Domestic Violence

Domestic violence remains a major health concern in Canada.

Its effects are seen in all areas of health care, and physicians clearly have a role to play in detecting and supporting victims of domestic violence. Guidelines on dealing with this problem have been developed by professional organizations across the country.

Most of the literature on domestic violence deals with situations in which the perpetrator is male and the victim female. It should always be remembered that abuse can occur within same-sex relationships and that males can also be victims of abuse. Domestic violence can occur at any age as well. For the purpose of this presentation, we are focusing on woman abuse.

What is Woman Abuse?

“any act as gender-based violence that results in or is likely to result in physical, sexual or psychological harm or suffering to women including threats of such acts, coercion or arbitrary deprivation of liberty whether occurring in public or private life.”

(Declaration on the Elimination of Violence Against Women, Proceedings of the United Nations General Assembly, 85th Meeting in Geneva, Dec.20/93 in Task Force.London p.9)
Based on the abuser’s need for power and control.

Domestic violence results in significant health related costs.

In Canada the estimated health related cost of violence perpetrated against women is $1.5 billion per year; this includes $225 million in medical consultations and $506 million in short and long term psychiatric care.

The prevalence of abuse is so high that most health professionals, especially physicians are likely to see or treat cases, regardless of the nature of their practice.

Surveying to assess the incidence of abuse is imperfect; however, in a Statistics Canada survey of 12,300 women over the age of 18:

1. 30% reported having been assaulted by their male partner at least once 
2. almost 20% more than once 
3. almost 10% more than 10 times.(2)

A 1997 report on homicides in Canada showed that 78% of all spousal homicide victims were women.(4)

It is frequently stated that domestic violence is exaggerated and that where it does occur the degree of violence is overstated.

The most prevalent forms of violence reported by women are:

1. Pushing, grabbing and shoving in approximately 25% of cases 
2. 44% of women report use of a weapon against them-36% of these stated that the weapon used was a gun or a knife 
3. 1/3 of women reporting abuse said they had feared for their lives.² 
4. The likelihood of a physician detecting abuse has been poor, as demonstrated in many studies. Of all health professionals physicians are in the best position to enquire about the experience of domestic violence

It is hoped that intensive educational efforts will make it less likely that:

1. 25% of abused women will seek health care at least 11 times for trauma before disclosing abuse. 
2. 23% will make 6-10 independent visits to MD’s for abuse related injuries.⁷

Myths of Abuse

Violence against women has been with us since recorded time and has been condoned throughout history. There are references to violence against women in Greek History and in the Bible. British Common Law that permitted a husband to ‘chastise his with a whip or rattan no wider than his thumb.” In order to empower abused women, we need to dispel the myths of abuse that have kept it in the dark for so long. Wife assault, including sexual assault, is a crime.

In Canada, it wasn’t until 1968 that the federal Divorce Act was passed, that physical and mental cruelty became grounds for divorce. The statute defining sexual abuse by a partner is only a few years old.

Myth: Abuse is not a widespread problem.
Fact: Ten percent of Canadian women live with an abusive partner.

Myth: An abusive act is usually a one -time event.
Fact: Most women will have suffered multiple abusive episodes before the abuse is
disclosed.

Myth: Injuries are usually not serious.
Fact: Twenty percent of all homicides in Canada are domestic. Twenty- five percent of
women who have attempt suicide are abused.

Myth: Alcohol is the cause of the abuse.
Fact: Alcohol can make it easier for a man to be violent. But the real cause of wife assault
is the batterer’s desire for power and control over his partner. Treating the alcoholism
does not end the abuse.

Myth: Women are responsible for the violence.
Fact: No woman EVER deserves to be beaten. Violent behavior is the responsibility of
the perpetrator.

Myth: Men who abuse their partners are mentally ill.
Fact: Wife assault is too widespread to be caused by mental illness. Men who assault their partners are not violent outside the home.