Tuesday, January 22, 2013

National task force: all women of child-bearing years, not men, should be screened by their physicians for domestic violence, even if there is no evidence of abuse

Roughly one-third of women and one-quarter of men purportedly report experiencing some form of domestic violence, also referred to as inter-partner violence, during their lifetimes. A national task force recommends that women of child-bearing years -- but not men of any age or any other group -- should be screened for domestic violence by their physicians.

"Although abuse of men, abuse of middle-aged women and abuse and neglect of elderly and vulnerable (physically or mentally dysfunctional) adults can have equally devastating consequences as IPV among younger women, there is currently not enough evidence about how primary care clinicians can effectively screen and intervene," the task force said Monday. (It is not clear why men and the other groups could not be screened the same way young women are screened.)

Aside from physical abuse, domestic violence includes emotional abuse and economic deprivation.

The task force isn't clear about what should be done if abuse is identified. The response might mirror the child abuse laws:  in all states, clinicians who suspect abuse or neglect are required by law to file a report with child welfare offices.

If the task force's recommendation is accepted, this would be the new reality for young men: if your wife or girlfriend is of child-bearing years, on her annual visit to her physician for a routine check-up, regardless of whether there is any evidence whatsoever to suspect abuse, she will be questioned about whether you are a criminal. The way the questions are posed, the way she answers, and the the way her answers are interpreted could be important in determining whether you are reported to law enforcement authorities as a domestic abuser. It is unlikely that the law would allow a report of domestic abuse to be ignored or treated lightly; such a report likely would play a significant role in determining the state's action against you, which could include a protection from abuse order and even arrest. Once the recommendation is instituted as law, physicians will err on the side of reporting to keep themselves out of trouble for not reporting.

The logical follow-up is this: why protect only women who have annual physical check-ups? Women who don't routinely see their doctors are every bit as vulnerable to abuse by their male companions, probably more so. Why not just cut to the chase and institute annual police visits to every home where young men and women reside together?  Two police officers, a male and a female, could go door to door, unannounced. The male officer would restrain the young man in one room of the house while the female officer gently questions the woman in another room to ascertain if the male is abusive to her. 

I know what some of my progressive friends are thinking: my suggestion is absurd because the Fourth Amendment protects against unreasonable searches and seizures without probable cause in order to protect privacy interests. Police aren't allowed to randomly wiretap homes to fish for evidence they can use against someone, so this door-to-door practice certainly wouldn't be permitted.

They are right. What on earth was I thinking? To skirt the "probable cause" requirement, the solution is the one the task force has recommended: instead of having the police do the questioning, we'll mandate that women's physicians fish for evidence to be used against husbands and boyfriends even if they don't suspect abuse. The physicians can pass along to the police anything they uncover that's juicy or that might help to get the male in trouble. Isn't that brilliant? This way, we can invade the privacy interests of young men all day long and not feel bad about it!

http://www.cnn.com/2013/01/21/health/task-force-violence/