This blog post is a writing assignment for HIMT 1200: Legal Aspects of Healthcare, part of the Health Information Management Technology (HI13) Associate of Applied Science Degree program at Georgia Northwestern Technical College.
Domestic violence against women is a serious public health issue. This topic affects 25% of the population, yet only between 2.5% and 15% of affected people report the problem. Victims have a variety of reasons not to report or seek help, including fear, embarrassment, economic dependency, victim-blaming, family privacy, and an imbalance of power between the sexes (Garcia, 2004).
State law requires care providers to report specific categories of patients to law enforcement or governmental authorities. Neglected or injured people are the largest group of such patients. Care providers follow these policies to report child and elder abuse. Most resources on child and elder abuse take the stance that reporting incidents improve safety for these individuals, but this theory is not tested. All states require care providers to report child abuse, and the majority of states require elder abuse to be reported. Mandatory reporting (MR) of injuries in these populations seems logical to decrease the risk of injury or death (Sachs, 2007).
Most states also require care providers to report any patient with injuries caused by a firearm or other weapon. A significant number of states’ requirements also include sexual assaults, additional severe injuries, and injuries caused by a criminal act. Every state considers injuries in intimate partner violence (IPV) to be criminal acts, so such incidents are required to be reported according to most state assault reporting laws (Sachs, 2007).
Adverse outcomes of mandatory reporting include injured patients avoiding medical attention. Abused women may fear the involvement of law enforcement, making their abuser more angry or aggressive. Going against the patient’s wishes and reporting the incident against their will violates the patient’s confidentiality and makes them feel more vulnerable and weak. The American Medical Association and the American College of Emergency Medicine do not approve of required intimate partner violence (IPV) reporting (Sachs, 2007).
No substantial proof exists to support mandatory reporting improving abusive situations or endangering the victims. Mandatory reporting enhances the detection of other abuse types. Surveys results questioning victim advocates and battered women focus groups show uncertainty regarding reporting intimate partner violence (IPV). Just under half of the victims surveyed had concerns that reporting would make their partner angrier (Sachs, 2007).
Positive outcomes of mandatory reporting also exist. Reporting improves detection and the documentation of injuries caused by abuse which might assist in pairing victims to the appropriate service needed. Since intimate partner violence (IPV) is criminal activity, reporting can improve safety through access to restraining orders and quick arrests (Sachs, 2007).
No substantial evidence exists to support or reject mandatory reporting. It seems that reporting should be allowed but not a required duty. Care providers can use their judgment as to which action would best benefit the situation. It could be beneficial either way, but victims have fears and concerns and want their privacy protected. Also, victims will usually hide the abuse, so the provider will need to be astute and make sure he is correct if the victim is not cooperative.
Gracia, E. (2004, June 11). Unreported cases of domestic violence against women: towards an epidemiology of social silence, tolerance, and inhibition. Journal of Epidemiology & Community Health. https://jech.bmj.com/content/58/7/536
Hammaker, D. K. (2020). Health Records and the Law. (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Sachs, C. J. (2007, Dec.). Mandatory Reporting of Injuries Inflicted by Intimate Partner Violence. AMA Journal of Ethics. https://journalofethics.ama-assn.org/article/mandatory-reporting-injuries-inflicted-intimate-partner-violence/2007-12
Assignment 9.1 - Amy Haisten
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