This week the Department of Justice released new sexual assault exam guidelines, updating a previous set from 2004. Unlike previous protocol, the new guidelines specify that rape victims are to be offered emergency contraception during the course of an exam.
The guidelines around offering emergency contraception reflect an approach intended to acknowledge and empower rape victims in the immediate aftermath of an assault, suggesting that a discussion of emergency contraception may be followed up with an immediate administration of medication or information that can be used in follow-up consultation with another health provider:
In cases of sexual assault, pregnancy is often an overwhelming and genuine fear. Therefore, discuss treatment options with patients, including emergency contraception. An immediate option is to offer hormone therapy (emergency contraception pills or EC). Another option is to forgo immediate treatment and have the patient follow-up with their primary care provider. Discuss options with the patient and information regarding the timeframe for emergency contraception provision, so she can make an informed decision. Inform the patient that the provision of any emergency contraception will not prevent sexually transmitted infections. The conversation with the patient should include a thorough discussion, including mechanism of action for each treatment option, side effects, dosing, and follow-up. This information should also be provided in writing in the preferred language of the patient, if possible.
Included are a workaround set of refusal instructions baked in for health-care providers refusing to offer the full range of constitutionally protected reproductive health care services to women. “In a case in which a provider refuses to offer certain forms of contraception for moral or religious reasons,” the guidelines state, “victims of sexual assault must receive information on how to access these services in a timely fashion.”
The guidelines further specify that facilities that don’t provide emergency contraception on-site are instructed to write prescriptions and provide a list of pharmacies that stock the medication. Practitioners who refuse to provide emergency contraception or write needed prescriptions are told, “It is recommended that the patient be given local referrals to medical facilities that can immediately assist with alternative treatment.”
The entire set of revised sexual assault exam standards are mandatory for federal prisons and the military, and offered as voluntary guidelines for hospitals and other medical facilities.