The FMEK project evaluated: value of forensic medical injury reports

Abstract

Introduction In 2020, forensic medical expertise for children with injuries suspicious of physical and/or sexual abuse was partially shifted from national organisations to regional forensic doctors across the Netherlands. This paper aims to evaluate what changes these renewed forensic medical injury reports have brought about in the work of Veilig Thuis and to what extent these injury reports are decisive in the criminal prosecution of child physical and sexual abuse.

Methods The years 2020-2022 in the regions Gelderland and Overijssel were analysed. An overview of all injury reports was made, analysing who requested them, victim’s details and type of injuries. An inquiry consisting of 15 questions regarding the quality of the injury reports and contentment about the project was distributed among confidential doctors and forensic nurses at Veilig Thuis and police employees. Rechtspraak.nl was searched for jurisprudence from 2016, 2018, 2020 and 2022, aiming to analyse the additional value of injury reports in the criminal prosecution of child abuse.

Results In total, 78 requests resulting in 112 injury reports were collected. The biggest applicant was Veilig Thuis in Overijssel, the largest age category was 4-<12 years and blunt trauma was most frequent. The inquiry revealed high contentment about the project, although the 9 respondents feared a shortage of forensic doctors. Jurisprudence analysis included 15 verdicts, of which 14 on physical abuse. The injury report was mentioned 3 times by the public prosecutor, 3 times by the defense attorney and the judges adopted the reports’ conclusion each time. The judges stated 3 times that the injuries could not be qualified as severe, without the forensic doctor having indicated the injuries’ severity.

Discussion This evaluation showed that the renewed injury reports of regional forensic doctors led to great improvement by bringing specialised forensic care closer and faster to child victims of abuse. There is great contentment on the quality of the injury reports. However, the task distribution between forensic and confidential doctors should be discussed and the shortage of forensic doctors handled. The additional value of the injury reports in criminal prosecution is lowered due to the different medical and legal definitions of severe physical injury. Therefore, it should be made mandatory for forensic doctors to state the injures’ severity using an abbreviated injury scale. In a few years, another evaluation should be performed taking into account the Netherlands as a whole.