Domestic Violence
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As future physicians, we all face a grave public health problem: intimate partner violence. This complex issue plagues a sizeable percent of our population, and you probably even know someone who has been a victim. In order to be effective physicians and leaders, it is our charge to understand domestic violence and to be comfortable responding to victims and their children. Domestic Violence DefinedDomestic violence is a term that describes a pattern of behavior used to establish and maintain power and control over an intimate or domestic partner. This includes physical, verbal, sexual, emotional, and/or financial abuse. By sheer numbers, the overwhelming majority of domestic violence victims are women who are abused by their male partners, but no relationship is immune. Same sex relationships, both male and female, as well as heterosexual relationships in which the female is the perpetrator, can also be violent. Recent studies have shown that the largest group of intimate partner abuse victims per capita in the US includes teens and young women between the ages of 16-24 (Bureau of Justice Special Report: Intimate Partner Violence, May 2001). It is also important to realize that abuse of elders and of those with disabilities is not uncommon. Domestic violence is best thought of in terms of inequality in a relationship-any intimate or domestic relationship. An abuser's principal motivation is to be the one in power. DV incidences do not occur as a result of a loss of control of the abusing party-rather, the abuse is a means of controlling the victim. Isolating, intimidating, name-calling, and belittling are all indications that the abuser has not lost control of him/herself. Domestic Violence and Health Care ProfessionalsOften what comes to mind when picturing a victim of domestic violence is an emergency room patient late at night with a broken jaw and a black eye. Although there certainly are such clear-cut cases, many are much more subtle. Furthermore, in some cases a physician is the only person an abuse victim is allowed to visit, which puts health care workers in a unique position to fight this issue. It has been estimated that 25-31% of all women in the U.S. will at some point in their lives be victims of an abusive relationship (The Commonwealth Fund, Health Concerns Across a Woman's Lifespan: 1998 Survey of Women's Health, May 1999). However, as mentioned above, any relationship can be abusive. Whether the situation is current, past, or yet to happen, it is important for physicians to comfortably address the subject with all of their patients. This could be as simple as asking the patient if s/he feels safe in her/his relationship and at home. What can you do?
ONLINE DOMESTIC VIOLENCE RESOURCES
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