Survivor Healthcare Rights and Choices
Survivors have a right to complete medical care whether or not they decide to have forensic samples collected (Sexual Assault Service, BC Women’s Hospital + Health Centre and Women Against Violence Against Women, 2017).
Survivors have a right to equal and non-discriminatory reproductive health care, including contraception, abortion, information to make decisions, and access to services. Affirming a survivor’s right to choose and advocating for reproductive self-determination is essential for providing trauma-informed care (Erdman and Cook, 2008; IAFN, 2022; Government of Canada, 2022).
Police
Police cannot direct physicians or nurses to complete a forensic exam or direct when to conduct one (Kafka, 2023).
Police should not be physically present during the medical assessment or forensic exam to maintain survivor privacy and confidentiality (RCMP, 2016). Healthcare providers are responsible for the integrity of the forensic exam and maintaining and ensuring the chain of custody for the forensic samples.
Consent
Medical and forensic procedures should only be completed with the survivor’s ongoing consent. The survivor can choose any portion of the medical assessment, treatment, and/or forensic exam.
Consent-based care respects the survivor’s autonomy by ensuring that the treatment they receive supports their goals and is chosen by the survivor.
Strategies for effective and informed consent-based practice include involving the survivor in decision making by:
- Being sensitive to the survivor’s preferences for information and their decision-making style.
- Systematically addressing the risks of care, expected benefits, alternatives, and what to expect before and after the procedure.
- Taking steps to ensure that the survivor is making a voluntary choice free of undue influence e.g., giving the survivor time and privacy to make a decision.
- Routinely checking the survivor’s understanding e.g., asking them to paraphrase what they heard (Daniel et al., 2012).
