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A just outcome, or ‘just’ an outcome? Towards trauma-informed and survivor-focused emergency responses to sexual assault
  1. Elaine J Alpert
  1. Undergraduate Medical Program, University of British Columbia Faculty of Medicine, Vancouver BC V6T 1Z4, Canada
  1. Correspondence to Dr Elaine J Alpert, University of British Columbia Faculty of Medicine, Vancouver BC V6T 1Z4, Canada; ejalpert{at}

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Sexual assault is one of the most violating and traumatising forms of abuse encountered by emergency department providers. Because the vast majority of sexual assaults are perpetrated by someone known, and possibly even related to the survivor, feelings of profound betrayal and loss of trust can make emergency clinical evaluation, including forensic evidence collection, particularly challenging.1

As described in the EMJ paper by Muldoon and colleagues, the collection of forensic evidence by specially trained clinicians may increase the effectiveness of legal prosecution, and is often assumed to be a ‘just’ or, in other words, desired outcome.2 The decision to obtain, and then process, forensic evidence, however, must be an individual, personal decision made by each and every survivor, informed by their own priorities, values and needs, and supported non-judgementally by emergency healthcare providers acting in a trauma-informed manner.

How does one define a ‘just’ outcome?

‘Just’ outcomes are unique for each patient and thus should be defined by each individual sexual assault survivor. The survivor’s decisions can be informed, but should neither be directed nor influenced by healthcare providers, administrators, law enforcement personnel, researchers or any other entity. Organisational policies …

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  • Contributors EJA is an international expert in family violence, sexual assault, and human trafficking education, advocacy, and policy. She is the Founding Chair of the Massachusetts Medical Society Committee on Violence Intervention and Prevention. As a Fulbright Scholar at the University of British Columbia (UBC), Dr. Alpert directed the Interpersonal Violence Prevention Program, and created the UBC Violence Intervention and Prevention (VIP) Connector.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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