Addressing Domestic and Family Violence: Healthcare Professionals’ Role and Responsibilities

This article was exclusively written for The European Sting by Ms. Sadia Khalid, a dedicated professional with an extensive academic background, holding an MBBS and an MD degree. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Worldwide, approximately 736 million women, which accounts for nearly one-third of women aged 15 and older, have experienced physical and/or sexual violence from an intimate partner, non-partner sexual violence, or both, at least once in their lives. It’s important to note that this statistic does not encompass instances of sexual harassment. Domestic and family violence is a pervasive issue in the United States, affecting an estimated 10 million people annually. Shockingly, as many as one in four women and one in nine men become victims of domestic violence. Statistic Estonia conducted a Largest and most comprehensive relationship survey and results were published in October. The survey results reveal that 41% of women have experienced intimate partner violence in their lifetime. Specifically, 39% encountered psychological violence, 13% faced physical violence (including threats), and 9% experienced sexual violence. Among men, 33% reported intimate partner violence, with 32% citing psychological violence, 8% physical violence, and 1% sexual violence. Notably, younger individuals (18-29) are more likely to have experienced violence, while older age groups (65-74) are less affected. Interestingly, factors such as daily activities, education, and location don’t significantly impact men’s likelihood of experiencing intimate partner violence, suggesting a generational shift in defining such violence.This problem transcends cultural, racial, religious, and socioeconomic boundaries. In response, healthcare professionals are often the first line of defence in identifying and assisting victims of domestic and family violence. This article explores the importance of recognizing and addressing this issue, emphasizing the role of team-based interprofessional care for victims.

Understanding Domestic and Family Violence:

Domestic and family violence encompasses various forms of abuse, including economic, physical, sexual, emotional, and psychological maltreatment, affecting children, adults, and elders. The consequences of such violence are severe, leading to worsened psychological and physical health, reduced quality of life, decreased productivity, and, in tragic cases, mortality.

It’s crucial to recognize that domestic violence is not limited to physical abuse; it also encompasses emotional, psychological, sexual, and economic abuse. Often, victims suffer in silence, and many cases go unreported to health professionals or legal authorities.

Identification of Domestic Violence:

Identifying domestic and family violence can be challenging, especially when victims are frightened or reluctant to disclose their experiences. To address this, healthcare professionals should establish an assessment protocol and maintain an awareness of the possibility that domestic violence may underlie a patient’s signs and symptoms.

Screening for domestic violence is essential, and healthcare professionals from various disciplines, including nurses, physicians, physician assistants, dentists, nurse practitioners, and pharmacists, should routinely conduct screenings. Interprofessional coordination in screening is vital for protecting victims and mitigating negative health outcomes.

Documenting and Reporting:

Documentation is a legal obligation in cases of suspected domestic violence. Healthcare professionals must document all findings and recommendations in the patient’s medical record, including statements made by the patient denying abuse. If domestic violence is admitted, the documentation should be comprehensive, including the patient’s history, physical examination findings, any interventions, referrals made, and, where applicable, photographic evidence.Since the medical record may become a legal document, it’s essential to maintain objectivity and accuracy. The patient should be offered a follow-up appointment, and assurance that additional assistance is available at any time is critical to protect the patient and break the cycle of abuse.

Collaboration and Resources:

Interprofessional collaboration is key to addressing domestic violence effectively. Involving social workers early in the process can provide crucial support for victims. Patients should not be discharged until a haven has been established, ensuring their protection.

Several national resources are available to aid victims, and healthcare professionals should be aware of these organizations. For example, in USA, the Centres for Disease Control and Prevention (CDC), Childhelp, Corporate Alliance to End Partner Violence, Futures without Violence, Love Is Respect, and many more. In Estonia, there are several domestic violence aid services and non-governmental organizations (NGOs) dedicated to supporting victims and addressing the issue of domestic violence. Here are some of the prominent ones:

1.Estonian Women’s Shelters Union (Eesti Naiste Varjupaikade Liit):

    The Estonian Women’s Shelters Union is an umbrella organization that coordinates the activities of women’s shelters across Estonia. They provide a haven for women and their children who are fleeing domestic violence and offer support, counselling, and legal assistance.

2. Victim Support Estonia (Ohvriabi):

   Victim Support Estonia aids, counselling, and legal support to victims of crime, including domestic violence. They aim to ensure that victims are aware of their rights and receive the necessary help and protection.

3. The Estonian Union for Child Welfare (Eesti Lastekaitse Liit):

This organization focuses on the well-being of children in Estonia. They work to prevent child abuse and neglect, which can be related to domestic violence, and provide resources and support to children in need.

4. The Estonian Women’s Studies and Resource Centre (ENUT):

ENUT is an NGO that conducts research and advocacy on gender-related issues, including domestic violence. They also offer support and information to victims and survivors.

5. Estonian Sexual Health Association (Eesti Seksuaaltervise Liit):

This organization focuses on sexual health and relationships and provides resources and counselling for individuals facing domestic violence and sexual abuse.

6. The Estonian Women’s Studies and Resource Centre (Tartu Naiskonna Seltsi naiste varjupaik):

  Located in Tartu, this women’s shelter provides refuge and support to women and children escaping domestic violence in the region.

7. The Estonian Human Rights Centre (Eesti Inimõiguste Keskus):

 While not solely focused on domestic violence, the Estonian Human Rights Centre works on a range of human rights issues, including gender equality and violence prevention.

Healthcare providers should offer information and referrals to these resources, and they must be aware of federal and state statutes governing domestic and family abuse.

The Legal and Ethical Responsibilities:Healthcare professionals should educate patients about the legal obligations and potential consequences of reporting domestic violence. Patients should be informed about how local authorities typically respond to such reports, follow-up procedures, and the availability of emergency protective orders in every state.

The clinical role in managing an abused patient goes beyond obeying the laws that mandate reporting; there is a primary obligation to protect the life of the patient. In cases where the patient’s safety is at risk, clinicians should work closely with the patient and authorities to ensure the patient’s well-being.

Domestic and family violence is a pervasive issue that affects countless individuals in the world. Healthcare professionals play a crucial role in identifying and assisting victims. By establishing assessment protocols, collaborating interprofessional, documenting cases, and providing information about resources and legal obligations, healthcare professionals can make a significant impact in addressing this deeply troubling issue. It is only through collective efforts that we can effectively combat domestic and family violence and protect those who are most vulnerable.Please note that the availability of services and contact information provided above may change over time, so it’s a good idea to visit the websites or contact these organizations directly for the most up-to-date information and support for domestic violence victims in Estonia. 

If you or someone you know is in immediate danger or needs urgent assistance, please contact the emergency services in Estonia by dialling 112. 

If you need advice and support, call the 24-hour Victim Support Helpline on 116 006.

About the author

Sadia Khalid is a dedicated professional with an extensive academic background, holding an MBBS and an MD degree. She is an Early-stage Researcher (ESR), accomplished Medical Writer, and Research Engineer based at Tallinn University of Technology (TalTech) in Estonia. Sadia’s research interests span a wide spectrum within the realm of medical sciences, including Molecular Medicine, Cell Biology, Infectious Diseases, Bacteriology, Hepatology, and Gastroenterology. Her work is underpinned by a strong belief in the mission of promoting public health, safety, and awareness.