Medical workers conflicted about reporting domestic abuse

http://www.sltrib.com/news/ci_14812167

Utah: Survey shows Emergency room staff said they don't always report domestic violence to police, need more training.

A mandatory-reporting law that requires health care providers to contact law enforcement when they treat a victim of intimate partner violence often isn't followed by hospital emergency department staff in Utah.


In a survey conducted last spring, a majority of emergency department employees -- nearly 87 percent of urban staff and 75 percent of rural staff -- reported they were not adequately trained to conduct abuse interviews. A majority also said lack of training was an obstacle in identifying abuse as the cause of an injury.


When they did identify or suspect injuries from intimate partner violence, emergency department staff said they were as likely to give the victim information on community resources as to contact law enforcement.



The survey findings highlight mandatory reporting as a "complicated" issue for health care professionals, one that raises fundamental ethical and legal issues, said Todd Allen, research director for the Department of Emergency Medicine at Intermountain Medical Center.


"First and foremost, health care professionals try to assure the safety and privacy of patients and many feel that mandatory reporting might put either or both of those principles in jeopardy," Allen said. "I think that [doctor-patient confidentiality] would be broken with reporting to law enforcement, and that the involvement of law enforcement might escalate the behavior of the perpetrator and put the victim at increased risk in both the short and long term."

What an interesting article. Too many victims do not really want to take it as far as the rescuers would like to go. They are so conditioned they can't advocate for themselves.

I wonder if these same folks would have any problem in reporting a case of suspected child abuse in that same Emergency Department setting? And if not, why not?

The "it may cause the behavior of the pereptrator to escalate" just doesn't make good sense when you apply it to child abuse, so why would it make good sense to apply it to an adult?

IMO, the children in the homes of adults being assaulted are in great danger, thus each incident should be reported across the board - just as when child abuse is supected.

Perhaps changing the name of the crime to "in home violence" and requiring that all suspected "in home violence" be reported is the way to go in the future.

If, as a society, we are not going to tolerate child abuse, why should we tolerate adult abuse?

AlwaysShocked said:

I wonder if these same folks would have any problem in reporting a case of suspected child abuse in that same Emergency Department setting? And if not, why not?

The "it may cause the behavior of the pereptrator to escalate" just doesn't make good sense when you apply it to child abuse, so why would it make good sense to apply it to an adult?

IMO, the children in the homes of adults being assaulted are in great danger, thus each incident should be reported across the board - just as when child abuse is supected.

Perhaps changing the name of the crime to "in home violence" and requiring that all suspected "in home violence" be reported is the way to go in the future.

If, as a society, we are not going to tolerate child abuse, why should we tolerate adult abuse?

Click to expand...

I think a big difference is that a child can be taken out of an abusive situation, while there is nothing to stop an adult from returning to one. A woman (yes, I'm generalizing) who refuses to file a complaint, make a report, or even accept a pamphlet about a shelter obviously plans to return to her abuser. If encouraging her to seek help and sharing resources that exist don't change her mind, then I can see how a caregiver might believe that the violence will only escalate with LE on the scene. And you know what? It's probably true.

While the report will document the history of the abuse and help her in the long run if she eventually leaves him (or for his murder trial, whichever comes first), it might only hurt in the short term.

Also, while an adult woman should have an expectation of privacy with her doctor, a child doesn't have that same expectation. Only into their older teens can a child request that some information not be shared with their parents, and SOME doctors will abide by that request. If the parent is the abuser or is allowing the abuse, then there is justification for bringing in LE despite dr/patient confidentiality.

It isn't even remotely the same thing.