The purpose of a medical interview is to:
- Obtain information about what sexual acts were committed to perform a comprehensive medical forensic examination and to collect biological evidence samples;
- Obtain information about physical injuries to document use of physical force and for medical examination and treatment purposes; and
- Determine whether the medical forensic findings are consistent with the history, and to provide this information to law enforcement officers.
The purpose of an investigative interview is to:
- Obtain the sexual assault history; and
- Obtain a detailed description of the events (e.g., who, when, what, where, and how).
Quoted verbatim from the SART Manual developed by the California Coalition Against Sexual Assault (CALCASA, 2001, p. 43)Alternatively, some argue that the two interviews are best conducted separately, given the very different purposes outlined above. This allows health care professionals to conduct an interview that is explicitly focused on their purpose and relevant content, and which may elicit different information from the law enforcement interview. Many victims are more comfortable telling a health care provider information that is sensitive or potentially embarrassing, such as the fact that they were subjected to oral or anal penetration during the sexual assault. There are also many aspects of a patient’s health history that are not relevant or even appropriate for law enforcement. The law enforcement interview has a very different purpose than a medical interview, and it is likely to be longer because it covers a wider range of topics related to the sexual assault, including: the events before, during and after the incident; the suspect, victim, and any witnesses; and the location of crime scene(s), along with any potential evidence that can be recovered. The primary danger with joint interviews is that roles will be muddled, and SAFEs will be drawn too far into the criminal investigation and the law enforcement function. This can leave SAFEs vulnerable to charges of bias when they testify at trial, which may weaken their expert testimony on scientific and medical matters. Further, it can have serious implications for hearsay testimony. The Crawford Supreme Court case means that SAFEs, if they are considered to be too closely aligned with the law enforcement function, can be viewed as adjuncts of law enforcement instead of medical providers. When that happens, statements made to them by patients can no longer be repeated (if necessary) by others as hearsay statements under the traditional exception that covers statements to medical providers made for the purpose of diagnosis and treatment. The bottom line is that, while it can be good practice to do joint interviews, the roles of the SAFE and law enforcement investigator must be kept separate and clearly defined, and the dangers of how courts will view this interaction must be considered carefully. This response is an adapted excerpt from the OnLine Training Institute (OLTI) module entitled, Interviewing the Victim: Techniques Based on the Realistic Dynamics of Sexual Assault.
For more information, please see Roger Canaff’s article entitled Nobility in Objectivity: A Prosecutor’s Case for Neutrality in Forensic Nursing published in the Journal of Forensic Nursing and A Prosecutor’s Reference: Medical Evidence and the Role of Sexual Assault Nurse Examiners in Cases Involving Adult Victims written by Jenifer Markowitz and published by AEquitas: The Prosecutors’ Resource on Violence Against Women