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Confidentiality and Legal Admissibility in a Sexual Assault Nurse Examiner Program


In cases of sexual assault or domestic violence, it is vitally important to satisfy two potentially conflicting goals. The patient’s urgent medical needs must be attended to, but at the same time a physical examination must be conducted and evidence gathered for possible prosecution. To a woman who has already been violated, the collection of the most intimate photographs and physical evidence can cause her to feel violated again. It is important to respect the patient’s privacy while at the same time ensuring that any evidence collected will withstand a legal challenge if the case is ever taken to court.

Because a sexual assault examination typically takes place within a healthcare facility, the strict confidentiality requirements of the Health Insurance Portability and Accountability Act (HIPAA), Health Information Technology for Economic and Clinical Health Act (HITECH), and HHS Breach Notification Rules must be satisfied. One of the best ways to ensure that Protected Health Information (PHI) is protected is through the use of encryption to limit access.

In recent years, the importance of this task has been widely recognized, and programs have been instituted to train selected nurses and other medical staff in forensic skills. Many hospitals throughout the country are now creating Sexual Assault Nurse Examiner (SANE) units to deal with these issues.

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