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OUR GOALS
It is the genuine hope of the authors that, after reading this publication, users will have reaped
the following benefits:
� Improved technical understanding: By becoming more familiar with the child
protection medical terminology and examination, members of the medical and legal
community will have a stronger grasp of the information contained within the medicolegal
certificate, reducing the possibility of misinterpretation.
� Ability to “speak the same language”: Child abuse occurs globally; hence, physicians
must share a single vocabulary so as to better communicate ideas and best practices
worldwide.
� Standardized procedures: The standardization of terminology and the certificate itself
may lead to standardized procedures. If one comprehensive examination can be created
and agreed upon by all members of the medico-legal community, there will be less
cause for multiple exams and, thus, less possibility of re-traumatizing patients.
Ultimately, it is our intention that this publication will serve as both an educational tool for
child protection professionals unfamiliar with the medico-legal examination, and as a guideline
for those in the medical community actually performing the examination. Please note that this
manual is not intended to be a substitute for actual child protection specialist training.
HOW TO USE THIS GUIDE
This publication serves as a supplement to the standardized medico-legal certificate. On the
following pages, the certificate will be dissected and explained in detail in order to clarify any
areas of confusion and, ultimately, to facilitate its use by physicians and members of the legal
community. Each section and subsection of the certificate is illustrated, complete with brief
instructions for proper completion of that section. When further explanation is required, more
detailed information is provided on the page, below the relevant section.
The diagnosis of sexual abuse should not be based solely on the physical examination. In
addition to the medico-legal exam, diagnosis depends heavily upon the results of the patient
interview, behavioral assessment and laboratory tests.
Further, medical evidence is only one component of the overall criminal investigation of child
abuse cases; other aspects such as crime scene investigation and witness corroboration by law
enforcement investigators, and home visits conducted by social workers, are equally as
important.