Domestic Violence

Patricia R. Salber Ellen H. Taliaferro


Emergency DepartmeM.PreseMStjons Barriers to Diagnosis Routine Screenjngfor Domestic Violence Consequences of Failure. to.Diagnose.Domesti.c Violence The Battered Woman Who.Is. She?


The... Effect. .of..Dome.stic.Violence... on.. Children Making ..the. .Dja.g.nosis...of .Domestic. Violence History,. .and ..,Ph,y,sical.,Ex,a,mina,tio,n iRou,tin.e..,,e,n,ing


Assess. .P, Suicide.. or..Hom,icide Safety. Assessment

Essential ..Information for..Battered.Women PreparingtheEmergencyDepartmentfor.. Optimal .Response


Medicolegal. .Considerations

Chapter.. References

It has only been in the last 15 to 20 years that domestic violence has been acknowledged as a social problem with disastrous health consequences. In 1985, at a workshop, the Surgeon General of the United States identified domestic violence as one of the nation's most important health problems. In January 1992, the Joint Commission on the Accreditation of Healthcare Organizations mandated that all emergency departments and ambulatory care facilities establish written guidelines for the identification, evaluation, management, and referral of adult victims of domestic violence. In June 1992, the American Medical Association published guidelines for identification and intervention of domestic violence victims.1

In September 1994, the American College of Emergency Physicians approved a policy on emergency medicine and domestic violence that states:

• The identification and assessment for domestic violence is an important, specialized part of the evaluation of the emergency patient;

• Emergency medical services, medical school, and emergency medicine residency training programs incorporate training for identification, assessment, and intervention in domestic violence in their curricula;

• A collaborative, interdisciplinary approach with emergency physician leadership should be used to

Collect data on the incidence and extent of domestic violence

Develop clinical and academic research on domestic violence, and

Use this information to detect, diagnose, and intervene with these patients;

• Hospitals develop multidisciplinary approaches including policies and protocols for emergency department identification, treatment, and referral of domestic violence patients;

• The special nature of and the necessary resources for the domestic violence screening evaluation and examination should be recognized. 2

Domestic violence is defined as the use of a pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks, as well as economic coercion, which adults or adolescents use against their intimate partners. The behaviors used include emotional abuse, psychological abuse, intimidation, deprivation, isolation, economic abuse, stalking, and physical and sexual assault. There are multiple, sometimes daily events. Some are criminal acts and some are not; some are physically injurious and some are not; but all are psychologically and emotionally damaging. Domestic violence, then, is about the use of power by one partner to control the other.

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