Volume 72 Number 4 July 2005	back to contents

The Mount Sinai School of Medicine, New York, NY, and Elmhurst Hospital Center, Elmhurst, NY.

Assistant Professor of Emergency Medicine, Department of Emergency Medicine, The Mount Sinai School of Medicine, Box 1620, One East 100th Street, New York, NY 10029, and Director, Division of Emergency Management, Elmhurst Hospital Center, 79-01 Broadway, B1-14, Elmhurst, NY 11373.

Address all correspondence to Laura G. Iavicoli, M.D., 150 East 2nd Street, Apt. 3A, New York, NY 10009; e-mail: lauramd97@hotmail.com

Presented at the Issues in Medical Ethics Conference on “Special Challenges of Emergency Medicine” at the Mount Sinai School of Medicine, New York, NY.

Abstract

Should physicians be mandated to report domestic violence involving a competent adult patient regardless of whether or not he or she consents to the report? This is a complex ethical and moral issue; in some states such as California, Colorado, Kentucky, New Hampshire, Rhode Island and New Mexico it has become a legal one as well. The Federal health privacy regulation instituted in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) addresses issues of privacy protection for survivors of domestic violence, but it does not preempt those state laws that are less (or more) protective of patient privacy. In the above states, physicians and/or health care providers are mandated to report acts of domestic violence to an agency, under their own circumstances, regardless of whether the physician or health care worker believes that reporting the violence is in the patient’s best interest or not. But is mandatory reporting truly “good” or “bad” for the patient, the physician or society as a whole? This article explores the laws and the evidence (including evidence-based research) surrounding the issue of mandatory reporting of domestic violence when it pertains to a competent adult.

KEYWORDS

Domestic violence, mandatory reporting, domestic assault, law, adult.

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