Doctors and spousal assault victims: prevention or perpetuation of the cycle of violence

Criminology Research Council grant ; (34/88)

Literature from overseas indicates that physicians frequently fail to identify battering as the aetiology of patients' physical injuries and / or psychosocial symptoms such as depression or anxiety. Blaming the victim and lack of sympathy have been reported in victim surveys both abroad and in Australia. The present research examines the attitudes that doctors in the ACT hold concerning the causes of wife battering; the reasons that they suspect it has occurred; the role that they believe physicians should play; and some beliefs about bashers and victims. The study also describes the experiences of a sample of battered women/patients and their perception of the care that they received.

The report states that many of the surveyed victims passed through doctors' offices and / or casualty units without initial or ultimate disclosure, and observes that this is particularly alarming if one considers that all of the women were seeking medical attention for physical injuries. Prior research shows that quite often this is not the case; the emotional by-products of domestic violence are frequently the presenting problem. Yet only about one-third of the general practitioners (GPs) identified emotional problems as symptoms they look for in determining assault cases.

Doctors' responses frequently contradicted the recollections of the victims. For example almost three-quarters of the GPs agree that doctors should query a patient if battering is suspected. Since it does not appear that this in fact takes place, respondents may be stating an ideal or they are simply not identifying the symptoms.

Further contradictions include use of tranquillisers and the question of physicians' helpfulness and sympathy. Eighty-three per cent of the GPs whom victims had seen prescribed tranquillisers. However, half of the GP sample disagreed with dispensing such medication in this type of case. Practitioners' responses do indicate sympathy toward battered women patients although more than one-third are unsure about or agree with a statement that victims provoke the bashers to violence. Victims evaluate the doctors as close to 'poor' on both the sympathy and helpfulness variables and cite many instances of blaming-type statements or behaviour.

The report states that few doctors received average scores and are perceived either as 'excellent or terrible'. The study concludes that this dichotomy may in fact be a reflection of real attitudinal differences in the practitioner population rooted in gender and length of service. Females do appear to be more attuned to the emotional symptoms of abuse and tend to hold other supportive beliefs. Those who have worked longer than seventeen years are significantly more conservative.

Only a small proportion of the doctors had received any training about domestic violence. Many of their comments are indicative of a lack of knowledge concerning the cycle of violence. It appears that in Australia, as abroad, a high percentage of doctors are not being trained to recognise wife battering symptomology nor to perceive their role as interventionist. This is particularly unfortunate given the indication that at least in the ACT, GPs are often the first and only professionals turned to by battered women. The obvious potential for diagnosis, prevention and treatment is not, in many cases, enacted or developed. The result for many of the victims in this research has been increased feelings of guilt and blame and the perpetuation of violence.