TUESDAY, July 31, 2001 (HealthDayNews) -- Almost half the victims of domestic violence don't like laws that require doctors to report the abuse to the authorities, a new study shows.
Mandatory reporting laws are a controversial issue, the researchers say, and only five states have passed laws requiring that health care professionals report suspected intimate-partner violence to the police. Policymakers need to take into account the needs of the victim before more laws are passed, the researchers add.
"One approach to addressing the problem of inadequate identification of survivors of abuse as well as inadequate intervention is that laws have been passed that require clinicians to report to the police injuries relating to domestic violence," says lead author Dr. Michael Rodriguez, an assistant professor of family and community medicine at the University of California at San Francisco.
"Most states have some form of law that requires clinicians to report injuries caused by deadly weapons," Rodriguez says in explaining the background of his study. "But since the early 1990s, states have passed various forms of mandatory reporting laws that require health care professionals to report intimate partner violence to the police. California is one. In order to inform the debate, we felt it was of crucial importance to see what survivors of abuse felt about the law."
Rodriguez and his colleagues collected data from 1,218 female patients who had gone to emergency rooms in both California and Pennsylvania in 1996 and asked them about domestic violence. Pennsylvania does not have a mandatory reporting law. Five states -- California, Colorado, Kentucky, New Mexico and Rhode Island -- mandate reporting in certain instances of domestic violence, while one -- New Hampshire -- excuses victims of abuse from its general mandate to report certain injuries.
About 12 percent of the women reported physical or sexual abuse within the past year from their partners, Rodriguez says. Of those, slightly more than 44 percent opposed mandatory reporting, while 70 percent of the non-abused women supported the laws. There was no difference in responses between the two states.
Women fear that reporting abuse will lead to retribution, Rodriguez says.
"In previous work I've done, women have expressed concern that these laws and the actual reporting may increase the risk of retaliation by the perpetrator," he explains. "And other patients have expressed concern over how such reporting violates their privacy as well as trust, and might prevent them from actually seeking medical care after abuse. In addition, it undermines a patient's autonomy because [these laws] do not give competent, informed adults the ability to decide what is in their best interests."
"A significant number of women opposed the law because of the potential dangers that it reflects," Rodriguez adds. "If we do anything, we need to weigh in on the side of patient safety before any intervention that might threaten the patient."
The findings appear in the Aug. 1 issue of the Journal of the American Medical Association. The American Medical Association adopted a position in 1997 opposing mandatory reporting laws, saying such laws "violate basic tenets of medical ethics and are of unproven value."
According to a study conducted by the National Institute of Justice and the Centers for Disease Control and Prevention, American women are victims of approximately 4.8 million intimate-partner rapes and physical assaults annually. Almost one-in-three adult women experience at least one physical assault by a partner during their lifetime, and women who were physically assaulted by an intimate partner suffered an average of 6.9 assaults by that same partner.
"The concern about the mandated reporting laws is that the reporting of the domestic violence incident to the police can sometimes increase the risk and the danger to the victims," says Juley Fulcher, the public policy director of the National Coalition Against Domestic Violence in Washington, D.C. "Batterers often retaliate, and victims know that. They have been threatened precisely with just such a threat, that if they go to the police, [they're told], 'I will hit you, I will hurt you, I will kill you.'"
Victims of domestic violence need to be able to choose whether the police should be involved, Fulcher insists. "Giving the victim the choice of reporting the incident or not is the issue here. And it's not just whether, it's also when, because reporting and trying to leave an abusive relationship requires a lot of safety planning, and victims of domestic abuse need to prepare and protect themselves."
What about the argument that victims of abusive relationships are so psychologically damaged that they don't know what is good for them, and that reporting violence to police will help break a vicious cycle?
It's an issue of trusting the criminal justice system, both Fulcher and Rodriguez say. "Many of them [victims of domestic abuse] are aware that the safety net we as a society have provided them -- our public safety institutions and the criminal justice system -- are woefully inadequate," Rodriguez adds.
It's also an issue of individual rights, she says. "Do we as a country really want to put ourselves in the position of making decisions for other adults?" she asks.
"Victims of domestic violence know where the dangers are," Fulcher continues. "They know what is really going to get them hurt or killed, and they are in the best position to know that. For us, as a society, to come in, report the abuser to the police -- without really dealing with the victim, making sure the victim is safe, has a plan, has a place to go, has money, that the kids are taken care of -- would further the crime."
What To Do
For more information on mandatory reporting laws, see Violence Against Women Online Resources. And visit the National Coalition Against Domestic Violence for more information on intimate-partner abuse.
