강간 피해에 따른 항문 및 성기 손상 분석
Analysis of Anogenital Injuries by Rape Victimization
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
본 연구는 일개 해바라기센터의 강간 피해자를 대상으로 강간 피해특성에 따른 항문 및 성기 손상의 특성과 중증도를 분석하고자 2015년 1년 동안 센터를 방문한 강간, 강간 미수, 특수강간 피해 자 296 명의 상담기록과 의무기록을 후향적으로 조사하였다. 성기손상의 중증도는 Genital injury severity scale로 평가하였다. 강간 피해자 296명 중 법의학적 증거 수집에 동의한 136 명 중 29 명에서 총 42 개의 성기 손상이 발견되었다. 성기손상은 소음순 28.6%, 후음순 소대 19.0%, 처녀막 16.7%, 항문 9.5%, 대음순 7.1%, 회음부 7.1%, 질 4.8%, 주상와, 음핵, 자궁경부 각 2.4%로 Y형 구역을 따라 분포하였다. 성 기손상의 중증도는 피해자가 20대와 30대, 의식이 있는 경우, 가해자를 모르는 경우에 더 높게 나타났 다. 정자의 검출율은 37.5%로 48시간을 초과 할수록 현저하게 감소하였다. 강간 피해자들은 재검율이 낮으므로 첫 방문시 호발하는 손상의 위치를 중심으로 신속하고 정확하게 법의학적 증거를 수집하고 손상의 중증도를 평가하여 기소율을 높여야 할 것이다. 법의학적 전문지식을 갖춘 성폭력 전담 의료진 의 확보를 통해 법의학적 증거 검출율을 높여 기소율 향상을 통한 강간재발을 방지할 필요가 있다. 현 실적 대안으로 성폭력 법의간호사를 양성하여 법의학적 증거수집과 함께 강간 피해자에 대한 정서적 지지와 법정 증언 등을 포괄적으로 지원하는 시스템 속에서 피해초기에 적극적으로 의료인이 개입하 여 의학적 평가와 지원이 이루어질 필요가 있을 것으로 생각한다.
Abstract
This study was aimed to analyze characteristics of genital injuries of rape victims who had visited to Sunflower Center in 2015. Their initial consultation and medical records of 296 rape victims were analyzed retrospectively. Twenty nine victims (21.3%) had total 42 ano-genital injuries which form Y zone. The majority of the genital injuries were observed in labial minora, posterior fourchette and hymen. The scale of genital injury was higher in the case of rape caused by stranger assailants (p=0.017), 20s and 30s (p=0.012) and alert mentality (p=0.011) of victims. The detection rate of sperm was 37.5%, remarkably decreased over 48 hours. Severity, location, and pattern of genital injuries are important forensic evidence in rape. For accurate and prompt forensic evidence examination, professional medical personnel are needed. In addition to collecting forensic evidence, a total system to help emotional support and legal testimony to victims of rape should be established, and medical evaluation and support should be conducted through active involvement of medical personnel at the beginning. It will contribute to the improvement of prosecution rate and prevent the recurrence of rape.
참고문헌 (28)
- 법무연수원, "범죄백서", pp.79~81 (2015)
- 성폭력의 실태와 원인에 관한 연구(II), "한국형사정책연구원", 108~118, pp.연구보고서 97-07 (1996)
- 김수곤, "성폭력 피해자에 대한 분석: 충남 원스톱지원센터 내원자를 중심으로", Obstetrics & Gynecology Science, 55(10), pp.736~744 (2012), 대한산부인과학회[DOI]
- N Riggs, "Analysis of 1,076 cases of sexual assault", Annals of emergency medicine, 35(4), pp.358~362 (2000)
- N Sugar, "Physical injury after sexual assault: findings of a large case series", American journal of obstetrics and gynecology, 190(1), pp.71~76 (2004)
- S Stears, "Anogenital injury in adolescent sexual assault: analysis of 1,024 cases using colposcopy and nuclear staining", Annals of Emergency Medicine, 52(4), pp.64~ (2008)
- PS Cartwright, "Factors that correlate with injury sustained by survivors of sexual assault", Obstetrics & Gynecology, 70(1), pp.44~46 (1987)
- L Slaughter, "Patterns of genital injury in female sexual assault victims", Am J Obstetrics and Gynecology, 176(3), pp.609~616 (1997)
- JS Jones, "Comparison of sexual assaults by strangers versus known assailants in a communitybased population", Am J emergency medicine, 22(6), pp.454~459 (2004)
- J Wiley, "Legal outcomes of sexual assault", Am J Obstetrics and Gynecology, 188(6), pp.1638~1641 (2003)
- B Rambow, "Female sexual assault : medical and legal implications", Annals of Emergency Medicine, 21(6), pp.727~731 (1992)
- A Solola, "Rape: management in a noninstitutional setting", Obstetrics & Gynecology, 61(3), pp.373~378 (1983)
- K Helweg-Larsen, "The value of the medicolegal examination in sexual offences", Forensic Sci Int’l, 27(3), pp.145~155 (1985)
- A Penttila, "Medicolegal findings among rape victims", Medicine and law, 9, pp.725~737 (1990)
- MJ McGregor, "Examination for sexual assault: Is the documentation of physical injury associated with the laying of charges? A retrospective cohort study", Canadian Med Association J, 160(11), pp.1565~1569 (1999)
- AA Lauber, "Use of toluidine blue for documentation of traumatic intercourse", Obstetrics & Gynecology, 60(5), pp.644~648 (1982)
- L Slaughter, "Colposcopy to establish physical findings in rape victims", Am J Obstetrics and Gynecology, 166(1), pp.83~86 (1992)
- MS Sommers, "Injury patterns in women resulting from sexual assault", Trauma, Violence, & Abuse, 2(3), pp.240~258 (2001)
- MS Sommers, "Injuries from intimate partner and sexual violence: Significance and classification systems", J Forensic and Legal Medicine, 19(5), pp.250~263 (2012)
- C Grossin, "Analysis of 418 cases of sexual assault", Forensic Sci Int’l, 131(2), pp.125~130 (2003)
- JS Jones, "Comparative analysis of adult versus adolescent sexual assault: epidemiology and patterns of anogenital injury", Academic Emergency Medicine, 10(8), pp.872~877 (2003)
- SM Ramin, "Sexual assault in postmenopausal women", Obstetrics & Gynecology, 80(5), pp.860~864 (1992)
- JE Tintinalli, "Clinical findings and legal resolution in sexual assault", Annals of Emergency Medicine, 14(5), pp.447~453 (1985)
- CA Poulos, "Genital injuries in postmenopausal women after sexual assault", J Elder Abuse & Neglect, 20(4), pp.323~335 (2008)
- GA Bachmann, "The impact of hormones on menopausal sexuality: a literature review", Menopause, 11(1), pp.120~130 (2004)
- K Brown, "Effectively detect and manage elder abuse", The Nurse Practitioner, 29(8), pp.22~31 (2004)
- C Spohn, "The effect of offender and victim characteristics on sexual assault case processing decisions", Justice Quarterly, 13(4), pp.649~679 (1996)
- K Gray-Eurom, "The prosecution of sexual assault cases: correlation with forensic evidence", Annals of Emergency Medicine, 39(1), pp.39~46 (2002)