La Gestione ospedaliera delle donne vittime di violenza sessuale alla luce del nuovo d.p.c.M. 24 novembre 2017

The term 'sexual violence' refers to a wide range of non-consensual sexual activities, which include acts with and without vaginal and/or anal and/or oral penetration and acts that involve the use of physical strength or psychological coercion. Being an acute event, the Emergency Department (ED) health professionals are often the first to treat the victims. It should be emphasized that the evaluation and the treatment of the victims of sexual violence are different from those implemented for any other type of patient. In this contest the health personnel have a double responsibility: the first is to provide the victim an adequate medical and psychological support, while the second consists in assisting the person in medical-legal procedures: performing a careful physical examination, providing documentation and finding any evidence of forensic interest, guaranteeing a correct chain of custody. For these reasons all health personnel who deal with women victims of sexual violence should have a satisfactory level of preparation and carry out their activities with scientific rigor, in order to guarantee an adequate caring of the woman both from a clinical and a forensic point of view. although several Guidelines for the management in hospital of victims of violence have been published, these are not always correctly applied. Furthermore, sometimes the information gathered by the victim in ed are inadequate or incomplete for the reconstruction of the aggression. in order to avoid discrepancies between the medical report and the reconstruction of the sexual abuse, it is crucial to employ strategies not only related to the technical aspects of collecting evidence, but also to the ways in which the victim's story is collected. this could lead to better management of victims of sexual violence and a greater guarantee of protection of their rights. It is crucial that healthcare professionals are adequately trained in the field of legal medicine to guarantee detailed documentation of physical damage and adequate collection of biological samples of forensic interest. These recommendations are also reflected in the “National Guidelines for Healthcare Organizations and hospital organizations for the management to women victims of violence” contained in the decree of the italian president of the council of Ministers (dpcM) of the 24th of November 2017.