Clinical Legal Medicine and Toxicology in Sexual Assaults

  • Mete K. Gülmen
  • Nebile Daglioglu
  • Ayse Serin
  • Dilek Battal


It is important for forensic centres to be appropriately accredited and to use cutting-edge technology and scientific knowledge for the benefit of their clients. This is a new phase for technology, science, medicine and justice. Daily clinical forensic practice needs to be more specific and clear in adopting objective criteria, especially considering human rights violations. In today’s technologically and scientifically advanced world, justice needs to be supported much more by qualified, standardized expertise. Clinical forensic examination includes systematic documentation of physical injuries and sampling of biological evidence for legal purposes. Clinical evaluation and reporting should be submitted to the clinician by an authorized clinical legal medicine specialist and/or competent forensic scientist, fully responsible for the results and the advice provided. Forensic experts should be independent—should only use scientific knowledge and nothing else through the standardization/accreditation of their works and quality assurance, as noted by all international regulations.


  1. 1.
    Cig MI (2016) Women Through History. Turkiye Klinikleri J Foren Med-Special Topics 2(2):1–5Google Scholar
  2. 2.
    Policy L, Affairs G, Committee, Statistics T, Sciences P, Council, N.R., Applied, C. on, Staff, T.S., Committee on Science, Technology, and Law and Committee on Applied and Theoretical Statistics (2009) Strengthening forensic science in the United States: A path forward. National Academies Press, Washington, DCGoogle Scholar
  3. 3.
    Heise LL, Pitanguy J, Germain A (1994) World bank discussion papers: The hidden health burden: No 255: Violence against women. World Bank Publications, Washington, DCGoogle Scholar
  4. 4.
    Anderson KL (1997) Gender, status, and domestic violence: An integration of feminist and family violence approaches. J Marriage Fam 59(3):655CrossRefGoogle Scholar
  5. 5.
    Kucuradi I (2004) Human Rights in Turkey and World. Turkey Philosophy Institution, pp 15–33Google Scholar
  6. 6.
    United Nations descriptions (2008) Ending violence against women: From words to action. Choice Reviews Online 45(7):45–4091. doi: 10.5860/choice.45-4091
  7. 7.
    Ward J (2005) Violence against women: a statistical overview challenges and gaps in data collection and methodology and approaches for overcoming them’ Conducting population-based research on gender-based violence in conflict-affected settings: An overview of a multi-country research projectGoogle Scholar
  8. 8.
    United Nations (2015) The World’s Women 2015: Trends and Statistics. United Nations, Department of Economic and Social Affairs, Statistics Division, New York. Sales No. E.15.XVIIGoogle Scholar
  9. 9.
    World Health Organization (2005) WHO Multi-Country Study on Women’s Health and Domestic Violence Against Women. WHO, GenevaGoogle Scholar
  10. 10.
    World Health Organization (2013) Global and Regional Estimates of Violence against Women: Prevalence and Health Effects of Intimate Partner Violence and Non-partner Sexual Violence. WHO, GenevaGoogle Scholar
  11. 11.
    Ertürk Y (2006) Integration of the Human Rights of Women and the Gender Perspective: the Due Diligence Standard as a Tool for the Elimination of Violence Against Women. Report of the Special Rapporteur on violence against women, its causes and consequences. United Nations, New YorkGoogle Scholar
  12. 12.
    Ertürk Y (2008) Promotion and Protection of All Human Rights, Civil, Political, Economic, Social and Cultural, Including the Right to Development. Report of the Special Rapporteur on indicators on Violence Against Women, Its Causes and Consequences: Indicators on Violence Against Women and State Response. A/HRC/7/6. Presented to the Human Rights Council, Seventh SessionGoogle Scholar
  13. 13.
    Hilden M (2004) A history of sexual abuse and health: a Nordic multicentre study. BJOG 111(10):1121–1127CrossRefPubMedGoogle Scholar
  14. 14.
    Rovi N (2002) An analysis of the quality of medical care provided to sexual assault victims. J Am Med Women’s Assoc 57(4):204–207Google Scholar
  15. 15.
    Ferris LE, Sandercock J (1998) The sensitivity of forensic tests for rape. Med Law 17(3):333–350PubMedGoogle Scholar
  16. 16.
    Grossin C, Sibille I, de la Grandmaison GL, Banasr A, Brion F, Durigon M (2003) Analysis of 418 cases of sexual assault. Forensic Sci Int 131(2–3):125–130CrossRefPubMedGoogle Scholar
  17. 17.
    Ozkok MS (2016) Medical and Forensic Management of Adolescent and Adult Sexual Violence Patience. Turkiye Klinikleri J Foren Med-Special Topics 2(2):62–75Google Scholar
  18. 18.
    Gaensslen RE, Lee HC (2002) Sexual Assault Evidence: National Assessment and Guidebook. US: Grant No. 92-IJ-CX-0041Google Scholar
  19. 19.
    Connery SA (2013) Three decade old cold case murder solved with evidence from a sexual assault kit. J Forensic Leg Med 20(4):355–356CrossRefPubMedGoogle Scholar
  20. 20.
    Burg A, Kahn R, Welch K (2011) DNA testing of sexual assault evidence: the laboratory perspective”. Journal of Forensic Nurs 7(3):145–152CrossRefGoogle Scholar
  21. 21.
    Newton M (2013) The forensic aspects of sexual violence. Best Pract Res Clin Obstet Gynaecol 27(1):77–90CrossRefPubMedGoogle Scholar
  22. 22.
    Johnson D, Peterson J, Sommers I, Baskin D (2012) Use of forensic science in investigating crimes of sexual violence: contrasting its theoretical potential with empirical realities. Violence Against Women 18(2):193–222CrossRefPubMedGoogle Scholar
  23. 23.
    Gomes V, Jardim P, Taveira F, Dinis-Oliveira RJ, Magalhães T (2014) Alleged biological father incest: a forensic approach. J Forensic Sci 59(1):255–259CrossRefPubMedGoogle Scholar
  24. 24.
    Acosta ML (2002) Collecting evidence for domestic and sexual assault: highlighting violence against women in health care system interventions’. Int J Gynaecol Obstet 78(1):99–104CrossRefGoogle Scholar
  25. 25.
    Lee HC, Ladd C (2001) Preservation and collection of biological evidence. Croat Med J 42(3):225–228PubMedGoogle Scholar
  26. 26.
    Benecke M (2004) Forensic DNA samples—collection and handling. In: Fuchs J, Podda M (eds) Encyclopedia of Medical Genomics and Proteomics. CRC Press, New York, NY, USA, pp 500–504Google Scholar
  27. 27.
    Horswell J (2004) Crime scene investigation. In: Robertson J (ed) The Practice of Crime Scene Investigation. CRC Press, Boca Raton, Fla, USA, pp 30–73CrossRefGoogle Scholar
  28. 28.
    Willott GM, Allard JE (1982) Spermatozoa-their persistence after sexual intercourse. Forensic Sci Int 19(2):135–154CrossRefPubMedGoogle Scholar
  29. 29.
    Magalhães T, Dinis-Oliveira JR, Silva B, Corte-Real F, Vieira DN (2015) Biological Evidence Management for DNA Analysis in Cases of Sexual Assault. Hindawi Publishing Corporation. Scientific World Journal
  30. 30.
    Colorado Sexual Assault Evidence Collection Protocol. 2nd ed. (2015). Available at
  31. 31.
    Harper NS (2011) Drug-facilitated sexual assault. In: Jenny C (ed) Child abuse and neglect: diagnosis, treatment and evidence. Elsevier Inc., St Louis, Missouri, pp 118–126CrossRefGoogle Scholar
  32. 32.
    Du Mont J, Macdonald S, Rotbard N et al (2009) Factors associated with suspected drugfacilitated sexual assault. CMAJ 180:513–519CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Cheze M, Duffort G, Deveaux M et al (2005) Hair analysis by liquid chromatography-tandem mass spectrometry in toxicological investigation of drug facilitated crimes: report of 128 cases over the period June 2003–May 2004 in Metropolitan Paris. Forensic Sci Int 153:3–10CrossRefPubMedGoogle Scholar
  34. 34.
    Scott-Ham M, Burton FC (2005) Toxicological findings in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3 year period. J Clin Forensic Med 12:175–186CrossRefPubMedGoogle Scholar
  35. 35.
    Gee D, Owen P, McLean I et al (2006) Operation MATISSE: investigating drug facilitated sexual assault. Association of Chief Police Officers, London (UK)Google Scholar
  36. 36.
    Negrusz A, Gaensslen RE (2003) Analytical developments in toxicological investigation of drug-facilitated sexual assault. Anal Bioanal Chem 376(8):1192–1197CrossRefPubMedGoogle Scholar
  37. 37.
    Newton M (2013) The forensic aspects of sexual violence. Best Pract Res Clin Obstet Gynaecol 27(1):77–90CrossRefPubMedGoogle Scholar
  38. 38.
    Flanagan RJ, Braithwaite RA, Brown SS, Widdop B, de Wolff FA (1995) Basic Analytical Toxicology. WHO, GenevaGoogle Scholar
  39. 39.
    Yayci N, Ağritmiş H, Turla A, Koc S (2003) Fatalities due to methyl alcohol intoxication in Turkey: an 8-year study. Forensic Sci Int 131:36–41CrossRefPubMedGoogle Scholar
  40. 40.
    Azmak D (2006) Methanol related deaths in Edirne (Tokyo). Leg Med 8:39–42CrossRefGoogle Scholar
  41. 41.
    Karadeniz H, Birincioğlu İ (2011) Methyl Alcohol Poisoning in Trabzon (Turkey). J Forensic Sci 56(3):822–824CrossRefPubMedGoogle Scholar
  42. 42.
    Drummer OH (2010) Forensic Toxicology. EXS 100:579–603PubMedGoogle Scholar
  43. 43.
    Allorge D, Tournel G (2012) Role of Pharmacogenetics. In: Danielle Sapse, Kobilinsky Lawrence (eds) Forensic Toxicology. Forensic Science Advances and Their Application in the Judiciary System. CRC Press, Taylor and Francis Group, New YorkGoogle Scholar
  44. 44.
    Sajantila A, Lunetta P, Ojanpera I (2006) Postmortem pharmacokinetics: toward molecular autopsies. In: Wong SH, Linder M, Valdes R (eds) Pharmacogenomis and Proteomics: Enabling the Practice of Personalized Medicine. AACC Press, Washington, DC, pp 301–310Google Scholar
  45. 45.
    Musshoff F, Stamer UM, Madea B (2010) Pharmacogenetics and forensic toxicology. Forensic Sci Int 203:53–62CrossRefPubMedGoogle Scholar
  46. 46.
    Bertilsson L, Aberg-Wistedt A, Gustafsson L, Nordin C (1985) Extremely rapid hydroxylation of debrisoquine: a case report with implication for treatment with nortripyline and other cyclic antidepressants. Ther Drug Monit 7:478–480CrossRefPubMedGoogle Scholar
  47. 47.
    Bertilsson L, Dahl M, Sjoqvist F, Aberg-Wistedt A, Humble M, Johansson I, Lundqvist E, Ingelman-Sundberg M (1993) Molecular basis for rational mega prescribing in ultra rapid hydroxylators of debrisoquine. Lancet 341:63CrossRefPubMedGoogle Scholar
  48. 48.
    Ingelman-Sundberg M, Sim SC, Gomez A, Rodriguez-Antona C (2007) Influence of cytochrome P450 polymorphisms on drug therapies: pharmacogenetic, pharmacoepigenetic and clinical aspects. Pharmacol Ther 116:496–526CrossRefPubMedGoogle Scholar
  49. 49.
    Sajantila A, Palo JU, Ojanpera I, Davis C, Budowle B (2010) Pharmacogenetics in medico-legal context. Forensic Sci Int 203:44–52CrossRefPubMedGoogle Scholar
  50. 50.
    Kaneko A, Lum JK, Yaviong L, Takahashi N, Ishizaki T, Bertilsson L, Kobayakawa T, Bjorkman A (1999) High and variable frequencies of CYP2C19 mutations: medical consequences of poor drug metabolism in Vanuatu and other Pacific islands. Pharmacogenetics 9:581–590CrossRefPubMedGoogle Scholar
  51. 51.
    Kirchheiner J, Grundemann D, Schomig E (2006) Contribution of allelic variations in transporters to the phenotype of drug response’. J Psychopharmacol 20(4):27–32CrossRefPubMedGoogle Scholar
  52. 52.
    Wong SHY (2008) Pharmacogenomics for forensic toxicology in enabling personalized medicine. In: Bogusz MJ (ed) Forensic Science. Elsevier, Handbook of Analytical Separations, pp 745–761CrossRefGoogle Scholar
  53. 53.
    Lehmann H, Ryan E (1956) The familial incidence of low pseudocholinesterase level. Lancet 271:124CrossRefPubMedGoogle Scholar
  54. 54.
    SOFT/AAFS Forensic Laboratory Guidelines. (2006) Society of Forensic Toxicologists (SOFT)/American Academy of Forensic Sciences (AAFS)Google Scholar
  55. 55.
    Plueckhahn VD, Cordner SM (1991) Ethics, Legal Medicine & Forensic Pathology Carlton, Victoria, Melbourne University Press,Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  • Mete K. Gülmen
    • 1
  • Nebile Daglioglu
    • 1
  • Ayse Serin
    • 1
  • Dilek Battal
    • 2
  1. 1.Addiction and Forensic Sciences Institute & Department of Forensic MedicineCukurova UniversityAdanaTurkey
  2. 2.Department of Toxicology, Faculty of PharmacyMersin UniversityMersinTurkey

Personalised recommendations