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The Violence of Care

The Violence of Care: Rape Victims, Forensic Nurses, and Sexual Assault Intervention

Sameena Mulla
Copyright Date: 2014
Published by: NYU Press
Pages: 288
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  • Book Info
    The Violence of Care
    Book Description:

    Every year in the U.S., thousands of women and hundreds of men participate in sexual assault forensic examinations. Drawing on four years of participatory research in a Baltimore emergency room, Sameena Mulla reveals the realities of sexual assault response in the forensic age. Taking an approach developed at the intersection of medical and legal anthropology, she analyzes the ways in which nurses work to collect and preserve evidence while addressing the needs of sexual assault victims as patients.Mulla argues that blending the work of care and forensic investigation into a single intervention shapes how victims of violence understand their own suffering, recovery, and access to justicein short, what it means to be a victim. As nurses race the clock to preserve biological evidence, institutional practices, technologies, and even state requirements for documentation undermine the way in which they are able to offer psychological and physical care. Yet most of the evidence they collect never reaches the courtroom and does little to increase the number of guilty verdicts. Mulla illustrates the violence of care with painstaking detail, illuminating why victims continue to experience what many call secondary rape during forensic intervention, even as forensic nursing is increasingly professionalized. Revictimization can occur even at the hands of conscientious nurses, simply because they are governed by institutional requirements that shape their practices.The Violence of Carechallenges the uncritical adoption of forensic practice in sexual assault intervention and post-rape care, showing how forensic intervention profoundly impacts the experiences of violence, justice, healing and recovery for victims of rape and sexual assault.

    eISBN: 978-1-4798-7890-1
    Subjects: Anthropology

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
    (pp. vii-viiii)
  4. Introduction: Sexual Violence in the City
    (pp. 1-36)

    It was the summer of 2002 in Baltimore, and I was a rape crisis advocate volunteering for a local rape crisis center. I completed my training for this in February 2002, and at that time I bought my first cell phone. I was on call four or five times a week, taking as many eight-hour shifts as I could. The calls would come at all hours, and sometimes, even if I was not on the schedule, I, or another of the advocates, might be called if there wasn’t enough coverage or there were multiple cases and additional rape crisis advocates...

  5. 1 “The Hand of God”: DNA and Victim Subjectivity in Sexual Assault Intervention
    (pp. 37-56)

    When we think about forensic intervention in this day and age, what most frequently captures our imagination is DNA—that fragile, ephemeral, and reliable key to many mysteries, both scientific and criminological. DNA is the key to justice, and efforts such as the Innocence Project, which seeks to exonerate those wrongfully convicted often in relation to DNA-related findings, reinforce this popular notion.¹ Our common wisdom holds that if a rape victim submits to the scrutiny of a forensic examination, and organic substance is recovered, subsequent tests will reveal the DNA hidden in the evidentiary depths, and the identity of a...

  6. 2 Making Time: Temporalities of Law, Healing, and Sexual Violence
    (pp. 57-75)

    A sexual assault forensic intervention is not a single process characterized by a single mode of time, though many things happen in a single space. The various processes that are set into motion in response to sexual violence all engender the ways in which sexual assault becomes storied. These stories, how they are told, and the experiences that they validate, are critically important for the victim, as well as to the criminal justice proceedings that take place. A legal narrative unfolds, discrete events strung together like beads on a thread. The criminal justice personnel will investigate each link in the...

  7. 3 On Truth and Disgust: Managing Emotion in the Forensic Intervention
    (pp. 76-102)

    This excerpt from an interview with Emma, one of the directors of the Forensic Nursing Program at City Hospital at the time of my research, contains in it one version of the origin stories of her program in its present form. In addition to introducing a clinical paradigm to the sexual assault intervention, the advent of the forensic nursing program marks a shift in the professional sphere in which nurses work and the skills and expertise they require to be effective. Individual professional fields often have unique standards by which vocational expertise can be ascertained (Latour and Woolgar 1986; Mitchell...

  8. 4 Re/production: Articulating Paths to Healing and Justice
    (pp. 103-129)

    If the law always demands the production of a body and this body is already constituted as a socio-legal subject (Das 2006b: 95), rape trials are particularly exacting in their stipulations for the constituting of the sexually violated body. The legal subjectivity of sexual assault victims depends on a narrowly bound imagination of a reproductive future, which the victim must subsequently enact by the adoption of a particular attitude toward conception and contraception. Studies of mass rape have clearly established a link between sexual violence and reproductive violence. Sexual assault emerges as “occupation of the womb” (Fisher 1996: 91); “biological...

  9. 5 Facing Victims: Vision and Visage in the Forensic Exam
    (pp. 130-151)

    This chapter considers a particular legal-medical artifact: the photos of wounds and injuries collected by forensic nurses who work with sexual assault victims. As we have seen in previous chapters, the use of medical expertise in legal procedures lends medicine’s authority to law without necessarily adopting the therapeutic concerns of medical practice. In demonstrating how clinical practices hinge on potential courtroom proceedings, Mary-Jo DelVecchio Good has disaggregated “medicine’s monolithic voices” (1995: 11) and traced the signs under which medical competence becomes a potent symbol in relation to malpractice. As chapter 3 demonstrates, while the forensic practitioner is also subject to...

  10. 6 Documentary Agency: Institutional Dispositions toward Gender and Rape Myths
    (pp. 152-175)

    This chapter analyzes the documents that serve as the vehicle for recording the findings of a sexual assault forensic examination as they provide insight into the competing imaginaries of kinship and care that arise from the intersection of legal protocols and medical techniques. Because documentation is such a central feature of sexual assault forensic examination, this chapter shows how a document might preserve and proliferate many problematic and damaging attitudes about sexual assault and sexual assault victims, despite the best intentions of practitioners who are relying on these documents. While the normative prevalence of acquaintance rape is a documented fixture...

  11. 7 There Is No Place Like Home: Home, Harm, and Healing
    (pp. 176-194)

    Building on the gendered norms that emerge from forensic documentary protocols in the previous chapter, this chapter examines the ways in which home and the sexually violated bodies within particular homes are configured and administratively rendered by the state. Violence between intimates, acquaintances, and “friends” is seen to be particularly destructive, and these distinctions carry over into the formalization of “stranger” and “acquaintance” categories by law enforcement personnel (Estrich 1988: 4–8).¹ A recent study of sex offenses in the United States determined that eight out of ten rapes were acquaintance rapes (Tjaden and Thoennes 2006: 21). The term “acquaintance”...

  12. 8 Patient and Victim Compliance: Drugs, AIDS, and Local Geographies of Care
    (pp. 195-216)

    This chapter begins by painting three ethnographic scenes in broad strokes: It is January 2002, and a rape crisis advocate-in-training shadows an experienced advocate to the local hospital to observe her accompany a sexual assault victim. The victim is in a special waiting room, still awaiting the arrival of the forensic nurse. She nods in and out of consciousness as the rape crisis advocate attempts to make contact with her. The advocate has a form she attempts to fill out to collect details about the case for the rape crisis center. The forms capture data required for reporting to the...

  13. Conclusion: “We’re Not There for the Victim”: The Violence of Forensic Care
    (pp. 217-230)

    From the outset, this book has argued that the particular form of care that emerges from the interaction of legal and therapeutic practices imposes a particular violence on victims of sexual assault. This violence is born not from the intentions of individual forensic nurses who consciously set out to alienate the victim-patient with whom they are working, but rather from the particular institutional, professional, and historical location of forensic sexual assault intervention. The characteristics typical to the institutional location described throughout this text arise from the training regimes, professional mores, temporal practices, technological tools, documentary styles, and ethical orientations of...

  14. NOTES
    (pp. 231-242)
    (pp. 243-266)
  16. INDEX
    (pp. 267-276)
    (pp. 277-277)