Education And Debate

Routinely asking women about domestic violence in health settings

BMJ 2003; 327 doi: (Published 18 September 2003) Cite this as: BMJ 2003;327:673
  1. Ann Taket, professor of primary health care (,
  2. Jo Nurse, specialist registrar in public health2,
  3. Katrina Smith, epidemiologist3,
  4. Judy Watson, domestic violence project manager4,
  5. Judy Shakespeare, general practitioner5,
  6. Vicky Lavis, part time lecturer in psychology6,
  7. Katie Cosgrove, programmes manager for gender based violence7,
  8. Kate Mulley, policy manager8,
  9. Gene Feder, professor of primary care research and development9
  1. 1Faculty of Health and Social Care, London South Bank University, London SE1 0AA
  2. 2Health Policy Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  3. 3Public Health Directorate, Greenwich Primary Care Trust, London SE10 8QG
  4. 4Crown Prosecution Service Headquarters, MWB Business Exchange, LondonEC4A 2AB
  5. 5Summertown Group Practice, Oxford OX2 7BS
  6. 6University of Huddersfield, Huddersfield HD1 3DH
  7. 7Department of Public Health, Greater Glasgow NHS Board, Dalian House,Glasgow G3 8YU
  8. 8Victim Support, Cranmer House, London SW9 6DZ
  9. 9Department of General Practice, Queen Mary, University of London, London E1 4NS
  1. Correspondence to: A Taket
  • Accepted 14 July 2003

Health professionals are ideally placed to identify domestic violence but cannot do so without training on raising the issue and knowledge of advice and support services

The stigma surrounding domestic violence means that many of those affected are reluctant or do not know how to get help. A systematic review of screening for domestic violence in healthcare settings concluded that although there was insufficient evidence to recommend screening programmes, health services should aim to identify and support women experiencing domestic violence.1 The review highlighted the importance of education and training of clinicians in promoting disclosure of abuse and appropriate responses.1 We argue that a strong case exists for routinely inquiring about partner abuse in many healthcare settings.

Size of problem

Domestic violence includes emotional, sexual, and economic abuse as well as physical violence. The different forms of abuse may occur together or on their own, although always in the context of coercive control by one partner over the other. To reinforce the fact that domestic violence does not necessarily involve physical violence, we prefer the term partner abuse. Abuse can continue after the partners have separated.

Partner abuse occurs in all types of relationships, both same sex and heterosexual.2 Although about one in seven men in the United Kingdom report experiencing physical assault by a current or former partner,3 these incidents are generally less serious than those reported by women, and men are less likely to be injured, frightened, or seek medical care.4 The context and severity of violence by men against women makes domestic violence against women a much larger problem in public health terms.25 Worldwide, 10-50% of women report having been hit or physically assaulted by an intimate partner at some time.w1 In the United Kingdom, 23% of women aged 16-59 have been …

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