Examination in Cases of Assault
The examination of a patient in the case of an alleged assault should follow the same pattern
whether the examinee is the complainant or accused.
Standard medical history taking techniques should be involved
• Introduction
• Consent
• History
• Examination
• Investigation
• Diagnosis
The "Diagnosis" in the forensic context, of course, as has been alluded to in other chapters, is a
formulation of opinion about causation.
Introduction
The FME should introduce him/herself to the patient explaining
1. The purpose of the examination
2. The procedure to be adopted
3. The investigations needed to be done (if any)
Consent
Consent should then be taken, including explicit parameters regarding disclosure, investigation and
photography etc. Chapter 2 on Consent should be read.
History
The history of the alleged events insofar as that history has a direct bearing on the clinical appraisal
should be taken.
Account must also be taken of factors which may affect such an appraisal. This would include any
intoxicants, or other drugs, past medical and surgical history, any medication being taken, and any
social history which may reflect on the condition of the patient, such as homelessness and having
lived "rough". Any other recent physical confrontation, of any form, which may have produced
stigmata must also be obtained.
Examination
A full body examination should be performed. It is classically known that in the stress of a physical
confrontation, symptoms of trauma, and memory of causation may be absent. This dictum is also
true in the examination of a police officer in the case of alleged "police assault". The oft related
habit of examining a constable's hands does a disservice to the profession and creates a two tier
standard with a reduced level of competency for the police. To the police officer in such a situation
should be extended the full facilities of a complete, competent and consensual examination.
The examination should be performed carefully. The order of the facets of the complete examination
is completely at the discretion of the individual doctor, though developing a standard format and
using proformata (see Chapter 4) can be helpful. It is important however, that any samples that
should be obtained are taken at a time when they are not going to have been contaminated by
previous procedures. This is particularly true in, but not exclusive to, sexual offences, and is covered
in Chapters 8 & 9.
Injuries
The recording of injuries accurately is absolutely vital.
The use of body charts (see Appendix 1c) is of great aid.
Any injury or lesion which can be measured, should be measured.
There are six objective parameters to any such traumatic lesion:
• Type of lesion
• Position
• Size
• Appearance
• Orientation
• Direction of causation
In addition to these there are the subjective symptoms of:
• Pain
• Tenderness
• Stiffness
The examination of a patient in the case of an alleged assault should follow the same pattern
whether the examinee is the complainant or accused.
Standard medical history taking techniques should be involved
• Introduction
• Consent
• History
• Examination
• Investigation
• Diagnosis
The "Diagnosis" in the forensic context, of course, as has been alluded to in other chapters, is a
formulation of opinion about causation.
Introduction
The FME should introduce him/herself to the patient explaining
1. The purpose of the examination
2. The procedure to be adopted
3. The investigations needed to be done (if any)
Consent
Consent should then be taken, including explicit parameters regarding disclosure, investigation and
photography etc. Chapter 2 on Consent should be read.
History
The history of the alleged events insofar as that history has a direct bearing on the clinical appraisal
should be taken.
Account must also be taken of factors which may affect such an appraisal. This would include any
intoxicants, or other drugs, past medical and surgical history, any medication being taken, and any
social history which may reflect on the condition of the patient, such as homelessness and having
lived "rough". Any other recent physical confrontation, of any form, which may have produced
stigmata must also be obtained.
Examination
A full body examination should be performed. It is classically known that in the stress of a physical
confrontation, symptoms of trauma, and memory of causation may be absent. This dictum is also
true in the examination of a police officer in the case of alleged "police assault". The oft related
habit of examining a constable's hands does a disservice to the profession and creates a two tier
standard with a reduced level of competency for the police. To the police officer in such a situation
should be extended the full facilities of a complete, competent and consensual examination.
The examination should be performed carefully. The order of the facets of the complete examination
is completely at the discretion of the individual doctor, though developing a standard format and
using proformata (see Chapter 4) can be helpful. It is important however, that any samples that
should be obtained are taken at a time when they are not going to have been contaminated by
previous procedures. This is particularly true in, but not exclusive to, sexual offences, and is covered
in Chapters 8 & 9.
Injuries
The recording of injuries accurately is absolutely vital.
The use of body charts (see Appendix 1c) is of great aid.
Any injury or lesion which can be measured, should be measured.
There are six objective parameters to any such traumatic lesion:
• Type of lesion
• Position
• Size
• Appearance
• Orientation
• Direction of causation
In addition to these there are the subjective symptoms of:
• Pain
• Tenderness
• Stiffness
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