Rape is a sexual offense that involves sexual intercourse, or other forms of penetration carried out against the person without their consent. According to the Criminal Law Amendment Act 2013, Section 375 of IPC, a man is said to rape if he, penetrates his penis, to any extent, into the vagina, mouth, urethra, or anus of a woman or insert any object or other part of the body apart from the penis, into her private body parts, manipulate any part of the body, applies mouth or make her do any of the above mentioned with him or any other person.
There are different types of rape like statutory rape, marital rape, custodial rape, gang rape, date rape, stranger rape. Each of them is defined under various sections and subsections of IPC. Section 376 subsection 1, subsection 2, section 376 A, 376 B, 376 C, 376 D, 376 E deals with punishment for rape and related offenses. There are mainly two exceptions under rape: a medical procedure or intervention shall not constitute rape and sexual intercourse or sexual act by a man with his wife, the wife not being under fifteen years of age, is not rape.
When a case is filed for such a crime, the medical examination is very important both of the rape victim as well as the accused to confirm it to be a sexual offense and also to collect enough evidence confirming the offensive act and the accused behind it. Rape can cause serious complications to the victim like mental agony, rape trauma syndrome, hemorrhage, shock, or even death.
Medical Examination of Rape Victim
The priority of the doctor examing a victim of rape is to save the life and provide medical support and then collect material evidence to facilitate and aid the justice. The examination of the rape victim who is a female should only be done with the presence of a female doctor.
The medical examination mainly consists of recording history, examination of the clothes, physical examination, collection of material evidence. Consent should be provided by the victim to the doctor before conducting the medical examination. If the victim is below the age of 12 or of unsound mind then the consent is taken from the parent/guardian.
Details to be Recorded of Rape Victim
1. History of Rape Victim
Details about the victim’s menstrual cycle, whether she was menstruating at the time of the alleged incident, marital status, and history, obstetric history if relevant, history of any venereal disease, history about the incident, time, place, location, date, nature of the assault, whether penetration was vaginal/anal/oral, number of assailants, whether resistance offered, whether bath or local washing was done after the incident, whether there was any ejaculation/discharge. Such information is collected from the victim.
2. Examination of Clothes
Clothes of the victim should be examined for the presence of bloodstains, semen, secretions, mud particles, hair, or any foreign material. Look for signs of struggle or application of force such as torn, marks cut, tear, rip, wear and tear, loss of buttons. Sometimes small blood droplets might get absorbed into the cloth and hence microscopic examination of the cloth or fabric threads can indicate blood.
3. Physical Examination of Rape Victim
As part of the general examination, record any two identification marks, height, weight, generally built, vital parameters. Examine mental maturity concerning age. Request the victim to stand on a large, clean, white sheet of paper and undress by herself.
This will help to collect any material evidence that might fall on the white paper. Ensure that the cloth is dry and then pack it in an envelope. Look for stains on the body. If found then these should be scrapped/swabbed and collected. Look for injuries over the face, breast, neck, thighs, etc. Check for physical assault injuries like grip marks, bite marks, ligature impressions, etc.
After the general examination, the local examination should be done. Good light is essential and the lithotomy position is preferable. Look for vaginal bleeding, swelling/injury/stains/soiling in the labial region, contusions or abrasions on the thighs. Note whether the pubic hair is shaved/unshaved/matted with semen/presence of blood or bloodstains. Also, check for the presence of any foreign hair. Take clippings of pubic hair from the victim for comparison.
4. State of Hymen of Rape Victim
Note the state of the hymen, whether torn or intact. If it’s found torn then check its position, fresh, or old. If it is fresh then look for bleeding, swollen margins, reddish, tender, inflamed. If it is old then:- the margins will be swollen, congestion and margins will show signs of healing.
If the tears of the hymen are due to ruptures with fingers then it will be usually lateral, whilst ruptures with the penis are usually posterior. In children, the hymen might appear to be red and congested because the hymen is deeply situated and also bruising of labia.
The hymen may not be ruptured if the penetration was not full, hymen is tough, fleshy, elastic, female is deflorated, victim happens to be a female child as the hymen is deeply situated. If it was anus penetration, check for any discharge/hemorrhage/injury.
5. Examination of Vagina
Check the vaginal mucosa for any foreign body or any injury, distinct or not distinct rugae of the vaginal wall, check the vaginal canal or fornix for semen/fluid.
Samples to be collected from a victim includes clothes and undergarments, foreign evidentiary material like hair, fiber, button, etc, fingerprint scrapping, stains from the body, scalp hairs for comparison, a swab from teeth bite mark, pubic hairs, swabs from vagina and cervix, washing of posterior fornix of the vagina for the detection of spermatozoa, urine for pregnancy and alcohol test, blood for serological/toxicological/DNA profiling, venereal disease.
Rape is a legal term and not a medical diagnosis. A doctor who is forming the report after diagnosis should not use the term rape in his report. Whether the rape has taken place or not is a legal conclusion drawn by the judge and not by a medical doctor.
Even if the penetration is only up to the vulva, it is sufficient to be constituted as rape. The medical examination report is vital for proving the side of the victim and delivering justice.