Domestic Violence

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Domestic Violence in America Domestic abuse in the United States is a large-scale and complex social and health problem. The family is perhaps the most violent group, with the home being the most violent American institution or setting today (Lay, 1994). Sadly enough, the majority of people who are murdered are not likely killed by a stranger during a hold-up or similar crime but are killed by someone they know. Not surprisingly, the Center for Disease Control and prevention has identified interpersonal violence as a major public health problem (Velson-Friedrich, 1994). Current estimates suggest that three to four million women are the victims of physical abuse by their intimate partners (Harris & Cook, 1994). According to the FBI, some form of domestic violence occurs in half of the homes in the United States at least once a year (Dickstein, 1988). In reality one out of every six marriages the wife is physically abused. Every fifteen seconds a women is battered in the United States. Daily, four American women lose their lives to their husbands or boyfriends, equaling more than one-third of all female homicide victims (WAC, 1994). These numbers report that too much violence is directed toward women. Historically, domestic violence has been a downplayed and, oftentimes, culturally condoned, American tradition. In the colonial period, laws derived from English common-law permitted a man to beat his wife when she acted in a manner that he believed to be inappropriate. For example, the so-called "Rule of Thumb" law, which permitted a husband to beat his wife with a stick that could be no larger than the circumference of his thumb, was in effect until the end of the nineteenth century (Dickstein, 1988). The issue of domestic violence, especially wife abuse, first gained national attention in 1974 with the publishing of Scream Quietly or the Neighbors Will Hear by Erin Pizzey, the founder of Chiswick's Women's Aid, a shelter in England for battered women. Pizzey's work helped to stimulate feminist concern and outrage over wife beating, verbal abuse, financial restrictions and social isolation of women by their husbands (Utech, 1994). Shortly thereafter, the women's liberation movement, through the National Organization for Women (NOW), advocated for the end of violence against women and sought improved social services for battered wives. NOW also was actively engaged in promoting shelter homes and lobbying congressional leaders for legislation that would result in better treatment and protection of women's health and well-being (Utech, 1994). The medical profession was greatly affected by the advocacy of the women's liberation movement and has, in recent years, attempted to combat this social ill both by itself and in coordination with the legal and social service professions. For example, beginning in 1992, the Joint Commission on the Accreditation of Health Care Organizations, required that all accredited hospitals implement policies and procedures for identifying, treating and referring victims of abuse (Mason, 1993). This included in-service training programs for staff members of their emergency departments and ambulatory care facilities (Mason, 1993). In 1994, 83 organizations, including the American Nurses' Association and the American Bar Association, met to identify gaps and barriers between the health care delivery and criminal justice systems in dealing with family violence cases. Among their recommendations were the following: a mechanism for community professional coordination in assessment to maximize family safety; the creation of community-based family violence coordination councils; and the need to establish, in every community, a comprehensive, culturally sensitive, and accessible intervention system for family violence that links health, justice, mental health, social service, and educational systems (Stanley, 1994). In addition, the American Medical Association (AMA) published guidelines for Health care...
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