Journal of Forensic and Legal Medicine
Volume 14, Issue 8 , Pages 503-514 , November 2007

An evaluation of ‘confirmatory’ medical opinion given to English courts in 14 cases of alleged child sexual abuse

  • Mary Pillai

      Affiliations

    • Corresponding Author InformationTel.: +44 8454 222337; fax: +44 8454 222403.

Received 9 July 2006 ,Revised 29 November 2006 ,Accepted 30 November 2006.

References 

  1. Berenson AB. The prepubertal genital exam: what is normal and abnormal. Curr Opin Obstet Gynecol. 1994;6(6):526–530
  2. McCann J, Voris J, Simon M, Wells R. Perianal findings in prepubertal children selected for nonabuse: A descriptive study. Child Abuse Neglect. 1989;13:179–193
  3. Berenson AB, Heger AH, Hayes JM, Bailey RK, Emans SJ. Appearance of the hymen in prepubertal girls. Pediatrics. 1992;89:387–394
  4. Gardner JJ. Descriptive study of genital variations in healthy non-abused premenarchal girls. J Pediatr. 1992;120:251–257
  5. Berenson AB. Normal anogenital anatomy. Child Abuse Neglect. 1998;22:589–596
  6. Myhre AK, Berntzen K, Bratlid D. Perianal anatomy in non-abused preschool children. Acta Paediatr. 2001;90:1321–1328
  7. Berenson AB, Grady JJ. A longitudinal study of hymenal development from 3 to 9 years of age. J Pediatr. 2002;140:600–607
  8. Heger A, Ticson L, Guerra L, Lister J, Zaragoza T, McConnell G, et al. Appearance of the genitalia in girls selected for nonabuse: Review of hymenal morphology and non-specific findings. J Pediatr Adolesc Gynecol. 2002;15:27–35
  9. Adams JA, Harper K, Knudson S, Revilla J. Examination findings in legally confirmed child sexual abuse: It’s normal to be normal. Pediatrics. 1994;310–317
  10. Adams JA, Knudson S. Genital findings in adolescent girls referred for suspected sexual abuse. Arch Pediatr Adolesc Med. 1996;150(8):850–857
  11. Heger A, Ticson L, Velasquez O, Bernier R. Children referred for possible sexual abuse: medical findings in 2384 children. Child Abuse Neglect. 2002;26:645–659
  12. Physical signs of sexual abuse in children. A report of a working party, Royal College of Physicians of London. April 1991. 2nd ed. Lavenham Press, 1997.
  13. Kirk Weir I. Clinical advice to courts on Children’s contact with their parents following parental separation. Child Adolesc Mental Health. 2006;11:40–49
  14. Royal College of Paediatrics and Child Health, Physical Signs of Sexual Abuse in Children, 3rd ed., RCPCH, London, in press.
  15. Adams JA, Harper K, Knudson S. A proposed system for the classification of anogenital findings in children with suspected sexual abuse. Adolesc Pediatr Gynecol. 1992;5:73–75
  16. Adams JA. Approach to interpreting physical and laboratory findings in suspected child sexual abuse: A 2005 Revision. The APSAC Advisor Summer 2005. p. 7–13.
  17. Heger A, Emans SJ, Muram D. Evaluation of the sexually abused child. 2nd ed.. Oxford University Press; 2000;p. 136
  18. Glossary of Terms and the Interpretations of Findings for Child Sexual Abuse Evidentiary Examinations Written by Interpretation of Physical Findings in Sexual Abuse subcommittee headed by John McCann, MD copyright 1998 APSAC.
  19. Berenson AB, Chacko MR, Wiemann CM, Mishaw CO, Friedrich WN, Grady JJ. Use of hymenal measurements in the diagnosis of previous penetration. Pediatrics. 2002;109:228–235
  20. Ingram D, Everett VD, Ingram DL. The relationship between transverse hymenal orifice diameter by the separation technique and other possible markers of sexual abuse. Child Abuse Neglect. 2001;25:1109–1120
  21. McCann J, Wells R, Simon M, Voris J. Genital findings in prepubertal girls selected for nonabuse: A descriptive study. Pediatrics. 1990;86:428–439
  22. Berenson AB, Chacko MR, Wiemann CM, Mishaw CO, Friedrich WN, Grady JJ. A Case-control study of anatomic changes resulting from sexual abuse. Am J Obstet Gynecol. 2000;182:820–834
  23. Berenson A, Heger A, Andrews S. Appearance of the hymen in newborns. Pediatrics. 1991;87:458–465
  24. Heppenstall-Heger A, McConnell G, Ticson L, Guerra L, Lister J, Zaragoza T. Healing patterns in anogenital injuries: a longitudinal study of injuries associated with sexual abuse, accidental injuries, or genital surgery in the preadolescent child. Pediatrics. 2003;112:829–837
  25. McCann J, Voris J. Perianal injuries resulting from sexual abuse: A longitudinal study. Pediatrics. 1993;91:390–397
  26. Berenson AB, Somma-Garcia A, Barnett S. Perianal findings in infants 18 months of age or younger. Pediatrics. 1993;91:838–840
  27. Holmes DS. The evidence for repression: An examination of sixty years of research. In:  Singer JL editors. Repression and Dissociation: Implications for Personality Theory, Psychopathology and Health. Chicago: University of Chicago Press; 1990;
  28. Brandon S, Boakes J, Glaser D, Green R. Recovered memories of childhood sexual abuse: Implications for clinical practice. Br J Psychiatry. 1998;192:296–307
  29. Royal College of Psychiatrists. Reported recovered memories of child sexual abuse: recommendations for good practice and implications for training, Continuing professional development and research. Psychiatric Bull 1997; 2. 663–5.
  30. Pope HG. Recovered memories of childhood sexual abuse. BMJ. 1998;316:488–489
  31. Baker RB. Anal fissure produced by examination for sexual abuse. Am J Dis Child. 1991;145:848–849
  32. Steele EK, Lowry DS. Labial adhesions following normal delivery. J Obstet Gynaecol. 2002;22:555
  33. Sharma B, Arora R, Preston J. Postpartum labial adhesions following normal vaginal delivery. J Obstet Gynaecol. 2005;25:215
  34. Kumar RK, Sonika A, Charu C, Sunesh K, Neena M. Labial adhesions in pubertal girls. Arch Gynecol Obstet. 2006;273:243–245
  35. Ingram DL, Everett VD, Lyna PR, White ST, Rockwell LA. Epidemiology of adult sexually transmitted disease agents in children being evaluated for sexual abuse. Pediatr Infect Dis J. 1992;11:945–950
  36. Hammerschlag MR. Sexually transmitted diseases in sexually abused children. Medical and legal implications. Sex Transm Infect. 1998;74:164–167
  37. Ceci SJ, Bruck M. Suggestibility of the child witness: a historical review and synthesis. Psychol Bull. 1993;113:403–439
  38. Memorandum of Good Practice. London, England: Her Majesty’s Stationery Office, 1992.
  39. Achieving Best Evidence in Criminal Proceedings, Guidance for vulnerable or intimidated witnesses, including children. Home Office Communications Directorate, January 2002. Available from: www.cps.gov.uk and www.homeoffice.gov.uk.
  40. Teenage Pregnancy, Report by the Social Exclusion Unit. The Stationary Office, London, June 1999.
  41. Man, 30, jailed over sex assaults on Girl, This was not a Case of a sexual predator, Crown court told. Coventry Evening Telegraph, September 9, 2004.
  42. Emans JE, Woods E, Allred E, Grace E. Hymenal findings in adolescent women, impact of tampon use and consensual sexual activity. J Pediatr. 1994;125:153–160
  43. Adams JA, Botash AS, Kellogg N. Differences in hymen morphology between adolescent girls with and without a history of consensual sexual intercourse. Arch Peditr Adolesc Med. 2004;158:280–285
  44. Daubert v. Merrell Dow Pharmaceuticals. Inc., 1993;113, S. Ct. 2786.
  45. Access to justice: Final report by the Right Honourable, The Lord Woolf, Master of the Rolls. London; HMSO. 1996.
  46. The Criminal Procedure (Amendment No. 2) Rules 2006 SI number 2636 of 2006. Available from: http://www.dca.gov.uk/procedurerules/si2636-06-guide.pdf.
  47. Paradise JE, Winter MR, Finkel MA, Berenson AB, Beiser AS. Influence of the history on physician’s interpretation of girl’s genital findings. Pediatrics. 1999;103:980–986
  48. Roberts REI. Forensic medical evidence in rape and child sexual abuse:controversies and a possible solution. J Royal Soc Med. 1999;92:388–392
  49. Reece RM. Letters – The evidence for shaken baby syndrome. BMJ. 2004;328:1316–1317
  50. Bravos ZM. Cross examination of the medical expert. IPT 1995, vol. 7. Available from: www.ipt-forensics.com/journal/volume7/j7_4_5.htm. Accessed 04.11.2004.

PII: S1752-928X(07)00004-2

doi: 10.1016/j.jflm.2006.11.006

Journal of Forensic and Legal Medicine
Volume 14, Issue 8 , Pages 503-514 , November 2007