The doctor's dilemma: caregiving and medicolegal evidence collection.

This paper reports on findings from a population-based study of sexual assault physicians who are responsible for both the health care of sexually assaulted persons and for conducting forensic medical examinations on them for the purpose of collecting corroborative evidence to aid in legal proceedings. Self-administered questionnaires were distributed to the 100 physicians attached to sexual assault care and treatment centres across the province of Ontario, Canada. The questionnaires were focussed on exploring their relative commitment to two assessment priorities: the collection of forensic evidence for the courts and the provision of medical care. While most of the 31 physicians replying expressed satisfaction with their participation in the legal arena, a substantial proportion indicated that although they believed medical care to be the most important part of their work, evidence collection and court appearances were the most time-consuming. In addition, over four-fifths admitted to having deviated from the standard protocol used for evidence collection, based on the belief that a particular procedure or information item might either emotionally or legally harm the victim or her/his case. We suggest that the implications of these findings point to a possible ambivalence towards the evidentiary dimension of the dual role of the sexual assault physician.