- Current bruise detection methods are often ineffective on darker-toned skin and very recent or older bruises.
- Bruise detection is vital to forensic confirmation of domestic violence or other physical abuse.
- Angelina Jolie wrote an editorial advocating for the use of nonbiased technology to provide more accurate results and support domestic violence survivors.
Bruising on darker skin tones can be difficult to detect under typical white light. Nurse researcher Katherine Scafide, Ph.D., RN, was profoundly frustrated during her work when a domestic violence survivor reported being injured, but there was no way to physically prove it. This situation often occurred among patients with darker skin, introducing even more healthcare and legal inequity. She was determined to find a way to change this.
We cover actor and activist Angelina Jolie’s involvement, Scafide’s research, and how they can help forensic nurses perform their work and produce results less affected by existing racial and color-based bias. Explore more in this development and how you can use unbiased forensic technology and promote its use.
Angelina Jolie Addresses Health Inequities in Survivors of Domestic Violence
In an op-ed in the American Journal of Nursing, Jolie describes the inadequacies of bruise detection under white light. Specifically, white light detection is inadequate in approximately 48 hours before bruising is visible, and after it has faded. Furthermore, white light is ineffective for revealing bruises on darker skin tones, which amplifies bias in attempts to document domestic violence.
Scafide, a forensic nurse, performed extensive research on technological solutions to address these inadequacies and the introduction of bias. She found that the same alternate light source (ALS) technology that is used to detect bloodstains invisible to the naked eye can also detect bruising in all skin types and over a longer period. During her research, Scafide became known as “the Paintball Lady” because she found that paintball players were ideal subjects for her studies.
The Role Alternate Light Sources Can Play in Bruise Detection
Bruising is a common indicator of domestic violence. However, inadequate documentation of bruising creates miscarriages of justice, especially among those with darker skin. However, forensic nurses can help improve bruise detection and reduce bias.
Using this type of non-biased forensic technology can help domestic violence survivors by:
- Documenting the abuse in more cases
- Giving domestic violence survivors a longer window of time in which to report abuse
- Limiting the sense of helplessness that domestic violence survivors can feel when they are unable to document abuse
It will take time for the medical field to adopt ALS and other nonbiased forensic technology and establish universal guidelines for practice and education. However, there are things that you can do in the meantime:
- Nurse educators can promote the use of nonbiased forensic technology like ALS in nursing education at all levels.
- Nursing boards, especially forensic nursing boards, can ensure that certification programs and exams cover the use of ALS and similar unbiased tools.
- Forensic nurses can adopt these tools as soon as possible and share information about their benefits.
- Any nurse who treats patients who are domestic violence survivors can continue to provide support, encouragement, and culturally competent care.
All nurses can take advantage of Jolie’s star power by sharing her op-ed, Scafide’s research as described for the layperson or for industry professionals, Scafide’s video or podcast about bruise detection, and information about health inequities and how they can be addressed.
Page last reviewed on July 25, 2023