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IT’S NORMAL TO BE NORMAL
Normal or non-specific findings in a patient do not necessarily imply that no abuse
occurred. In 1994, Adams, et al., conducted a study to determine the frequency of
abnormal findings in a population of children with legal confirmation of sexual abuse.
In their review of 213 cases with perpetrator conviction for sexual abuse, 77 percent
of these girls had normal or non-specific genital examination findings. As Adams
notes:
“Abnormal findings are not common in sexually abused
girls…More emphasis should be placed on documenting the
child’s description of the molestation, and educating prosecutors
that, for children alleging abuse, ‘It’s normal to be normal.’”
Further, the Supreme Court of the Philippines ruled in an en banc decision
(People v. Llanita G.R. No. 134101, September 5, 2001) that “the absence of
hymenal lacerations does not disprove sexual abuse.”
It is quite common for a medical certificate to be issued immediately after the patient is examined,
since a provisional medical certificate is often required for inquest purposes even before the results
of the diagnostic and forensic tests are available. As it is also a recommended practice to submit the
colposcopic pictures for peer review, the following statement may be used in the medical certificate
after the examining physician records the impression:
“The final interpretation of the evaluation and physical findings will be released
after the diagnostic and forensic tests are completed and the peer review is
concluded.”