Attached
Background: Aim of medico-legal examination in alleged sexual abuse is providing an opinion on
physical/sexual contact between individuals. Supportive scientific evidence is often absent and
experts are in a dilemma.
Objectives: To identify the limitations of medico legal opinion in alleged sexual abuse and the
factors influencing these limitations.
Methods: A retrospective descriptive study based on medico-legal case records of females who
had been referred to a Teaching Hospital in the Western province of Sri Lanka following an
allegation of sexual abuse during a period of 3 years (2012-2015). Data analysis was done with
Statistical Package for Social Sciences (SPSS).
Results: Out of 441 medical records perused, the main complaint (n=180, 40%) was related to
concerns of the guardians. Majority (n=302, 68%) had presented for medico-legal examination
72-hours after the incident. Giving a firm positive medico legal opinion as per the complaint had
been possible in 280(63%). A firm opinion could not be given in 19 (86%) out of 22 victims
reporting intracrural intercourse and for 22 (79%) out of 28 victims complaining of fingering. Out
of 376 victims with no recent injuries, 276 (73%) presented late. Out of the 128 victims who had
experienced physical threats, only 35 (27%) had supportive injuries.
Conclusions: Many factors including late presentation and type of complaint influence the medico
legal opinion in a case of sexual abuse and therefore it is a challenge to the forensic expert. Thus,
proper administration of justice needs an insight into these factors, challenges and the
limitations.
