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Canadian Medical Association Journal
April 7'98

Familial abuse: a multifaceted problem

CMAJ 1998;158:868

Re: Responding to our abused patients, by Dr. Barbara Lent (CMAJ 1997;157[11]:1539-40 [full text / résumé])

In response to: B.F. Rudrick

Dr. Rudrick's request for a "balanced view of domestic abuse" contrasts sharply with his emotional response to my editorial. Although I agree that it is important to acknowledge that men may be the victims of domestic violence perpetrated by women, violence and abuse within intimate relationships are not gender neutral. Numerous reports founded on community-based surveys and police statistics indicate that men are much more likely to inflict abuse and women are much more likely to be the victims. Yes, women in both heterosexual and lesbian relationships have been known to behave in an abusive or violent manner toward their partners, but this represents a relatively small proportion of abusive intimate relationships.

Rudrick cites US data on murders in domestic situations, but because of differences in social systems and gun laws, these data are not relevant to the Canadian situation. Domestic violence accounts for 15% of all Canadian homicide victims, the risk being greater for women (3.2 women are killed by their husbands for each man killed by his wife).1 In 32% of cases in which a man kills his wife, he also commits suicide. Clearly, physicians need to see domestic violence as a potential health risk for both female and male patients.

Children are potential victims of these abusive relationships as well. Data from Statistics Canada2 indicate that children witness 40% of the abusive incidents in their home, and these experiences have been shown to have a negative impact on the health and well-being of both male and female children and also increase the likelihood that these children will later become involved in abusive relationships.

Physicians must continue to consider the possibility that violence and abuse may influence the physical and mental health of all their patients, male and female, adult and child, while recognizing that such experiences are more common in certain subsets of their patients.

Barbara Lent, MA, MD
Victoria Family Medical Centre
London, Ont.

References

  1. Wilson M, Daly M. Spousal homicide. Juristat 1994;14(8):1-15.
  2. Wilson M, Daly M. Spousal homicide. Juristat 1994;14(8):1-15.

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