title: Overweight and the sexual assault forensic medical examination: a pressing problem.
abstract: This paper examines the problems faced by forensic physicians assessing overweight victim/survivors of sexual assault, using sample cases and reviewing the literature. This under-researched area is a minefield of practical difficulties and unanswered questions, with the need for solutions becoming more pressing as overweight becomes more common. Overweight has the potential to alter injury patterns; the way forensic medical examinations are conducted; and injury and specimen interpretation. Pertinent questions include whether the "cushion effect" noted in motor vehicle accidents is relevant to sexual assault and how obesity-related comorbidities affect our ability to age injuries. Practical problems include positioning the client safely, obtaining clear views of areas of interest, and taking high-quality specimens. Although overweight victims appear to be uncommon in sexual assault services, as the obesity epidemic progresses clinicians will need to address these issues.
authors.affiliation: Coffs Harbour Sexual Assault Service, Coffs Harbour, Locked Mail Bag 812, Coffs Harbour, 2450 New South Wales, Australia. kknospam@tpg.com.au
authors.forename: Kathy
authors.initials: K
authors.lastname: Kramer
mesh_terms: D001003:Anal Canal / Q000293:injuries / Q000473:pathology; D001828:Body Image; D019548:Crime Victims; D005260:Female; D049429:Forensic Pathology; D005835:Genitalia / Q000293:injuries / Q000473:pathology; D006801:Humans; D008297:Male; D050177:Overweight / Q000150:complications* / Q000473:pathology; D056888:Patient Positioning; D010808:Physical Examination / Q000379:methods*; D012649:Self Concept; D012742:Sex Offenses; D014945:Wound Healing; D014947:Wounds and Injuries / Q000473:pathology