More than Reporting Requirements Needed to Address Domestic Violence

“She worked at a hospital, why didn’t anyone report the abuse?” I heard that question all day on March 9, 2017, the day Kelly Pease, a nursing student and victim of domestic violence, was found murdered in the Kootenai Medical Center parking lot.  The unspoken belief seemed to be that if only someone had reported the domestic violence perpetrated on Kelly by her fiancé, Steven Denson, then Kelly would still be alive.

The truth is that Kelly’s abuse was reported.  There was a documented history of domestic violence between Steven and Kelly, culminating in an altercation that involved law enforcement in January where Steven wrapped both his hands around Kelly’s throat and left marks on her wrists, neck, stomach, and chest.  The further truth is that reporting isn’t enough to address the pervasive problem that is domestic violence.

Idaho, along with forty-three other states, enacted legislation that requires mandatory reporting of domestic violence by health care providers.  Idaho’s law, Idaho Code § 39-1390, requires any person operating a hospital or other medical treatment facility or any physician, resident on a hospital staff, intern, physician assistant, nurse, or emergency medical technician to notify local law enforcement upon the treatment of or request for treatment of a person when the reporting person has reason to believe that the person treated or requesting treatment has received any injury inflicted by means of a firearm or any injury indicating that the person may be a victim of a criminal offense.  The report to law enforcement must include the name and address of the injured person, the character and extent of the person’s injuries, and the medical basis for making the report.

While shedding light on domestic violence is an incredibly important part of responding to the nation-wide problem, legislation like that enacted in Idaho is not a solution to domestic violence.  A law requiring only the reporting of suspected domestic violence does nothing more than remove the closed doors from behind which the violence is hiding.  Which, while a crucial piece of creating an answer to domestic violence, does not ensure patient safety.  In fact, requiring medical providers to report suspected abuse places the patient at risk of a retaliatory attack.  Further, knowing that their medical providers are required to report injuries that are suspected to be the result of domestic violence may cause many abused partners to refrain from seeking medical treatment altogether.

Rather than only reporting, medical providers should be provided education in domestic violence and become knowledgeable about barriers to leaving relationships filled with domestic violence and resources to help people address those barriers.  Children, finances, housing, employment, social support, and emotional health all add additional layers to an abusive relationship.  A blind, report-only requirement doesn’t take any of these extras into consideration.

Required reporting may be necessary to fully address the problem, but reporting alone is not a solution.  Not only does it undermine a patient’s trust in their medical provider and place him or her at risk for retaliation by the abuser, but it also strips the patient of their autonomy and removes the ability for them to make critical life decisions.  Incorporating education about domestic violence and resources available to those living in these situations will prepare medical providers to help their patients make positive choices without removing the patient’s control over their own life.

If anything can be learned from the tragedy that took place on March 9, 2017, it’s that reporting is just not enough.  It does not protect people from continuing abuse and it does not address the barriers to leaving a relationship filled with domestic violence.  In order to really protect the people suffering from domestic violence, there has to be more.

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