Evaluation of family sexual harassment (incest) cases sent from the Zonguldak Bülent Ecevit University Medical Faculty Hospital

Entry and Aim: Incest relationships are a social problem that can cause victimization in many ways by causing harm to the victim in a biological, psychological and social manner as well as in the family structure which is the smallest unit of society. It is more difficult to detect incest relations in all developed or undeveloped societies than in other forms of abuse because of sexual abuse in the family, because it is prohibited and unacceptable by the society. It was revealed that most of the incest cases were not reported to judicial authorities. The emergence of incest relationships behind the closed doors caused the social reaction to the victim, the defendant, the family of the victim, and the religious and moral understanding. In our study, it was aimed to reveal sociodemographic characteristics of the cases sent by judicial authorities for incest and to develop solutions for forensic medicine. Technique: In our study, 113 cases of incest were examined retrospectively between July 2010 and December 2018 in the Zonguldak Bülent Ecevit University Medical Faculty Hospital Forensic Medicine Clinic. During the evaluation of the cases, the results of the examination of Forensic Medicine and other departments, the results of the intelligence test and the results of the other examinations, the victims, witnesses and defendants statements in the sent judicial documents, the previous forensic and medical documents belonging to the victim or the attacker were also included in the study. Findings: The majority of the cases (81.4%, n: 92) were female and the number of male patients was 21 (18.6%). When the cases were evaluated according to age groups; the majority (35.4%, n: 40) were in the 6-11 age range. It was determined that 12-14 years old (23.9%, n: 27) and 15-17 years old (21.2%, n: 24) followed this case. It was found that the mean age of the patients was 13.43. It was found that 88.5% (n: 100) of the cases were in the pediatric age group and 11.5% (n: 13) were in the adult age group. Most of the incest (47.8%, n: 54) was found at the home where the victim lived. 23.9% (n: 27) of the defendants' home, 19.4% (n: 22) were in a closed area outside the home and 7.1% (n: 8) were in the open area. It was found that in 31.8% (n: 36) of the cases, incest was performed by first and second degree relatives, 68.2% (n: 77) was performed by other people. It was determined that the distribution of the cases where the attackers are first and second degree relatives; the rate of father (10.6%, n: 12) and stepfather (10.6%, n: 12) were found to be equal and the highest. These were followed by step-brothers with 6.2% (n: 7) and 2.7% (n: 3). In one case, there is a grandfather and in one case a stepmother who has been sexually abused by a child pushed to the crime. It was found that 61.1% (n: 69) of the patients had a psychiatric diagnosis after the event and the majority of them (38.1%, n: 43) were diagnosed with Posttraumatic Stress Disorder. Results: Although each discipline brings different definitions within the framework of its own dynamics, the incest concept in our study has been discussed in the broadest sense as mentioned in the TCK (Turkish Criminal Law). The abuse carried out by the people who has an authority on the victim and the victim trusts as well is accepted as a crime regardless of having blood relation. In order to detect the incest and for the sake of victims' overcome this situation with the least harm, society must be informed to raise awareness and to declare incest. In a close family structure, schools, perhaps the only place where victims can communicate with other people, should be seen as an opportunity to reveal incest. For this purpose, all teachers, especially guidance teachers, should be trained on child sexual abuse.Thus, it should be possible to reach every child in schools and to provide incest with the right approach. Another important point in revealing incest is that there should be sex education for children in schools. Together with these training courses, children should be taught what behaviors are sexual abuse and what they should do when they encounter with abuse. Health workers should also consider the possibility of incest when they encounter all forms of abuse and neglect. Another important point is that all operations are managed one-by-one in a multidisciplinary center, so that the victim cannot be traumatized by repeated examinations and expressions after the appearance of incest. Incest is a problem that concerns the whole society in respect of health, education, social, economic and political aspects. A multidisciplinary approach is required to address this problem. In the short, medium and long term, the implementation of the regional and all national plans within the plans to be prepared will ensure incest to be minimized or perhaps eliminated.