19 Oct 2017

Should nude photos be taken as part of the SANE exam?

Authored by

Linda E. Ledray, RN, SANE-A, PhD, FAAN, and

Kim Day, RN, SANE-A, SANE-P, Forensic Nursing Director, International Association of Forensic Nurses

While performing a clinical training just this month the nurses shared that during their recent didactic training at another site they had been told they should take pictures of the front and back of all clothing collected before packaging. They were also told they should have patients undress and then take nude full body pictures front, back, and sides.

They were instructed to do this with all patients regardless if injuries were present.

As forensic educators, we are concerned about excessive handling the clothing and are unsure of the benefit of these pictures. Additionally, we both are greatly disturbed by the direction to take full nude body pictures of a patient reporting a sexual assault. Unfortunately, this is not the first time we have encountered nurses who recalled similar instructions from a trainer or even other team members who may encourage this practice.

We suspect that the instructor(s) were promoting the practice of obtaining nude full body photographs following the advice of “experts”. In fact, there are several textbooks that do promote taking full body photographs of the patient after a sexual assault, including Forensic Nursing Science 2nd Edition[1] and Quick Reference to Adult and Older Adult Forensics: A Guide for Nurses and Other Healthcare Professionals[2].

To encourage best practices in the medical forensic care of the sexual assault patient we do not want to cause additional trauma to our patient.

In light of that, we would like to discourage taking full body nude photographs of the patient. There are photography guidelines available in A National Protocol for SexuaL Assault Medical Forensic Examinations Adult/Adolescent 2nd edition.

The Protocol clearly states we should take pictures of all trauma while carefully draping our patient to protect their modesty. The Protocol also states that photos taken solely for the purpose of identification should be done with patients fully clothed or in a gown.

Although there may be circumstances in which taking a full body photograph may be warranted (for example, if the patient’s clothing is torn, or obviously damaged), it should not be a routine practice when no trauma is present and there is no reasonable rationale for taking those types of pictures.

To be clear: if there is no rationale, they simply should not be done.



[1] Forensic Nursing Science / Edition 2 by Virginia A. Lynch, Janet Barner Duval. Published by Elsevier Health Sciences, 2010.

[2] Quick Reference to Adult and Older Adult Forensics: A Guide for Nurses and Other Healthcare Professionals by Kathleen M. Brown PhD, APRN-BC, Mary E. Muscari PhD, MSCr, CPNP, PMHCNS-BC, AFN-BC. Published by Springer Publishing Company, 2010.

3 Responses

  1. Sandra Dearborn, SANE Coordinator, Help In Crisis, Tahlequah, OK

    I agree 100% with no NUDE photos or pictures of clothing. We take pictures of the patients with gowns on, providing facial id at the beginning and conclusion of the forensic exam.

  2. Denise Atkinson

    Wow! There are some things that when you hear it, you just know it is wrong and I hope that is why this was brought to your attention. I think this also goes along with not routinely turning over genital photographs to law enforcement. It is our obligation as nurses to treat the patient with the same respect and dignity as we would expect and want to be treated.

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