Examination of Suspect in Sexual Assault
This chapter is short.
The brevity with which this particular aspect of FME work has been treated is inversely proportional
to its importance.
The two previous Chapters (7 & 8) need to be read.
The standard of detail with which a specific suspect needs to be examined is no less than in the
examination of an alleged victim.
The forensic clinician owes a duty to accused, victim and the courts to perform a thoroughly
professional appraisal.
If the alleged offence is remote from the examination of the suspect, such that weeks have passed, it
may not be worthwhile looking for forensic material other than blood for identification.
It should be remembered that bruises may be visible for 14 days. 70 They may be visualised with
specialist UV photography (mainly of benefit in bite-marks) for up to 4 months.75
If a particular scar, skin lesion or other distinguishing mark has been mentioned by the complainant,
it may be appropriate to perform an inspection whatever the delay.
Repeated here is the opinion emphasised in the previous chapter.
It is not improper for the clinician examining the suspect, to discuss, by telephone, any
peculiar findings with the police surgeon examining a complainant.
Discussions have, apocryphally, attracted a condemnation of this practice as collusion. Such is not
the case. There is no difference between giving the forensic scientist as much information as
possible to enable him/her to carry out a professional analysis and extending the same courtesy to
ones clinical colleagues. In all cases the clinician's role is to gather evidence which will help any
court make a balanced decision.
Procedure
Discuss with the Senior Investigating Officer (SIO) the purposes of the examination. No forensic
clinician should be satisfied with a request to simply ''get blood and hair samples please". Full
discussion should take place about the complexities of the case and then the police surgeon should
inform the SIO about the extent and restrictions of any examination. The FME should also ensure
that the appropriate requirements for the obtaining of intimate samples (v.i.) have been fulfilled.
The suspect should have the right to be seen without the presence of a police officer. Though as has
been mentioned previously in the guidelines, the custody officer may object to this if there is a
safety consideration.
If the suspect wishes the solicitor to be present, then this should pose no problem. However undue
delay should not be contemplated at the risk of losing forensic evidence. Fibre evidence, for
example, may degrade within a few hours.
Written consent should be obtained. This should include in the dialogue a mention of why the
examination is being performed. An example would be "in the case of an alleged rape". The
examination structure and sample procedure should be outlined. The disclosure pathways should be
mentioned (see Chapters 2 & 3).
If consent is refused, then the police surgeon can still make observations and record those findings.
Intimate Samples
If intimate samples are required then consent under PACE requirements which includes the written
consent of the examinee will already have been obtained. 76 This should not deter the clinician from
obtaining his/her own consent. A simple explanation that such consent is a medical ethic rather than
a legal requirement usually produces amicable compliance.
Intimate samples are defined under Police and Criminal Evidence Act 1984 s65 as amended by the
Criminal Justice and Public Order Act 1994 s58
Intimate samples are:-
• Dental impression
• Sample of blood
• Sample of semen
• Any other tissue fluid
• Urine
• Pubic hair
• Swab from a body orifice other than the mouth.
With the exception of urine, none can be taken by anyone other than a registered dental or medical
practitioner.
Having obtained consent, a history of the alleged incident should be requested. As many allegations
relate to the question of consent or what actually occurred rather than the identification of who the
perpetrator was this is not as fruitless as it may at first seem.
Sometimes, however, no event related history is forthcoming.
The examination should proceed.
A sexual offences kit should be used and, unless the clothes have already been obtained by the
police, the examinee undressed on a paper sheet as with a victim. The clothes should be carefully
packaged and the same courtesy of dignity extended to the patient as is given to the victim.
Clinical findings and the sample harvest should be performed meticulously and recorded accurately.
If injuries are discovered duing the examination, the examinee can be asked to account for them,
even if no history was obtained, and even if legal advice, or the patient himself results in no
response. The police surgeon should record "no response" without expression or comment and carry
on with the procedure. Though "comments" should not be made, it is good clinical practice to
maintain a discourse with the examinee throughout the contact, even if only in so far as explaining
exactly what is entailed in the examination process. However the doctor should not embark on an
interrogation that should properly be conducted by the investigating officer.
The genital examination should be as gentle as possible but thorough. The area, as with the rest of
the body should be viewed under UV light for fluoresence, and any stain swabbed. Even in the
absence of fluorescence a swab should be taken of the coronal sulcus.
The anal and peri-anal area should be inspected and examined in more detail depending on the
allegations and findings. Though it must be remembered that consent may be witheld for any
individual part of the examination process, and such a decision must be respected.
At the end of the examination it could be advantageous to ask the suspect and particularly the
solicitor, if present, if they have any comment or criticism to voice. Record any answer.
The samples should be labelled in the same manner as described in Chapter 8 and also disposed of
similarly.
The Doctor at the Scene of Death
Introduction
Police surgeons get called to many scenes of death.
The majority will not become the scene of a major crime investigation.
It is imperative that the clinician brings his/her skills and knowledge to the scene, alert from the
beginning. It is likely that the police surgeon is the only one present with the medical and scientific
training to perceive some anomalies which may give rise to suspicion.
FMEs are usually called to a death, because it is "suspicious", sudden or the General Practitioner of
the deceased is unknown or not contactable. Suspicious deaths, in this context, are likely to include
homicide, suicide or accidents, as well as some cases of natural death.
This chapter is not intended to be a panorama of death and its forensic aspects but to draw attention
to the main areas of consideration.
These are:-
1. Approach to the scene
2. Communication
3. FMEs actions at the scene
4. Safety
All police surgeons should be familiar with the Scenes of Crime Directive produced by their Police
or by the Home Office Forensic Science Laboratories (or the Metropolitan Service).
Approach to the Scene
Contamination of the scene should be avoided.
The only exception to a slow measured and controlled approach to a body is the possibility
that the life may be preserved in which case the primary responsibilty is the patient. Such
preservation should not be under
taken without first making sure the scene is without danger to the doctor or others (see "Safety"
below).
Approaching the scene of death, the doctor should alight from his/her transport no closer than the
nearest police vehicle, unless directed to a particular area by a uniformed police officer or other
official. It may appear that some vehicle is closer to the scene, but that may be one that is connected
with the death.
If the FME is only the second or third person to arrive, he should discuss with the reporting officer
the circumstances of the case before inspecting the body, and determine life to be extinct with as
little disturbance to the scene as possible. If it is early in the case, or there may need to be an
investigation, the police surgeon should not hesitate to inform his police colleagues about protection
of the scene and the prevention of intrusion by unwanted observers.
If an investigation team is already there, it is likely that one officer will be keeping the log. The
doctor should report his/her arrival to that log-keeper. Discussion with the Senior Investigating
Officer (SIO) or equivalent should occur to determine the path of entry to the body and the known
circumstances. The FME should keep to this path, which should be marked, with tape or stepping
plates, where necessary.
The metaphor that it is best to keep ones hands in ones pocket should be taken literally. If without
pockets, thinking about this adage should be enough to keep ones hands away from anything other
than the body.
Having determined that life is extinct, no further interference with the body should take place
without clearance from the SIO, and until after the Scenes of Crime Officers (SOCO) have
completed their evidence gathering from the undisturbed body and environs. If the case is one
without suspicion and no investigation is taking place it is still good practice for the professionals
there to be informed before the doctor moves the body. In these latter circumstances, if the doctor is
intending to take photographs for his/her clinical records, they should also be started before moving
the body.
It is good practice, even in the most obvious and benign cases, for the body to be inspected on all
sides, just in case a suspicious lesion or object lurks beneath.
The doctor should exit by the agreed pathway.
In the case of suspicious deaths, the doctor should remain, whenever possible, to offer to the
investigating team his/her expertise, until the Home Office Pathologist arrives, or the body is
removed. It is educational, if ever case load permits, for the clinician to attend the autopsy if
possible
This chapter is short.
The brevity with which this particular aspect of FME work has been treated is inversely proportional
to its importance.
The two previous Chapters (7 & 8) need to be read.
The standard of detail with which a specific suspect needs to be examined is no less than in the
examination of an alleged victim.
The forensic clinician owes a duty to accused, victim and the courts to perform a thoroughly
professional appraisal.
If the alleged offence is remote from the examination of the suspect, such that weeks have passed, it
may not be worthwhile looking for forensic material other than blood for identification.
It should be remembered that bruises may be visible for 14 days. 70 They may be visualised with
specialist UV photography (mainly of benefit in bite-marks) for up to 4 months.75
If a particular scar, skin lesion or other distinguishing mark has been mentioned by the complainant,
it may be appropriate to perform an inspection whatever the delay.
Repeated here is the opinion emphasised in the previous chapter.
It is not improper for the clinician examining the suspect, to discuss, by telephone, any
peculiar findings with the police surgeon examining a complainant.
Discussions have, apocryphally, attracted a condemnation of this practice as collusion. Such is not
the case. There is no difference between giving the forensic scientist as much information as
possible to enable him/her to carry out a professional analysis and extending the same courtesy to
ones clinical colleagues. In all cases the clinician's role is to gather evidence which will help any
court make a balanced decision.
Procedure
Discuss with the Senior Investigating Officer (SIO) the purposes of the examination. No forensic
clinician should be satisfied with a request to simply ''get blood and hair samples please". Full
discussion should take place about the complexities of the case and then the police surgeon should
inform the SIO about the extent and restrictions of any examination. The FME should also ensure
that the appropriate requirements for the obtaining of intimate samples (v.i.) have been fulfilled.
The suspect should have the right to be seen without the presence of a police officer. Though as has
been mentioned previously in the guidelines, the custody officer may object to this if there is a
safety consideration.
If the suspect wishes the solicitor to be present, then this should pose no problem. However undue
delay should not be contemplated at the risk of losing forensic evidence. Fibre evidence, for
example, may degrade within a few hours.
Written consent should be obtained. This should include in the dialogue a mention of why the
examination is being performed. An example would be "in the case of an alleged rape". The
examination structure and sample procedure should be outlined. The disclosure pathways should be
mentioned (see Chapters 2 & 3).
If consent is refused, then the police surgeon can still make observations and record those findings.
Intimate Samples
If intimate samples are required then consent under PACE requirements which includes the written
consent of the examinee will already have been obtained. 76 This should not deter the clinician from
obtaining his/her own consent. A simple explanation that such consent is a medical ethic rather than
a legal requirement usually produces amicable compliance.
Intimate samples are defined under Police and Criminal Evidence Act 1984 s65 as amended by the
Criminal Justice and Public Order Act 1994 s58
Intimate samples are:-
• Dental impression
• Sample of blood
• Sample of semen
• Any other tissue fluid
• Urine
• Pubic hair
• Swab from a body orifice other than the mouth.
With the exception of urine, none can be taken by anyone other than a registered dental or medical
practitioner.
Having obtained consent, a history of the alleged incident should be requested. As many allegations
relate to the question of consent or what actually occurred rather than the identification of who the
perpetrator was this is not as fruitless as it may at first seem.
Sometimes, however, no event related history is forthcoming.
The examination should proceed.
A sexual offences kit should be used and, unless the clothes have already been obtained by the
police, the examinee undressed on a paper sheet as with a victim. The clothes should be carefully
packaged and the same courtesy of dignity extended to the patient as is given to the victim.
Clinical findings and the sample harvest should be performed meticulously and recorded accurately.
If injuries are discovered duing the examination, the examinee can be asked to account for them,
even if no history was obtained, and even if legal advice, or the patient himself results in no
response. The police surgeon should record "no response" without expression or comment and carry
on with the procedure. Though "comments" should not be made, it is good clinical practice to
maintain a discourse with the examinee throughout the contact, even if only in so far as explaining
exactly what is entailed in the examination process. However the doctor should not embark on an
interrogation that should properly be conducted by the investigating officer.
The genital examination should be as gentle as possible but thorough. The area, as with the rest of
the body should be viewed under UV light for fluoresence, and any stain swabbed. Even in the
absence of fluorescence a swab should be taken of the coronal sulcus.
The anal and peri-anal area should be inspected and examined in more detail depending on the
allegations and findings. Though it must be remembered that consent may be witheld for any
individual part of the examination process, and such a decision must be respected.
At the end of the examination it could be advantageous to ask the suspect and particularly the
solicitor, if present, if they have any comment or criticism to voice. Record any answer.
The samples should be labelled in the same manner as described in Chapter 8 and also disposed of
similarly.
The Doctor at the Scene of Death
Introduction
Police surgeons get called to many scenes of death.
The majority will not become the scene of a major crime investigation.
It is imperative that the clinician brings his/her skills and knowledge to the scene, alert from the
beginning. It is likely that the police surgeon is the only one present with the medical and scientific
training to perceive some anomalies which may give rise to suspicion.
FMEs are usually called to a death, because it is "suspicious", sudden or the General Practitioner of
the deceased is unknown or not contactable. Suspicious deaths, in this context, are likely to include
homicide, suicide or accidents, as well as some cases of natural death.
This chapter is not intended to be a panorama of death and its forensic aspects but to draw attention
to the main areas of consideration.
These are:-
1. Approach to the scene
2. Communication
3. FMEs actions at the scene
4. Safety
All police surgeons should be familiar with the Scenes of Crime Directive produced by their Police
or by the Home Office Forensic Science Laboratories (or the Metropolitan Service).
Approach to the Scene
Contamination of the scene should be avoided.
The only exception to a slow measured and controlled approach to a body is the possibility
that the life may be preserved in which case the primary responsibilty is the patient. Such
preservation should not be under
taken without first making sure the scene is without danger to the doctor or others (see "Safety"
below).
Approaching the scene of death, the doctor should alight from his/her transport no closer than the
nearest police vehicle, unless directed to a particular area by a uniformed police officer or other
official. It may appear that some vehicle is closer to the scene, but that may be one that is connected
with the death.
If the FME is only the second or third person to arrive, he should discuss with the reporting officer
the circumstances of the case before inspecting the body, and determine life to be extinct with as
little disturbance to the scene as possible. If it is early in the case, or there may need to be an
investigation, the police surgeon should not hesitate to inform his police colleagues about protection
of the scene and the prevention of intrusion by unwanted observers.
If an investigation team is already there, it is likely that one officer will be keeping the log. The
doctor should report his/her arrival to that log-keeper. Discussion with the Senior Investigating
Officer (SIO) or equivalent should occur to determine the path of entry to the body and the known
circumstances. The FME should keep to this path, which should be marked, with tape or stepping
plates, where necessary.
The metaphor that it is best to keep ones hands in ones pocket should be taken literally. If without
pockets, thinking about this adage should be enough to keep ones hands away from anything other
than the body.
Having determined that life is extinct, no further interference with the body should take place
without clearance from the SIO, and until after the Scenes of Crime Officers (SOCO) have
completed their evidence gathering from the undisturbed body and environs. If the case is one
without suspicion and no investigation is taking place it is still good practice for the professionals
there to be informed before the doctor moves the body. In these latter circumstances, if the doctor is
intending to take photographs for his/her clinical records, they should also be started before moving
the body.
It is good practice, even in the most obvious and benign cases, for the body to be inspected on all
sides, just in case a suspicious lesion or object lurks beneath.
The doctor should exit by the agreed pathway.
In the case of suspicious deaths, the doctor should remain, whenever possible, to offer to the
investigating team his/her expertise, until the Home Office Pathologist arrives, or the body is
removed. It is educational, if ever case load permits, for the clinician to attend the autopsy if
possible
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