Chapter 6
The Physician’s Duty in Domestic Violence

Most physicians will encounter cases of domestic abuse in their practices. They must be aware of their obligations in these cases, as well as their potential liability for failing to diagnose and/or report domestic abuse. In general, doing what is medically best or most appropriate is good risk management. If an injured person is treated by a physician who does not inquire about abuse or who accepts an unlikely explanation of the injuries and then the victim returns to the abusive situation and undergoes further injury, the physician could be held liable for the subsequent injuries.

Thus, physicians must be willing to ask all suspected victims about abuse, and should know how to diagnose it. Failure to conduct the interview and examination apart from the suspected victim’s spouse or partner may interfere with an accurate diagnosis.

Physicians also should be aware of certain "red flags" that can signal particularly dangerous situations for the victim: stalking behavior by the abuser, substance abuse by the abuser, and threats of suicide by the abuser (increased risk for a murder/suicide). Thus, physicians need to be aware of local resources to make appropriate referrals and to advocate for expanded resources.

In states that have enacted mandatory reporting statutes, a physician’s failure to report could give rise to liability, but since reporting laws rarely explicitly give victims such a right to sue, courts must determine whether their state statutes implicitly contain that right. Criminal reporting statutes usually are enacted to inform the police to occurrence of crimes rather than to protect victims of violence. In contrast, child abuse report statutes are usually enacted with the clear purpose of protecting abused children, and some to sue physicians who violate a reporting statute. If a state has a specific domestic violence reporting statute, courts may be more likely to allow a suit against a physician who failed to report the abuse.

Many states recognize a legal duty that physicians have toward third parties that might be harmed by their patients. In those states, if a physician is aware of a patient’s intent to harm a third party, such as the patient's spouse or partner, the physician may have a legal duty to break the patient’s confidence and to warn the third party of the impending danger. Physicians, especially therapists, should know the law where they practice.

Reporting Requirement for Domestic Violence in Florida

Child Abuse

Chapter 39 of the Florida Statutes mandates that any person who knows, or has reasonable cause to suspect, that a child is abused, abandoned, or neglected by a parent, legal custodian, caregiver, or other person responsible for the child's welfare shall report immediately such knowledge or suspicion to the central abuse hotline of the Department of Children and Families.

All health care professionals are required to provide their name to the Hotline staff. The name of the person reporting shall be entered into the record of the report but shall be held confidential as provided in s.39.202, F.S.
[s.39.201(2)(c), F.S.]
 

The name of any person reporting child abuse, abandonment, or neglect may not be released to any person other than employees of the department responsible for child protective services, the central abuse hotline, law enforcement, or the appropriate state attorney, without the written consent of the person reporting. This does not prohibit the subpoenaing of a person reporting child abuse, abandonment, or neglect when deemed necessary by the court, the state attorney, or the department, provided the fact that such person made the report is not disclosed. [s. 39.202(4), F.S.]

You should be prepared to describe:

Intimate Partner Abuse

Florida statute 790.24 requires health care providers to report gunshot or life threatening wounds or injuries. Obviously, this does not cover the majority of injuries sustained in IPV. However, reporting suspected domestic violence without the informed consent of the woman is unethical and may cause the abuser to retaliate.

Elder Abuse

Florida statute requires that all health professionals, including employees of long term care facilities, are required to report known or suspected cases of elder abuse.

 

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