**2. Related legislation in Turkey**

One of the main actions to be taken in sexual assault cases is the effort to prove the event. This means to determine the signs of physical and emotional damage caused by sexual assault, to determine the existence, degree, and results of sexual intercourse, and to ensure that the attacker is identified.

A new legislation that has been actively used by 2005 has detailed articles related to sexual assault cases and the above-mentioned statements. There is an article that regulates all the activities related to obtaining evidence linked to a crime and legalizes the procedures and principles regarding the various ways of collecting biological evidence, blood, hair, buccal swabs, nails, and similar samples for genetic analysis in order identify the suspect and the accused. According to this regulation, in order to obtain evidence related to a crime, request by the public prosecutor, the judge, or the victim is essential. The decision of the public prosecutor is submitted to the judge or court for approval within 24 hours. The judge or court is obliged to decide within 24 hours.

The internal body examination of the suspect or the accused can be carried out only by the doctor. The external body sample collection can be performed by medical staff (nurses, midwifes, etc.) under the control of a medical doctor.

For the medical examination to be carried out, there should be no foreseeable risk of harm to the person's health. An examination of the genitals or anus area is also considered an internal body examination.

In cases where mentally retarded people or children are involved, the legal representatives have the right to decide. If the child or the mentally ill person is in a position to comprehend the consequences of the testimony, her/his opinion is also taken. The issue becomes more complicated in incest cases where the legal representatives can be the perpetrators themselves.

The results of the examination made on the samples taken in accordance with the provisions of this regulation are considered personal data and cannot be used for any other purpose. The contents of the case file cannot be given to anyone other than those who have the authority to be involved. The analysis results are sent to the relevant authority by a written and signed expert witness report.

In the presence of the victim's consent, the prosecutor's intervention is not required to carry out the analysis. In this case, medical examinations can be performed and samples can be taken to be analyzed. The prosecution and the legal system, in general, are informed following the examination. There are various official institutions that are considered expert witness centers by the law. The Ministry of Justice has its own institution called "The Council of Legal Medicine" and deals

with various issues of forensic sciences. It is centered in Istanbul with branches all over the country. Additionally, the departments related to Legal Medicine and Forensic Sciences are expert witnessing institutions by law. Furthermore, the hospitals have the right of collecting evidence and reporting to the court in all related cases [13].

### **3. The process of medical examination**

Following the victimization, the victims need medical, forensic, and psychological support. The suffering person when she/he decides to ask for help has eventually to go to a hospital for treatment and evidence collection. Following these two steps, additional medical and psychological care should be given to the person. However, this very important step is most of the time avoided by the victims and constitutes one of the main reasons for denying reporting the event. There is a perception that the victims will be poorly treated in hospitals at the early stages of the rape examination and treatment [14, 15]. The possibility that the reported sexual assault may not even prosecuted is also a fact. Owing to the possibility of disbelief, the police may not proceed in informing the prosecution or, sometimes, the prosecution does not trust the confession. On the other hand, the event is not considered a very serious crime and it is underestimated, which certainly is not the case. There is a complex medicolegal attitude that should be undertaken starting from the police to the prosecution, to the nurse, and to the doctors. Once the involved group is so big, coordination is essential for the benefit of medical, legal, and psychological wellbeing of the suffering person.

Systematically stating, apart from the low reporting rate, hospitals generally do not employ forensic pathologists and nurses, they do not have a proper forensic examination setting, the medical personnel is poorly trained in evidence collection, and they almost never are organized for a legal, psychological, and medical support following the examination. There are no proper settings for medicolegal examinations, and the equipment is far from standardized. The sexual rape examination is a delicate issue, and the traumatized victim is deeply concerned. Sometimes, they refuse to be examined by male doctors and that is frequent for our country. Female gynecologists are not always ready in hospitals to perform this kind of examination. A proper solution for this problem lies in the interdisciplinary collaboration of the various parameters that are involved in the assault and violence cases. Turkey has no effective collaborative networks between the stakeholders. The police, the criminal justice system, and the medical care have little coordination [16, 17]. As a result, a suffering victim has to visit all the involved authorities to be able to complete the application for the court and for the forensic examination with evidence collection. The victim has to go to the police to talk about the event; most probably, she/he will be sent to the appropriate department for application; then, the police direct her/ him to the hospital; the medical examination may or may not be performed immediately, a waiting period will follow; sometimes, the hospital visit will have to be repeated because of poor evidence collection, and following all these, the suffering person will have to encounter the burden of talking to prosecutor(s).

To overcome these problems, we established a facility in the form of single-step application (the characteristics of which are given below). The purpose of establishing a one-stop Sexual Assault Crisis Center is to guarantee a system where full and real cooperation between different stakeholders (healthcare professionals, lawyers, police forces, etc.) will result to a broad and inclusive rehabilitation with proper care. The main idea of the establishment is developing and improving accessibility to supporting services for victims. Additionally, it is aimed to get a detailed anamnesis

and correct physical and biological evidence to help the legal system to tackle the crime and punish the perpetrator. We based the establishment on the already present legislation in our country and to best practice examples globally [17–20].
