title: Legal, Social, Ethical, and Medical Perspectives on the Care of the Statutory Rape Adolescent in the Emergency Department.
abstract: Rapes involving adolescents who present to the emergency department (ED) are fraught with ethical and legal complexities and are often emotionally turbulent for patients, their families, and medical providers. Management requires a thoughtful approach from multiple standpoints, including legal, psychosocial, ethical, and medical ones. However, there is no standardized sexual assault education for emergency medicine residents, and management practices vary widely.1,2We present a hypothetical statutory rape case based on real cases that occurred in New York City and bring together the perspectives of an attorney on the legal parameters, two social workers on the psychosocial issues, an ethicist on the moral considerations, and a pediatric emergency physician-who is also a sexual assault forensic examiner-on the medical treatments. We aim to provide a framework for physicians to navigate issues of patient-physician privilege involving minors, privacy rules, and mandatory reporting laws.
authors.affiliation: Division of Pediatric Emergency Medicine, the Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, Pediatric Ethics Committee, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, and Presidential Advisory Committee on Sexual Assault, Columbia University, New York, NY. Electronic address: st166@cumc.columbia.edu.
authors.forename: Shiu-Lin
authors.initials: SL
authors.lastname: Tsai
authors.affiliation: Department of Social Work, NewYork-Presbyterian Hospital, New York, NY.
authors.forename: Elvira
authors.initials: E
authors.lastname: Acosta
authors.affiliation: Department of Social Work NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY.
authors.forename: Toni
authors.initials: T
authors.lastname: Cardenas
authors.affiliation: Minton Law Group, New York, NY.
authors.forename: Jeremy K
authors.initials: JK
authors.lastname: Sigall
authors.affiliation: Program for the Protection of Human Subjects, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Kevin
authors.initials: K
authors.lastname: Van Geem
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001291:Attitude of Health Personnel; D003219:Confidentiality / Q000941:ethics* / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence*; D008297:Male; D019221:Mandatory Reporting / Q000941:ethics*; D033242:Minors / Q000331:legislation & jurisprudence* / Q000523:psychology; D009519:New York City; D010290:Parents / Q000523:psychology; D010808:Physical Examination; D010819:Physician's Role; D010817:Physician-Patient Relations; D011902:Rape / Q000175:diagnosis* / Q000331:legislation & jurisprudence / Q000523:psychology; D014342:Truth Disclosure / Q000941:ethics