and the examiner’s name/initials on a plain sheet of paper, or using a patient label).
- Digital imaging can automatically embed the date/time and a variety of other technical data in each image.
- Mechanisms should be in place to protect patients’ privacy and confidentiality related to the photographs.
- Use adequate lighting whether the source is natural, flood, or flash.
- Include a color bar in the photograph to ensure accurate color reproduction.
- Strive for undistorted photographs with good perspective and multiple angles.
- Maintain sharp focus (keep the camera steady, focus carefully, use maximum depth of field, and look at the frame of the scene).
- Use a forensic scale or ruler for size reference in photographs.
For additional information, please refer to the National Protocol for Sexual Assault