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Examining a victim of sexual assault — medical and legal principles
Examining a victim of sexual assault combines medical care and support first, and then — with separate informed consent for each step — evidence collection and documentation; the aim is to protect the victim's health and choices, not to decide whether the victim is telling the truth.
Why it matters in the exam
Questions test priorities, consent, timing and privacy. The order: treat injuries and life-threatening conditions; prophylaxis — emergency contraception (up to 72 hours for levonorgestrel and up to 120 hours for ulipristal), HIV post-exposure prophylaxis started as early as possible and no later than 72 hours, prophylaxis for sexually transmitted infections and hepatitis B vaccination as needed; and psychological support. Evidence collection is best within 72 hours, but is sometimes possible up to about a week, so it should not be abandoned because of time alone. When drug-facilitated assault is suspected, urine is taken as early as possible, because substances remain there longer than in blood; later hair testing can help afterwards.
Informed consent is required for each step separately — examination, photography, evidence collection and handing over to the police — and the person may refuse some of them. The examining doctor assesses the person's capacity to consent. The examination takes place in a private room, with a companion as the person wishes, with a focused medical history and no exploration of sexual history beyond what is medically needed. Photographs are labelled with a case number, not a name, and kept separately. To insert a speculum, water is used rather than lubricant, which may interfere with tests.
Findings: a normal genital examination does not exclude penetration, and in most cases there is no genital injury; bleeding at first intercourse is not the rule. The doctor therefore describes findings and does not rule "rape did or did not happen". For minors, the Penal Law (section 368D) places reporting duties on professionals in the situations it defines, mainly according to the offender's identity and the circumstances; when the duty applies it overrides the minor's wishes, and the minor must be told so openly. In Israel there are designated centres for examination and evidence collection, and the victim can decide about filing a complaint later.
Key points
- Medical care comes before evidence collection.
- HIV prophylaxis up to 72 hours; emergency contraception up to 120 hours.
- Separate consent for each step.
- A normal examination does not exclude assault.
- For minors, the reporting duty under the Penal Law, section 368D, when it applies.
Summary table
| Step | What is done | Timing | Legal point |
|---|---|---|---|
| Medical care | Injuries, stability | Immediately | Before any evidence |
| Prophylaxis | Contraception, HIV, STIs, hepatitis B | Up to 72 hours for HIV; up to 120 hours for ulipristal | Offered to every victim by risk |
| Evidence collection | Swabs, clothing, blood and urine | Best within 72 hours; sometimes up to a week | Separate consent and chain of custody |
| Documentation | Description, body chart, photographs by case number | During the examination | Describe, do not judge |
| Reporting for minors | Under the Penal Law, section 368D | When the duty applies | Overrides the minor's wishes |
A free exam question
במהלך בדיקה של נפגעת תקיפה מינית , על מנת להקל על החדרת ציוד דוגמת ספקולום לפתחים אנטומיים ,אפשר להיעזר בחומר סיכה על בסיס: (the question as examined, in Hebrew)
- א. אלכוהול
- ב. שמן
- ג. פרפין
- ד. מים
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Sources
- WHO: Guidelines for medico-legal care for victims of sexual violence, 2003 — Examination, specimen collection and treatment
- WHO: Consolidated guidelines on HIV post-exposure prophylaxis, 2024 — Timing of PEP after sexual exposure
- חוק העונשין, התשל״ז-1977, סעיף 368ד, נוסח עדכני — Duty to report offences against minors and helpless persons
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.