Theory, Research and Policy on Criminology

Theory, Research and Policy on Criminology

Introduction

A policy of universal and regular inquiry for intimate partner violence in child health settings presents dilemmas to the providers who assess that may not exist when assessing patients in an adult health setting. Perhaps the fundamental difference lies in the fact that adults are not the primary patients during pediatric visits. This section reviews several major dilemmas and provides specific recommendations for responding. Because these dilemmas present challenging practice and ethical questions for the provider, this panel strongly recommends that child health practices have access to legal consultation, as well as consultation from battered women's service providers, child protection and child mental health. These resources can be helpful in making decisions about how to intervene in ways that do not increase risk for the family or unnecessarily alienate the non-offending parent.

Because of the high rate of co-occurrence of intimate partner violence and child abuse, child health providers need to be concerned about the possibility of child abuse whenever intimate partner violence is disclosed. Whenever a child is abused, either intentionally or unintentionally, as a result of intimate partner violence, state law requires health care providers to report this abuse to child protection services. Mandated reporters would also report any high-risk situation of intimate partner violence in which children are at risk. However, state laws are less clear about whether exposure to domestic violence in the absence of injury or serious risk of injury to the child would require a report to children's protective services.

Analysis

In some states, stringent rules/laws require mandated reporters to notify child protection services whenever a child is in the home and has been exposed to a parent's abuse, whether or not the child has been directly abused. Proponents of this definition point to the ample documentation of the overlap between adult intimate partner violence and child abuse and the adverse psychological effects on children who witness intimate partner violence. Opponents of this policy believe it penalizes women for abuse that they have no control over and may discourage women from seeking help.

In other states, a child's exposure to intimate partner violence does not automatically require a mandatory child protection report. The provider has wider discretion to assess whether a child has been directly involved and what other factors may exist to put the child at risk. In these states, a provider would take into account the existence of direct injury to a child, the potential danger of the situation, and the capacity of the mother to keep her children safe in deciding whether to notify Child Protective Services (CPS).

Many victim advocates recommend having the victim place a phone call themselves to CPS from the practitioner's office, thus protecting her from charges of "failure to protect" while simultaneously protecting the child and meeting statutory child abuse reporting laws. Unless a child health care provider is legally required to report all incidences of intimate partner violence to CPS, it is preferable to make this decision based on the specifics ...