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Your first... request to record a battered wife's injuries

Mrs Smith is covered in bruises; she says her husband hit her while drunk, and asks you to record the injuries 'just in case'. Dr Melanie Wynne-Jones discusses

Mrs Smith is covered in bruises; she says her husband hit her while drunk, and asks you to record the injuries 'just in case'. Dr Melanie Wynne-Jones discusses

Deal with your own emotions quickly and show empathy. You will need to:

  • Record and manage each injury appropriately
  • Discuss whether she should report it to the police
  • Assess her continuing risk
  • Find out whether any children may be at risk
  • Discuss her options

Ask about the assault and the circumstances leading up to it. What were his 'reasons', and does he regularly abuse her or is he usually the 'perfect husband'? Has he apologised, or said he will seek help?

You should also assess her current mental state – is she depressed or at risk? Ask what her 'just in case' comment meant.

You may not get all the facts: she may be embarrassed, want to protect him, take the blame, be worried that you will try to take the children away – or may even be lying.

Record each injury and her account of how it was caused; suggest she takes photographs. Unless you are qualified in forensic examination, advise her that the proper person to record her injuries is the police surgeon.

She may be reluctant to go to the police because of her fear of reprisals, her love for him, or her fear that she could not manage on her own (violent partners often systematically undermine their victim's self-belief). If so, advise her to consult a solicitor (many do pro bono work). The level of violence may escalate and she must be made aware of the possible risks of staying in the marital home.

Before or instead of making a formal complaint, she could speak to police officers from the domestic violence unit; they can advise, offer support, place her statement on record, arrange a refuge (safe house with a secret address) and involve social services.

DVU officers can also accompany her to court, identify attempts at intimidation and provide access to witness protection if necessary. Any children may also be at risk (and seeing their mother attacked is in itself a form of abuse). Even if she assures you that he 'would never lay a finger on them', it would be wise to discuss them with your trainer as this may also be a child protection issue.

At the end of the discussion, Mrs Smith may reject all your suggestions; you may at least have provided some support, both now and for the future.

Some doctors experience violence in their own families; if this is a personal issue that could affect you or your patient care, talk to a trusted colleague or your own GP.

Melanie Wynne-Jones is a GP in Marple, Cheshire

Resources

1) Tackling Domestic Violence – The Role of Health Professionals www.homeoffice.gov.uk/rds/pdfs04/dpr32.pdf

2) NSPCC www.nspcc.org.uk/html/home/ needadvice/domesticviolence.htm

3) English National Domestic Violence helpline 0808 2000 247

4) Northern Ireland Women's Aid 24-hour Domestic Violence Helpline, telephone 028 9033 1818

5) Scottish Domestic Abuse Helpline 0800 027 1234

6) Wales Domestic Abuse Helpline 0808 80 10 800

7) Male Advice & Inquiry Line 0845 064 6800

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