Drug-facilitated sexual crime by use of ketamine and diazepam by a gynaecologist.

Drug facilitated crimes (DFCs) can be defined as criminal acts carried out by means of administering a substance to a person with the intention of impairing behaviour, perceptions, or decision-making capacity. It also extends to taking advantage of an impaired person after voluntary intake of an incapacitating substance. Crimes include robbery, money extortion, and maltreatment of the elderly, children, or mentally ill patients. Rape or other types of sexual assault are referred to as drug facilitated sexual assault (DFSA). In DFSA cases, the victim is subjected to a sexual act without legal consent as a result of the pharmacological effects of alcohol and/or drug(s). A large number of psychoactive substances have the potential to alter the victim’s state of mind, alcohol being the number one candidate because of its widespread use. Illicit drugs, psychoactive prescription drugs and even over-the-counter medicines are also likely candidates, either consumed alone or in combination with alcohol. The resulting pharmacological effects may include relaxation, euphoria, and lack of inhibition on the one hand and drowsiness, loss of motor function, unconsciousness, and amnesia on the other hand. Information on the frequency of DFC cases is scarce but there has been a significant increase in reports worldwide. However, several factors complicate the registration of the actual number of DFSA cases. Governmental statistics show a general underreporting of sexual assault crimes. The impact that central nervous system depressant drugs have on memory and consciousness might lead to a situation where the victim is not able to remember what has actually happened and chooses not to report the incident. If the incident is reported, police officers often assume that the victim was simply drunk rather than drugged. If an investigation is initiated, the delay between the collection of biological evidence and the alleged assault can be between several hours and more than a day. This case report describes a DFSA case in a medical setting: a gynaecologist was suspected of assaulting a young patient after drug administration. In the presented case, the time delay between the alleged assault and the sampling was 30 h. Evidence collection via a standardized sampling kit and the choice of sample in such cases is discussed. The analytical strategy is described with regard to the choice of methods, uncertainty measurement, and limitations of the methods which are important during interpretation of the analytical results. Finally, interpretation of this specific case, but also interpretation issues of DFSA cases in general, is discussed.