By Jason Cruz

A senate bill protecting victims of domestic violence via strangulation was signed into law this past April. The bill covers costs of a forensic nurse examination related to nonfatal strangulation when it is part of a sexual assault or if a victim applies for program benefits. Washington becomes the first state in the nation to provide this service.

The proposed law aids domestic violence survivors and was supported by Washington state senators T’wina Nobles and Manka Dhingra.

For the domestic violence and sexual assault victim, there is a medical response but strangulation may not leave obvious marks and the bill will provide further look into the injuries. Forensic nurse exams prioritize documenting issues related to strangulation. As a part of the bill, data will be collected related to the exam to keep track of those exams that are used to assist in prosecution.

According to the senate bill report, “Strangulation is the most intimate form of partner violence. A person who suffers from nonfatal strangulation is 750 percent more likely to become a homicide victim and these crimes can be hard to prosecute as they mostly happen behind closed doors. There is a need to rely on evidence and the strangulation may not leave any marks to the untrained eye. Medical exams are the best way to hold abusers accountable. In 2018, in King County alone, there were 323 known cases of strangulation, 64 of which were treated in the hospital and only four received a forensic exam because it also involved a sexual assault. This bill is greatly needed, long-term effects of strangulation make it harder to be successful in healing, not just physically as victims often suffer from PTSD.”

The bill provides a unique perspective on treating domestic violence as a public health issue. The law would allow for the costs of a forensic nurse exam to be paid for by the state. Exams could cost up to $1,400 and had been an obstacle for the prosecutors of abusers. Prior to the bill, forensic exams were offered only to victims of sexual assault. A strangulation survivor would have to pay for the exam out of pocket.

“This bill is so critical in making sure that we have resources for strangulation cases,” said Dhingra. She noted that it was brought to her attention by a victim’s advocate in the prosecutor’s office. “These are wounds that can be invisible,” explained Dhingra.

As a former prosecutor, Dhingra recalled reading reports in which the victim had bruises around their neck, but there could be nothing further to be done unless a forensic exam was performed.

She explained that data is collected in forensic exams to determine whether or not they will follow-up with prosecution. The data will show how many were paid for and how many resulted in criminal charges to be filed.
“I think it’s really important to get a lay of the land and see what the data shows us,” said Dhingra.

“Victims of domestic violence and serial abusers are sometimes unable to afford a forensic examination.” Senator Nobles stated 68% of survivors from domestic violence have suffered near strangulation.

“Medical examinations are the best ways to hold abusers accountable.” She also noted that photographic evidence does not show internal injuries. As evidence in court, without a forensic exam, the abuser may not be convicted of their crime.

“It is important to have a victim-centered public health response to victims of sexual assault,” said David Martin of the Domestic Violence Unit of the King County Prosecuting Attorney’s Office. With the law, the forensic nurse exam will be available across Washington state.

The bill unanimously passed the house and senate. It was one of several laws that passed this legislative session which addressed the issue of domestic violence and assault.

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