NZMA Position Statement on Domestic Violence
The New Zealand Medical Association believes that family violence is a serious health issue in New Zealand because of the adverse physical, mental and social health consequences, and significant economic cost to the nation.
Domestic Violence is defined in New Zealand law as physical, psychological or sexual abuse of intimate partners, family members, household members or persons with a close personal relationship. The United Nations and World Health Organisation identify violence against women as an important health issue. Reducing interpersonal violence in families is one of the Health Goals in the 2000 NZ Health Strategy.
New Zealand research suggests that up to 1 in 4 women experience abuse of one kind or another during their lifetime - a similar prevalence to that in other developed countries. Fifty percent of adult female homicides in this country are the result of intimate partner assault. Women who are victims of domestic violence have a much higher rate of hospital admission for physical injury and mental illness than non-abused women.
Approximately 500 children a year are seriously injured by physical abuse, and 1% of those die.
Children witnessing domestic violence of any kind are known to suffer effects that are detrimental to their physical and mental health and wellbeing, and to be at an increased risk of suffering physical, sexual or emotional abuse.
All cultural groups consulted within New Zealand strongly support non-violent family environments.
In 1994 the cost of reported domestic violence to the New Zealand economy was conservatively estimated at $1.2 billion. Cost to Vote Health was $140.7million, and the cost of health services directly borne by victims was a further $16.5 million per annum. A preventive approach to addressing domestic violence has economic benefits as well as improving the health of all New Zealanders.
It is clear that intervention strategies can make a difference.
The NZMA believes that:
- Medical Practitioners have key roles to play in the detection, early intervention and treatment of people who suffer from family violence. All medical practitioners have an important role to play in identifying family violence so that personal suffering and health costs to the individuals, families and the nation can be reduced.
- Research programmes and medical education on family violence should be supported at all levels to encourage doctors in all disciplines to learn about family violence and develop skills for caring effectively for the patients concerned
- Intervention strategies should be in line with the ethical principles of beneficence, non-maleficence and justice
- There should be support for research-based, trialed protocols and guidelines for medical practitioners, to use in screening and intervention, following opportunities for practical training
- It is important for doctors to work collaboratively and in a coordinated way with accountable community agencies when dealing with family violence and its effects.
Selection of Supporting Documentation for Proposed Policy
Health Consequences of Male Partner Violence: Fact Sheets 1 & 2 Public
Health Promotion Services, Auckland Healthcare.
Facts about the Mental Health Effects of Domestic Violence -American
Medical Association
The Health Sector and Family Violence: The Response to Male Partner
Violence. Discussion Paper of Family Violence Advisory Committee, Jo Elvidge
1997
Health Impact of Partner Abuse, Mental Health and Partner Abuse, Ha Ora,
Public Health Promotion, Paper precis sheets.
Domestic Violence in a Primary Care Setting- Patterns and Prevalence;
Barbara A Elliott, Marilou M Johnson: Archives of Family Medicine: Vo14,
February 1995 p113-19 Danielle Mazza, Lorraine Dennerstein and Vicky Ryan MJA
Vol164, 1 January 1996
Domestic Violence Act 1995: Meaning of "domestic violence".
Strategic Objectives from the Beijing Platform for Action, and outcome
document report to 23rd Special Session of the General Assembly of the United
Nations 10 June 2000. Section 2, 10/11, pg 6.
World Health Organisation Fact Sheet 239 June 2000 Violence Against Women
Abuse during Pregnancy: Progress, Policy and Potential,: Jacquelyn C
Campbell Am J Pub Health Feb 1998 vol 88 no 2 pp 185-6
New Zealand Health Strategy: Dec 2000, Ministry of Health, Wellington p17
Screening for Domestic Violence in the Community Paediatric Setting.
Robert Siegel et al; Paediatrics Vol104 no 4 Oct 1999 p 874-877
Child abuse and wife abuse: the connections. Jacquelyn C Campbell
Maryland Medical Journal; April 1994 p349-50
Health Effects of Domestic Violence Dr Russell Wills National
Paediatrician RNZ Plunket Society overhead precis, seminar presentation:
1/10/2000
Physicians and Domestic Violence: Ethical Considerations. Council on
Ethical and Judicial Affairs, American Medical Association JAMA June 17, 1992
Vo1257, no 23 pp 3190-93 Nancy S Jecker. JAMA Feb 10, 1993- Vo1269, no 6 pp
776-80
The New Zealand Economic Cost of Family Violence Suzanne Snively: Coopers
and Lybrand Dec 1994 for Family Violence Unit, Department of Social Welfare,
Wellington
Domestic violence: the general practitioners role; lona Heath; College
Viewpoint: The Royal College of General Practitioners. Ww. rcgp .org. uk/rcgp/corporate/position/dom-
violence/index.asp
Diagnostic and Treatment Guidelines on Domestic Violence: American
Medical Association 1992
Diagnostic and Treatment Guidelines on Mental Health Effects of Family
Violence: American Medical Association 1995
Domestic Violence Position Statement: Australian Medical Association -1998
Domestic Violence: American College of Obstetrics and Gynaecology
Educational Bulletin 257 Dec 1999
Policy Statement: Violence against Women; Clinical Practice Guidelines No
46, March 1996 Society of Obstetricians and Gynaecologists of Canada, Social and
Sexual Issues Committee.
Policy statements: American Medical Association E-2.02, H-515.983, 984,
985, 975, and 976, 977.
Recommendations Arising from Study Group on Violence against Women -Royal
College of Obstetrics and Gynaecology. Dec 1977
Family Violence Intervention Training for Health Professionals: Summary
for presentation to Women's Health Caucus Labour MPs 1999: Wtn NZ
Domestic Violence Centre: Dual intervention -Domestic Violence and Child
Abuse. SAFTINET
Screening for Abuse/Pregnancy and Partner Abuse/Primary Care and Partner
Abuse. Ha Ora Pubic Health Promotion Auckland Healthcare Services Summary
Papers on Various Topics.
Adopted by the NZMA Board, 7 August, 2001.