VFPMS Guideline: Recommended approach for photographic and video documentation

Documenting a child’s injuries is an important aspect of a forensic assessment and should always be performed carefully. When possible adequate photographic or video documentation should be used in conjunction to medical notes and use of diagrams. However, when video or photo-documentation is not available, diagrams and written descriptions of examination findings may be adequate for evidentiary purposes.

Key points:

• Consent (ideally written) should always be obtained prior to photographic or video documentation.
• Video-documentation is the ‘gold standard’ method for documenting genital examination findings (i.e. video-documentation – USB, DVD, CD, SVHS and VHS – is superior to still photography).
• Video-documentation of genital examinations should only be performed by medically qualified professionals.
• All video-documentation of genital examinations should be stored securely at all times.
• Video – documentation is intensely personal material that will NOT be released for viewing by non- medically trained professionals under any circumstances.

Recommendations for video-documentation of genital examinations

Consideration should be given to video recording the colposcopic examination in every child examined in the context of suspected sexual abuse. Video-recording of a genital and anal examination is strongly recommended when:

• a child or young person has alleged penetrative or attempted penetrative sexual abuse of the genital region
• there is a history of genital or anal bleeding
• there is a history or genital or anal pain
• there is a history of genital rash, discharge or itch
• there is a history of observed anomaly of the genital or anal region
• a sexually transmitted disease is suspected
• an intra-vaginal foreign object is suspected

N.B. A support person of the child’s choice could be present during the examination unless the child requests that the examination occur in the absence of a support person, in which case VFPMS strongly encourages the presence of an independent observer (for example a CASA worker or a nurse). 

Identifying data (child’s name, UR, date of examination and initials of the examiner) should be recorded at the commencement of the examination.

The examination findings and the medical professional’s interpretation of these findings should be discussed with the child and their support person.

The video-documentation should be stored securely in a locked receptacle (filing cabinet or safe). No copies should be made of video-documentation of genital examinations. Doctors should keep a written log to be stored with the video-documentation to facilitate audit and quality assurances activities.

Consent

The decision whether or not to video-record the genital examination lies with the examining doctor and is dependent on appropriate medical indications and informed consent from the child’s guardian and assent from the child.

Informed consent for photographic or video-documentation must be obtained from the child’s guardian. The Gillick principle might enable mature children / young persons to provide their own consent. Video-documentation should not proceed in the absence of the child’s assent (at the least, consent at the best).