Assumptions are statements accepted as given truths without proof. Assumptions set the foundation for the application of a particular theory. Central to the forensic nursing theory is the assumption that integrating disciplines of social science, nursing science, and the legal sciences involves the notion that the multiskilled forensic nurse benefits the patient, the healthcare institution, society, the law, and human behavior.

Truth is the mantra of the forensic sciences and central to the field of all scientific investigation. Truth explains the objective methodology of forensic sciences applied across a broad base of disciplines and facilitates the collective search for the truth. Reforms in criminal justice systems have come about through advances in DNA technology that have sustained truth and justice in cases where justice had been denied. The Innocence Project was founded in 1992 to determine the truth as it relates to the exoneration of incarcerated prisoners through postconviction DNA testing. It cannot be overemphasized that the forensic nurse is not a victim advocate but rather a patient advocate. The patient, however, may be the accused, a convicted felon, the condemned, or the victim. A forensic nurse is required to remain essentially unbiased and value neutral in all matters—an advocate for truth and justice. Objectivity and neutrality are essential values in the care of forensic patients. The role requires an incisive comprehension of fundamental medicolegal issues as well as the ability to prepare and present testimony in a court of law. It is the search for truth.

Truth, as the central implicit assumption to all forensic investigations, brings enlightenment to unknown, unanswered, and questioned issues related to the origin and manifestations of pathological conditions that affect the person, environment, health, and nursing. The philosophy of forensic nursing practice is based on an ancient philosopher’s love of truth (Plato, 347 B.C.). Without the discovery of truth, diagnosis, treatment, evaluation, rehabilitation, recovery, and prevention would be precluded. Without truth, reconciliation and justice are denied.

Research is an essential element for further developing the concepts, theories, and models of care that apply to forensic nursing. Research initiatives and clinical inquiries form the basis of evidence-based practices (Brenner, 1984). Yet research requires appropriate theoretical frameworks for practice, advanced nursing preparation, competency-based training, and experimental work-based academic development to move out of the shadows and forward into the pursuit of truth.

Central to all nursing theories is the assumption that human beings are made up of various dimensions and that each dimension relates to health and well-being. Forensic nursing theory incorporates the human dimensions pertinent to all nursing theories of care, yet it projects beyond the aspects of bio-psychosocial spiritual and cultural beings to introduce and incorporate a dimension of laws. Laws that portend to govern human behavior and social needs represent the direct correlation among the human dimension, health, and well-being. Culture can advance or limit the human dimension. Cultural change can be seen as social learning. Cultural care and cultural interventions are essential components of the forensic and clinical investigation of trauma.

Forensic nurse examiners utilize Carper’s fundamental patterns of knowing in their practice with a variety of models and theories (Carper, 1978). Patterns of fundamental knowing consist of those described as empirical knowledge, aesthetic knowledge, personal knowledge, and ethical knowledge. Other nursing theories and models are symbiotically intertwined and functionally applicable to forensic nursing science.

The following components are typically addressed in any theoretical concept of nursing practice: (1) role clarification, (2) role behavior, and (3) role expectation.

Role clarification identifies shared knowledge and skills. It establishes explicit expectations and boundaries between the role of the self and that of others, and it delineates goals as well as costs and rewards associated with enacting them. Role clarification also demonstrates the extent to which significant others reinforce or validate role behavior via complementary and counter roles.

Role behavior is the performance or enactment of differentiated behavior relevant to a specific position. Role expectation is the obligation or demands placed on the individual in a role position. It encompasses the specific norms associated with the attitudes, behaviors, and cognition required and anticipated for a role occupant.

A major component of the integrated model for forensic nursing is interactionism. The focus of interactionism concerns specific links or associations among persons, environment, concern for persons, social integration, development of meaning, and the integration of persons in a social context, as well as processes engaging persons. Not all social systems generate a sense of community, but those that do create a shared culture and social order among their members. Patient advocacy recognizes healthcare as a primary source of physical and emotional stability to the physically or psychologically traumatized patient. Patient advocacy, an aspect of social behavior that protects and provides patients with an emotionally supportive community, serves as one platform for the forensic nurse examiner role. The understanding and explanation of social order as community is the goal of social sciences. This includes the understanding and explanation of criminal behavior and human violence. It focuses on individuals involved in a reciprocal social interaction as they actively construct and create their environment through a symbiotic interaction. The main focus of this perspective reinforces the need for social order and interdisciplinary coordination in healthcare delivery and the social justice sciences.

Problematic social situations, such as the escalation of trends in criminal violence, demand new interpretations and new lines of action, which reinforce the need to continually redefine the role of the forensic nurse. This parallels the major focus of forensic nursing as it deals with change, dynamics, and the processes by which individuals creatively adapt to a society in flux. The ongoing problems in society and rapid social change place new demands on public service providers. Their role behaviors, in turn, quickly generate new and valid concepts that contribute to safe, effective patient care.

A dynamic role of the forensic nurse examiner has evolved in clinical and community nursing practice; it facilitates specialized and unique behaviors in forensic nursing. This role helps nursing, medical, social, and legal systems to clarify questioned issues in response to the epidemiology and query of murder, suicide, sexual assault, abuse, neglect, intentional trauma, communicable disease, and violent criminal acts that threaten lives. The principle of reciprocal social interaction represents the multifaceted relationships among patient, clinician, and multidisciplinary team members that involve law enforcement agencies, social services, legislative authorities, judicial systems, and healthcare operatives. The reciprocal interaction of interagency coordination and cooperation works to improve the structural and functional management, delivery, and effectiveness of services offered by health and justice institutions.

This theoretical framework makes the following assumptions:

Propositions are ideas brought forward for consideration, acceptance, or adoption. The basic propositions considered in the formation of forensic nursing theory include truth, presence, perceptivity, and regeneration. These propositions are explained as follows:

Care that incorporates the nursing process—assessment, planning, intervention, and evaluation, to restore and promote health in the patient throughout the forensic process—is essential. The concepts of truth, presence, perceptivity, and regeneration will guide the forensic practitioner in the ways of knowing, patterns of being, and shared intuition between patient and practitioner.

The model is described as follows: Three principal components embracing the outer triangle constitute the theoretical basis of forensic nursing. The interlocking circles indicate interconnected, interagency coordination, cooperation, and communication essential to public health, safety, and social justice.