News Release

Mandatory Reporting Of Domestic Violence Cases To Police Has Mixed Support From California Physicians

Peer-Reviewed Publication

University of California - San Francisco

A study of California physicians shows the majority has mixed feelings about a state law requiring suspected cases of domestic violence to be reported to authorities.

While some believe legislation improves a physician's response to providing care, many also note that mandatory reporting requires physicians to violate patient confidentiality, which could deter many patients from seeking care or could jeopardize patient safety.

"We conducted this study because intimate partner violence is a problem of high priority in the health care and legal communities. However, the California reporting law, enacted in 1994, has remained controversial," said study director Michael Rodriguez, M.D., M.P.H., a UC San Francisco assistant professor of family and community medicine who treats patients at San Francisco General Hospital Medical Center.

California is one of six states--including Colorado, Kentucky, New Hampshire, New Mexico, and Rhode Island--with specific laws on reporting suspected cases of intimate partner violence.

While most of these states have provisions for protecting victim identity, obtaining informed consent, or reporting to social service agencies, the California law requires that identification information be reported to police regardless of patient consent.

There has been no evaluation of the impact of the California mandatory reporting law on domestic violence victims, and these study results are not encouraging, according to Rodriguez. "The findings support the concern that this law violates basic tenets of medical ethics and may create barriers to health care for victims. There is a serious need for research into how the law impacts abuse victims in their daily lives. When dealing with people's lives, we need to avoid circumstances where well-intentioned laws do more harm than good," he said.

Research results are published in the April issue of the American Journal of Public Health.

The UCSF study randomly surveyed 508 California physicians from four specialties: emergency medicine, family medicine, internal medicine, and obstetrics/gynecology. All were members of the California Medical Association. The age range was 29-83 years.

Study results showed:

  • Of the four specialties, emergency medicine physicians showed significantly greater awareness of mandatory reporting legislation and experience in identifying a patient who was a victim of domestic partner abuse.
  • About half (59 percent) of study physicians reported that they might not comply with the reporting law if a patient objected.
  • Primary care providers reported higher rates than emergency physicians of noncompliance with the law in any situation in which a patient objected. (Emergency physicians, 25 percent, family physicians, 57 percent; internists, 67 percent; and ob/gyns, 67 percent)
  • A majority of physicians in each specialty agreed that reporting legislation creates possible barriers to care (60-79 percent), can escalate violence or abuse (53-82 percent), and violates confidentiality (59-85 percent).
  • On the positive side, most physicians thought the law improves collection of useful statistics (77-86 percent), the prosecution of perpetrators (72-87 percent), and physician responsiveness to treatment (53-73 percent).
  • More than 90 percent of physicians in each specialty said the following circumstances require reporting to police regardless of the law: extreme abuse, immediate threats to the patient's safety, and involvement of children or guns. Based on these findings, the study team noted that by infringing on the patient-provider relationship, the law may inadvertently discourage patients from discussing their abuse and thus preclude them from receiving referrals and support.
Study co-investigators are Heidi Bauer, M.D., M.P.H.; Kevin Grumbach, M.D.; and Valentine Parades, M.D., M.P.H., of the UCSF Department of Family and Community Medicine at SFGHMC; and Elizabeth McLoughlin, ScD, Pacific Center for Violence Prevention.

Rodriguez also serves as research director for the Pacific Center for Violence Prevention, an organization that develops and promotes public policies to reduce youth violence using a public health approach.

The study was funded by the Trauma Foundation, the UCSF's San Francisco Injury Center, the California Academy of Family Physicians, UCSF Center for the Health Professions, and Picker-Commonwealth Scholars Program.

###

NOTE TO THE MEDIA: Reporters who would like to interview Michael Rodriguez, M.D., M.P.H., study principal investigator, can reach him directly at 415-206-4989.



Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.