By Douglas Stutz, Naval Hospital Bremerton BREMERTON, Wash. - From the clinical to the courtroom, the initial Sexual Assault Medical Forensic Examiner (SAMFE) training held at Naval Hospital Bremerton switched to the military justice process for the final day July 24, 2015.
Several members of the Navy Judge Advocate General Corps’ were on hand to share their professional experience, insight and information with the examiners and their specific role at trial. The goal was to educate, inform and perhaps even alleviate any pre-trial jitters that could arise if and when any of them gets called upon to testify.
“There is a reason why some in Navy Medicine don’t want to do SAMFE and that’s because of nervousness from having to go into court and testify. This training today gives us the opportunity to go through a mock direct examination and cross examination process. We’re learning hints and tips from Navy legal experts in going to court,” said Lt. Cmdr. Lacy L Gee, Nurse Corps, Certified Nurse Operating Room, Main Operating Room division officer, Sexual Assault Nurse Examiner and organizer of the SAMFE training at NHB.
Naval Hospital Bremerton’s Judge Advocate Lt. Keleigh Anderson, opened the Military Justice Brief by going over Uniformed Code of Military Justice articles, the difference between rape and sexual assault, the step-by-step process how an allegation becomes a case and where a SAMFE fits in the judicial scheme of things.
“As a SAMFE you are there to teach the judge and jury what you know. You are an educator. You are not there to determine if the case happened but to help make an informed decision,” said Anderson, adding that the examiner’s priority is always the health and well-being of the patient since a SAMFE is a medical provider and not a law enforcement agent. The bottom line, according to Anderson, is that any SAMFE who does get called to testify has got to realize that not only is their credibility at stake, but also that of the official evidence.
There are several common sense steps to follow when testifying. They are: Be prepared. Review the medical records and all documentations and photos (if applicable). Be precise. Use terminology correctly. Sloppy wording can be problematic on a cross examination. Be concise. Only answer the question asked. Be plain-spoken. Medical jargon gets lost in the dialogue. “A SAMFE is supported by medical experience, science and practice. They are not there to make the case. The medical testimony is only one aspect of a sexual assault case,” stressed Anderson. A viable resource that the Navy established to help those dealing with the traumatic effects of sexual assault is the Victims’ Legal Counsel Program that was started in 2013. The program offers attorney-client relationship with privileged communications and duty to represent the client. Active duty and reservists are assisted anytime and anywhere. Dependents, retirees and certain civilians when assaulted by active duty members are also helped.
“It’s important to share that in my capacity as a victim legal counsel I don’t work for the prosecutor, defense or command. I work solely for the victim and form that attorney-client relationship directly with victim(s) of sexual assault,” explained Lt. Cmdr. Steven Meredith, Judge Advocate General Corps and Victims’ Legal Counsel assigned to Naval Base Kitsap Bangor, who covers all of the West Sound region/greater Kitsap Peninsula area.
Meredith provides legal advice, assistance and advocacy related to alleged sexual offense. He give clients a ‘voice and choice,’ protects a client’s privacy, and advances and advocate a client’s interests “Any time there is any sexual assault case, the sooner I can meet with the victim the better,” continued Meredith. “I can help with their concerns, such as explaining the process so they can make informed decisions. I also can advocate for them in court; be with them doing an interview with NCIS; and if they are worried about collateral misconduct, such as underage drinking, their sharing is confidential and [falls under] restricted reporting.”
“One thing to also remember is that if a victim legal counsel is involved as soon as possible, it lessens the victim having to retell their story a million times,” Anderson added. Testimony strategy was then shared by Lt. Cmdr. Travis J. Owens, Senior Trial Counsel assigned to Region Legal Service Office Northwest and Lt. Julie Sherman-Dumais of the Military Justice Department, Region Legal Service Office Northwest.
“As a SAMFE, you are not there to give your personal opinion. You will be called upon to admit the Sexual Assault Forensic Exam (SAFE) report and to explain the report,” stated Owens, sharing such practical strategies as reviewing documents, protocols, exam procedures and other issues all part of the process to make sure a SAMFE and counsel are on the same page. Owens and Sherman-Dumais went through a mock filed report of a simulated sexual assault, peppering called-forth examiners with queries to test their response ability. Lt. Matthew Landon from the USS Boxer (LHD 4) calmly handled and explained every question from Owens. “That’s what we’re looking for,” commented Owens on Landon’s performance, explaining that direct examinations rely on open-ended questions whereas cross-examination questions differ stylistically from direct by using leading questions that are usually answered by a "yes" or "no." “The long and short of it is that a SAMFE doesn’t have to sweat it. We will prep beforehand. We’re here today to show the concepts,” Owens said.
According to Cmdr. Gregory Freitag, Navy’s Bureau of Medicine and Surgery (BUMED) Sexual Assault Medical Program manager, historically the sexual assault medical forensic examiner role has been seen as an arm of law enforcement.
“When a provider presented themselves as a law-enforcement proxy, a lot of the time their testimony would be discounted. We’re going over the cross examination skills needed and refining how to be objective witnesses,” Freitag said.
Judicial expertise and medical experience aside, there was one common assessment throughout the training scenario that linked everyone together in combating sexual assault. “Victims … look like everybody,” stated Owens. NHB held the SAMFE training for the week of July 20-24 for experienced Navy Sexual Assault Medical Forensic Examiners. The training featured enhanced curriculum to augment the command’s response ability in preventing and eliminating sexual assault, as well as continuing to provide timely patient-centered care to any victim in need.
“This training is very important to the Navy. It has the attention, alignment and purpose of all the service surgeon generals. Congress has called for the uniform training and this is our beginning. We will deliver patient-centered trauma support and care. The focus of the course is that the victim comes first,” said Cmdr. Gregory Freitag, Navy’s Bureau of Medicine and Surgery (BUMED) Sexual Assault Medical Program manager.
Freitag is part of the BUMED team directing the advanced and enhanced training, with an emphasis on policy, headquarters oversight, and being able to address questions and provide insight to how the training relates to Navy Medicine. NHB was the initial stop on the training itinerary that is the culmination of months of behind the scenes work by the three services – Navy, Army, and Air Force – to have uniformed standard training to expand provider knowledge and comprehension of medical-forensic care to sexual assault patients.
The SAMFE curriculum had multiple disciplines share, including Fleet Family Support Center, Sexual Assault Prevention and Response (SAPR), Victim Advocates, Pastoral Care, Mental Health, law enforcement, Naval Criminal Investigative Service, as well as the representatives of the Navy Judge Advocate General Corps. Freitag attests that the biggest difference between the civilian sector and the military is that in the armed forces, sexual assault is a more broadly defined concept. Any type of unwanted sexual contact can be considered a crime and will be investigated as such.
“Our nation’s military works sexual assault differently. Every report is investigated. Every allegation is taken seriously,” Freitag stressed.
The release of the FY15 National Defense Authorization Act (NDAA) increased the training requirement for a qualified SAMFE stating that they needed to hold either a Sexual Assault Nurse Examiner Adult/Adolescent certification or equivalent, or have training and clinical/forensic experience in sexual assault forensic examinations similar to that required for certification.
“To have the senior leadership and surgeon general’s concurrence and endorsement is very gratifying. As we continue to practice in the fleet, we will ensure robust delivery of care is in alignment with the Chief of Naval Operations, Adm. Jonathan Greenert goal for the program,” Freitag said.