NCJ Number
143971
Date Published
1993
Length
13 pages
Annotation
This analysis of medical records of women whose injuries suggested abuse concluded that the structural constraints of a busy urban emergency room in a training institution led not only to nondetection and nonintervention in abuse but also to a lack of receptiveness and response by health care providers to the issues with which battered women struggle.
Abstract
The research was conducted at a large public hospital that served a low-income population that was mainly black and Hispanic. The study first focused on all emergency room charts for women during a 2-week period in August and September 1987. The analysis focused on the use of language, the impact of the medical model, and the responses of the women in the 52 cases in which the women were deliberately injured by another person. A majority of these women gave very strong clues about being at risk for abuse; these clues were recorded but were generally avoided, even though the emergency room had a formal protocol for recognizing and caring for women at risk of abuse. Nurses and physicians did not differ in their recording of explicit information of abuse. However, both nurses and doctors used indirect means to deal with battered women. Nurses reported cases to the police, satisfying their legal obligations; physicians prescribed pain medications, satisfying their medical obligations. Few medical staff were able to ask the direct questions that would have led to more appropriate and comprehensive interventions. Findings indicated that medicine's epistemological model of care recreates abusive relationships through a medical encounter in which what is most significant is not seen. 39 references