last updated February 1, 2006

Health care systems can be an important part of a coordinated, community-wide effort to combat domestic violence. Many battered women do not contact advocacy organizations, shelters, police or prosecutors, or do not do so until the abuse has become quite serious and life-threatening. Women often continue, however, to seek emergency and routine medical care for themselves and their children. In fact, medical assistance may be required more frequently because of the health effects of abuse on women and children. Mental health professionals may see women suffering from anxiety, post-traumatic stress disorder, and depression, all of which might be linked to domestic violence. Health care professionals—whether pediatricians, general practitioners, dentists, nurses or emergency room physicians—can thus provide needed assistance to women who may not seek other types of help, or may be able to intervene earlier than can advocates or agencies.

Doctors and other health care providers can assist victims of domestic violence in many ways. Health care workers can assist victims of violence by (1) avoiding victim-blaming behavior that can reinforce a victim's isolation and undermine her self-confidence, (2) conducting both individualized and general screening (i.e., watching for signs of abuse in individual patients and asking all patients about violence in their lives), (3) documenting injuries and details of the abuse, (4) referring patients to resources in the community, and (5) maintaining patient privacy and confidentiality. From World Health Organization, Violence Against Women: What Health Workers Can Do. In addition, doctors are often respected members of the community; their involvement in efforts to end domestic violence can contribute significantly to raising awareness about the issue and to efforts to eliminate the abuse.

Advocates have also worked together with health care providers to establish "one-stop" victim assistance centers in hospitals. The Special Rapporteur has cited as a "best practice," for example, the Hospital-Assisted Crisis Intervention to Women Survivors of Violence Environments (HAVEN) in the Philippines. HAVEN "provides medical and legal services and serves as a drop-in centre for victims of violence against women." Women can be connected with a variety of services at HAVEN, including housing, counseling, and legal and financial assistance. Also cited as a "best practice" is the Pan American Health Organization's initiative in Latin American to locate initial detection points in health services and to sensitize and involve men through programs focused on reproductive health. From Addendum 1 to the Special Rapporteur's 2003 Report, International, regional and national developments in the area of violence against women 1994-2003, 2162 (E/CN.4/2003/75/Add.1) (27 February 2003).

In the CEE/FSU region, access to court systems either requires or heavily depends upon formal forensic medical certificates to prove domestic violence. According to such systems, forensic doctors examine a woman and document her injuries with a certificate. The certificate indicates the seriousness of the injury and the category of assault that applies. From Cheryl Thomas, Domestic Violence, in 1 Women and International Human Rights Law 219, 225 (Kelly D. Askin & Dorean M. Koenig eds., 1999). One of the many problems associated with forensic medical systems is that since the institutions exist for the purpose of providing documentation for court proceedings, their primary focus is not the best medical care and treatment of domestic violence victims. Women seeking treatment for their injuries may be confused and misled by the process and may never receive adequate medical care. Domestic violence advocates should be aware of the hurdles presented to domestic violence victims by the forensic medical system.

The Family Violence Prevention Fund (FVPF), a U.S.-based NGO, provides a Fact Sheet containing additional information on the health care system's response to domestic violence, an online newsletter, Health Alert on current issues, and information packets on health care issues that can be ordered on-line.

For links to research and reports on the role of health care providers, click here. Also, see the 2008 United Nations expert group report entitled "Good practices in legislation on violence against women" Section 6 on protection, support and assistance to survivors of violence against women. For the Russian version of the recommendations of "Good practices in legislation on violence against women," click here.