Here are the salient features of the POCSO act, and details on the role of medical professionals in the emergency care and clinical and medicolegal management of child sexual abuse.

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What is POCSO act?

POCSO act was enacted for the protection of children from sexual offences. The act is a comprehensive law to provide for the protection of children from the offences of sexual assault, sexual harassment and pornography while safeguarding the interests of the child at every stage of the judicial process by incorporating child-friendly mechanisms for reporting, recording of evidence, investigation and speedy trial of offences through designated special courts.

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Features of POCSO

POCSO act defines a child as a person under the age of 18 years. It criminalises all forms of assault, not merely penetration; criminalises watching or collecting porn involving children. Abetment of child sexual abuse is considered an offence. Under section 20 of the act under chapter V, hospital or employees are required to report sexual abuse. The act criminalises consensual sexual intercourse between two people below the age of 18.

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Management of child sexual abuse

1. Every case of sexual assault is a medical emergency for which free treatment is mandatory at government or private medical facilities, and no document or precondition is necessary for providing emergency medical care.
2. A victim of child sexual abuse may approach a health facility directly for treatment, with a police requisition after a police complaint, or with a court directive.
3. The hospital is bound to provide treatment and conduct a medical examination with the consent of the child/parent/guardian, depending upon the age of the child.
4. The victim may or may not want to lodge a complaint, but requires medical examination and treatment. In such cases, the doctor is bound to inform the police as per law.
5. However, neither the court nor the police can force the survivor to undergo a medical examination without the informed consent of the child/parent/guardian.
6. If the victim does not want to pursue a police case, a medico-legal case (MLC) must be made and an informed refusal documented.
7. If the victim has reported with a police requisition or wishes to lodge a complaint later, the information about the MLC number and police station must be recorded.

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Relevant legal provisions in the act and rules and related laws

Section 27 – Medical Examination: 27

(1) The medical examination of a child in respect of whom any offence has been committed under this act, shall, notwithstanding that a First Information Report or complaint has not been registered for the offences under this Act, be conducted in accordance with section 164A of the Code of Criminal Procedure, 1973.

(2) In case the victim is a girl child, the medical examination shall be conducted by a woman doctor.

(3) The medical examination shall be conducted in the presence of the parent of the child or any other person in whom the child reposes trust or confidence.

(4) Where, in case the parent of the child or other person referred to in sub-section (3) cannot be present, for any reason, during the medical examination of the child, the medical examination shall be conducted in the presence of a woman nominated by the head of the medical institution.

Rule 5 - Emergency medical care

(1) Where an officer of the special juvenile police unit (SJPU), or the local police receives information under section 19 of the act that an offence under the act has been committed, and is satisfied that the child against whom an offence has been committed is in need of urgent medical care and protection, he shall, as soon as possible, but no later than 24 hours of receiving such information, arrange to take such a child to the nearest hospital or medical care facility centre for emergency medical care: Provided that where an offence has been committed under sections 3, 5, 7 or 9 of the act, the victim shall be referred to emergency medical care.

(2) Emergency medical care shall be rendered in such a manner as to protect the privacy of the child and in the presence of the parent or guardian or any other person in whom the child has trust and confidence.

(3) No medical practitioner, hospital or other medical facility centres rendering emergency medical care to a child shall demand any legal or magisterial requisition or other documentation as a pre-requisite to rendering such care.

(4) The registered medical practitioner rendering emergency medical care shall attend to the needs of the child, including –

1. treatment for cuts, bruises, and other injuries including genital injuries, if any;
2. treatment for exposure to sexually transmitted diseases (STDs) including prophylaxis for identified STDs;
3. treatment for exposure to Human Immunodeficiency Virus (HIV), including prophylaxis for HIV after necessary consultation with infectious disease experts;
4. possible pregnancy and emergency contraceptives should be discussed with the pubertal child and her parent or any other person in whom the child has trust and confidence; and,
5. wherever necessary, a referral or consultation for mental or psychological health or other counselling should be made.

(5) Any forensic evidence collected in the course of rendering emergency medical care must be collected in accordance with section 27 of the act.

Thus, doctors and support medical staff are involved both at the time of rendering emergency medical care as well as at the time of medical examination.

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Emergency medical care

The child may be brought to the hospital for emergency medical care as soon as the police receive a report of the commission of an offence against the child. In such cases, the rules under the POCSO act, 2012 prescribe that the child is to be taken to the nearest hospital or medical care facility. This may be a government facility or a private one. This is reiterated by Section 23 of the Criminal Law Amendment Act, which inserts Section 357C into the Code of Criminal Procedure, 1973. This section provides that all hospitals are required to provide first-aid or medical treatment, free of cost, to the victims of a sexual offence.

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Modalities of medical examination of children

Role of medical professionals in the context of the POCSO act, 2012

Doctors have a dual role to play in terms of the POCSO act 2012. They are in a position to detect that a child has been or is being abused (for example, if they come across a child with an STD); they are also often the first point of reference in confirming that a child has indeed been the victim of sexual abuse.

Mandatory reporting

When a doctor has reason to suspect that a child has been or is being sexually abused, he/she is required to report this to the appropriate authorities (i.e. the police or the relevant person within his/her organization who will then have to report it to the police). Failure to do this would result in imprisonment of up to six months, with or without fine.

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author, Dr. Vidya Shetty is an Obstetrician & Gynaecologist and a certified Medicolegal Consultant from Mumbai.