SA/DV CLINICAL EDUCATION FORUM

Transcription

1 SA/DV CLINICAL EDUCATION FORUM GOING TO COURT: WHAT YOU NEED TO KNOW March 2013 Alice Stoner, RN, SANE-A

2 Introduction The Ontario Network of Sexual Assault and Domestic Violence Treatment Centres is the provincial lead for 35 hospital-based Sexual Assault Programs in Ontario. In the majority of these programs, more than 90% of the sexual assault examinations that are performed on adolescent and adult sexual assault patients are conducted by SANEs (Network Coordinators, personal communication, Nov, 2010).

3 Factual Witness How did the patient present? What did the patient say? What did you observe during the examination? Was a SAEK performed? What treatment did the patient receive?

4 Hearsay Evidence Testifying to statements made by another person, outside of the court Usually not admissible in court, although there are some exceptions to the hearsay rule Exceptions may be allowed if it is related to medical care and treatment

5 Expert Witness SANE s have acquired special skill and knowledge through education, and or experience that permits the drawing of inferences from the facts which would be difficult of impossible for the layperson to draw (Finlay, Cromwell, 1999) Can testify to the facts of the case AND Opinions and conclusions that can be drawn from the evidence

6 Before court.

7 The Subpoena

8 Curriculum Vitae Should be current work experience, skills and educational background Any publications you have authored Membership in professional organizations (IAFN, CNO, RNAO) Educational activities (Peer reviews, certifications) Previous court testimony, level of court, qualified as an expert, in what? Provide several copies

9 Google yourself Facebook, Twitter, etc Do you have a website or blog Do you identify yourself Organization Does your hospital have a Social Networking Policy? Online Presence

10 Review the Chart Contact your Coordinator or Health Records to review the record Note any errors or omissions Identify areas or research or literature to review

11 Know the Literature Read, webinars, websites Join professional organization What research is the Network doing? Position papers, etc. Anticipate the questions and practice thoughtful responses!

12 Initiate contact with Counsel to arrange a meeting Review the patient record before the meeting Bring a copy of your CV with you Provide / develop questions to help counsel highlight your qualifications Meet with Counsel

13 Introductory Questions What is your name and occupation? How long have you been a Registered Nurse? Are you currently employed? What is your current position? In what areas of nursing have you practiced? Does your practice include specimen collection? Does your practice include taking patient histories or performing a physical assessment of your patient? Does your practice include assessing and caring for patients with wounds?

14 Experience/Education When did you begin working at the Sexual / Domestic Assault Treatment Centre? Did you receive any special training in the area of sexual assault? Did that training include the basic 40 hr Sexual Assault Nurse Examiner (SANE) Course? After that initial training, was there any other component to your training? Is there a certification for Sexual Assault Nurse Examiners? Are you certified? What does the certification process entail? Have you received or participated in any other education specific to the care of the patient who has been sexually assaulted? How many sexual assault examinations have you done in the last 5 years? At your centre, how many doctors, compared to nurses, perform the sexual assault examinations on adolescent and adult sexual assault patients? Do you belong to any Professional Forensic organizations? Do you regularly participate in Peer Review, specifically as it relates to your role as a SANE? Have you authored or co-authored any publications related to the field of sexual assault? Have you ever testified as an expert witness in the past? At what level of court? How many times? Have you ever been disqualified as an expert witness? Do you testify only for the prosecution? Are you being paid for your testimony today? How much?

15 Policies / protocols /processes followed when caring for a sexual assault patient Do you follow a specific process when preparing the examination room to do a sexual assault examination? Do you wear gloves? How is the room cleaned before / following a patient examination? Is this part of your invariable practice? Do you use a colposcope or a camera to document your findings? Why not? Is there anyone else present during the examination? Do you document those in attendance? Is there a special kit that you use to collect specimens? Where do you get these kits? What is in the kit? Who collects and packages the specimens? What do you do with the specimens after you have collected them? Do you have a protocol that outlines how you maintain the chain of custody of all specimens you collect?

16 The day of Court.

17 Stay calm!

18 Credibility Be respectful Be truthful Be punctual Dress appropriately Bring something to read Phone /pager OFF Be careful who you are talking to in the waiting room Listen carefully for your name to be called Acknowledge errors or gaps in your knowledge I don t know or I forgot to check that box or I don t recall

19 Credibility Be objective Know your limits Do not promote an agenda Testify as a clinician not an advocate Do not testify outside of the parameters set by the court

20 Voir Dire to speak the truth Examination and cross examination of your credentials Ask to refer to CV if necessary Make sure you feel comfortable with the scope of expertise granted

21 The Expert Report Meet with Counsel: Report might include: outline issues to be addressed What format does counsel require How much detail? What date the report is due Cover page Table of Contents Signature page Appendices Definitions of terms or concepts Graphs and charts

22 After Court..

23 Exhale Update your CV Touch base with Crown Case Review

24 Questions?

25 Resources Admissibility of Expert Testimony : Federal Court Rules: Code of Conduct for Expert Witnesses - Ontario Network of Sexual Assault/Domestic Violence Treatment Centres Social Media usage guidelines : contact [email protected]

26 References Brodsky, S.L. (2007). Testifying in court: Guidelines and maxims for the expert witness. American Psychological Association. Bruce, C. (1999). The role of expert evidence. Retrieved from Campbell, R., Long, S. M., Townsend, S. M., & Kinnison, K. E. (2007). Sexual assault nurse examiners experiences providing expert witness court testimony. Journal of Forensic Nursing, 3, Campbell, R., Patterson, D., & Lichty, L. F. (2005). The effectiveness of sexual assault nurse examiner (SANE) program: a review of psychological, medical, legal, and community outcomes. Retrieved from Daubert v. Merrell Dow Pharmaceuticals (92-102), 509 U.S. 579 (1993). Retrieved from Finlay, B., & Cromwell, T. (1999). Preparing experts.. In Witness Preparation Manual ( pp ). : Edmond Montgomery Publications Ltd.. Ledray, L. E. (2001). Evidence collection and care of the sexual assault survivor. The SANE-SART response (white paper). Retrieved from Violence Against Women Online Resources website: Littel, K. (2001). Sexual assault nurse examiner (SANE) programs: improving the community response to sexual assault victims. Retrieved from Plichta, S. B., Clements, P. T., & Houseman, C. (2007). Why SANEs matter: model of care for sexual violence victims in the emergency department. Journal of Forensic Nursing, 3, The Ontario Network of Sexual Assault and Domestic Violence Treatment Centres website. (n.d.).