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Education: Higher Education

Domestic Violence: A History of Reform and Activism in the United States

Class 4: The Medical Community Responds to Domestic Violence

Introduction

Nurses, doctors, and emergency room personnel were often, and still remain, a point of first contact for domestic assault victims. How nurses and physicians studied, shared knowledge, and formed best practices with each other across the nation from the late 1970s to the present reveals a variety of attitudes towards patients who may present with evidence of physical abuse. Nurses Hendrix and Lieberknecht introduce the “battered wife” and offer best practices to their colleagues in a nursing journal. The two articles by physicians reveal very different approaches to the same issue. Drs. Petro, Quann and Graham take a clinical approach while acknowledging inevitable changes in their legal and social responsibilities to their patients. In “Medicine and Patriarchal Violence: The Social Construction of a Private Event,” Drs. Stark, Flitcraft, and Frazier expose and systematically analyze the role of patriarchy in medical practice as it relates to domestic violence. They deconstruct the premise that doctors are helping battered women; instead, they argue that the current prevention and referral protocol actually stabilizes the violent family in ways that “virtually insure women will be abused in systematic and arbitrary ways.” To this day, the article remains challenging, complex, and powerful.

This final class may be followed by a research project on current best practices in hospitals, emergency rooms, and family clinics that are informed by the history of domestic violence. The international and multicultural breadth of research now available makes this a particularly rich field of investigation. This growing and wide array of material addresses domestic violence across cultures, races, communities, and institutions in the medical and social work profession and, as such, it offers an important opportunity for career-relevant, interdisciplinary study for pre-med, medical school and social work students. For the research project, students may be provided a list of the websites, including those used in the module, as well as several from the list of online resources from the “Related Resources at NLM” and “Other Resources” web pages.

Class Resources
Readings
  • Hendrix, Melva Jo, Gretchen E. LaGodna, and Cynthia A. Bohen. “The Battered Wife.” The American Journal of Nursing, vol. 78, no. 4 (1978): 650-653.
  • Lieberknecht, Kay. “Helping the Battered Wife.” The American Journal of Nursing, vol. 78, no. 4 (1978): 654-656.
  • Petro, Jane, Patricia L. Quann, and William P. Graham. “Wife Abuse: The Diagnosis and Its Implications.” Journal of the American Medical Association, vol. 240 (1978): 240-241.
  • Stark, Evan, Ann Flitcraft, and William Frazier. “Medicine and Patriarchal Violence: The Social Construction of a Private Event.” International Journal of Health Services, vol. 9, no. 3 (1979): 461-493.
Film Resources
Discussion Questions
  1. For Hendrix and Lieberknecht: What is the overarching objective of these articles, and how are they related to medical practice, if at all? What conclusions and questions about the intersection of services do these articles reveal? Who are their sources? What impact did the battered women’s movement have on the information the articles use? How would you describe their approach when it came to offering help and resources to battered women?
  2. For Petro, et al: Compare this article to those by Hendrix and Lieberknecht. How do these articles differ in tone and substance? Treating the articles as primary source documents, what language can you identify that asserts notions of authority, privacy, and social norms on the one hand, and empathy, outreach, and assistance on the other? How have both of these approaches influenced the medical response to domestic violence?
  3. For Stark, et al: Assign the entire reading but when class meets, divide students into groups with sections of the article assigned to each group. After small group discussions, have them share with the class as a whole the main points of the section with their questions and comments.
  4. Optional activity for Domestic Violence and Health Care: Best Practices in Action: Watch or read the transcripts of the three interviews with health care providers—Jackie Campbell, Deborah Holbrook, and Colleen Moore. What has changed in the medical profession since the 1970s regarding domestic violence cases that present in the hospital? How do they describe the role of screening, technological advances, and the long-term health impact of domestic abuse?
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