For many years, medical training for the identification of domestic violence injuries, including strangulation, for police, prosecutors, and advocates was often overlooked and not included in core training. It wasn’t until the deaths of 17-year old Casondra Stewart and 16-year old Tamara Smith in 1995 that the San Diego criminal justice system first began to understand the lethality and seriousness of “choking” cases. The deaths of these two teenagers were a sobering reminder of the reality of relationship violence, prompting then-San Diego City Attorney Casey Gwinn to study existing “choking” cases being prosecuted within his office. The study revealed that on a regular basis victims had reported being choked, and in many of those cases, there was very little visible injury or evidence to corroborate the “choking” incident. The lack of physical evidence caused the criminal justice system to treat many “choking” cases as minor incidents, much like a slap on the face where only redness may appear. These two horrific deaths ultimately changed the course of history and launched an aggressive awareness and education campaign to recruit experts and improve the criminal justice system’s response to the handling of choking cases, which are now referred to as near-fatal strangulation cases.
As a result of those early efforts, many strangulation cases are now being elevated to felony-level prosecution due to professionals understanding the lethality of strangulation. Police and prosecutors are using existing statutes or working with legislators to create new felony legislation. Currently, forty eight states have passed felony strangulation laws according to the National Strangulation Training Institute. Doctors, forensic nurses, and domestic violence detectives are being utilized as experts and are testifying in court about strangulation. Strangulation training is also being provided at conferences and included at some regional police training academies, often aided by the strangulation training videos produced out of San Diego through partnerships with the Law Enforcement Television Network (1997) and IMO Productions (2000/2010). In addition, many articles on strangulation have been written by the National Strangulation Training Institute’s Faculty and Advisory Team.
Casondra Stewart and Tamara Smith did not die in vain. Their tragic deaths have clearly led to dramatic changes within the system. However, there is still a need for consistent, basic and advanced strangulation training nationwide. Family violence professionals rarely receive medical training concerning the identification and documentation of injuries or the signs and symptoms associated with strangulation. Providing these trainings on a regular basis will help institutionalize the best practice understanding of strangulation, increase the capacity of professionals to handle these cases adequately, and ultimately save lives.
There is also a need to develop an implementation plan for the integration of strangulation training into core training programs for all professionals, especially after a state passes a new felony strangulation law. Training, policy development, and use of documentation instruments have not been universally instituted in all disciplines. Rather, implementation has been intermittent and unpredictable due to poor leadership, management, and frequent turnover of staff in these fields.
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