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Sexual assault nurse examiners (SANEs) are specially trained to meet the postassault medical forensic needs of sexual assault patients. However, there remains a dearth of literature comparing directly postassault service provision and action in cases treated by SANEs as compared to non-SANE medical providers. In this study, we compare rates of emergency contraception administration, toxicology kit use, reports to police at the time of examination, and mandatory child abuse reports among n = 3,969 sexual assault cases treated by SANEs and non-SANE medical providers. Compared to cases treated by non-SANE medical providers, cases treated by SANEs were significantly more likely to have emergency contraception administered, less likely to have a toxicology kit collected, less likely to have a police report filed at the time of examination, and more likely to have a mandatory child abuse report filed. Observed patterns suggest that non-SANE medical providers may find it difficult to balance the needs of the criminal justice system with those of their patients, whereas SANEs provide a tailored, comprehensive first response. We discuss the importance of consistent, accurate documentation and clearly defined protocols in the medical forensic response to sexual assault patients.

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Conclusions: It appears that improving engagement with palliative care will require more than just education. Conversations about ''palliative care'' appear to offer a safer space to help the individual begin to conceptualise themself as a person who is dying. The use of narratives and mythology provides patients and their health professionals with a language for talking about dying that otherwise remains unspeakable. Understanding this function of narrative suggests new ways to introduce this sensitive conversation about impending death.