FOR IMMEDIATE RELEASE
MARCH 31, 1998
CONTACT:
LAURA GORE
(202) 728-0610, EXT. 3006
Washington, D.C.--Domestic violence reports to police did not increase following a 1994 California mandatory domestic violence reporting law, according to the April issue of Annals of Emergency Medicine. The journal also presents new studies on domestic violence screening, how alcohol abuse history is a strong predictor for acute injury from domestic violence, and the success of a program that increased organ donation referrals by 100 percent.
DOMESTIC VIOLENCE
A study of California's mandatory domestic violence reporting law shows that reporting of domestic violence by medical personnel to police did not increase in the 2 years after its implementation ("Failure of the Mandatory Domestic Violence Reporting Law to Increase Medical Facility Referral to Police"). Authors speculate failure of the law may be due to such causes as fewer victims seeking medical care for fear their partners will be arrested, physician ignorance, and physician noncompliance. This study of 26,051 dispatch reports to the Los Angeles Sheriff's Department compared dispatches to medical facilities before and after implementation of the law and differentiated for an increase in reports of domestic violence following the murders of Nicole Brown Simpson and Ronald Goldman and the enormous media attention surrounding the murder trial.
"The California law was intended to increase domestic violence detection by medical professionals, but this has not happened," said Carolyn J. Sachs, M.D., MPH, of the UCLA Emergency Medicine Center. "Victims may not be seeking medical attention because they know their partners will be reported, and medical professionals may feel torn between their allegiance to their patients and compliance with a state law. Many victim advocates also fear the law is doing more harm than good. I do believe that many medical personnel and victims are unaware of the law, and clearly more studies need to be done to address the reasons for noncompliance and to verify whether the law has a negative or positive impact on individuals who suffer from domestic violence."
At least five states, including California, Colorado, Kentucky, New Hampshire, and New Mexico, have enacted legislation to specifically mandate partner assault reporting to state authorities. Criteria for reporting vary from state to state.
In another study of 175 patients in a rural, university-affiliated emergency department, a tape-recorded questionnaire was found to be as effective as physician interviews in screening for domestic violence (Comparison of Domestic Violence Screening Methods: A Pilot Study). The goal of the study was to design a screening tool that circumvented barriers to and eliminate errors in identifying domestic violence victims in the emergency department. The tape-recorded questionnaire and self-coded answer sheet were found to quickly and successfully detect domestic violence in an emergency department setting. In another study of 46 cases of domestic violence against women, a history of alcohol abuse by a male partner was found to be the strongest predictor of all the socioeconomic variables examined for acute injury from domestic violence ("Emergency Department-Based Study of Risk Factors for Acute Injury from Domestic Violence Against Women"). One half of the cases stated their male partners were intoxicated with alcohol at the time of the assault.
ORGAN DONATION
A study of an urban teaching emergency department found that the rate of referral for organ donation increased to 100 percent following intensive training of emergency department staff, proper identification and referral of donors, and timely intervention by organ procurement representatives ("Organ Procurement in an Urban Level 1 Emergency Department"). The number of referrals from the emergency department increased from 30 percent in 1994 (3 of 10) to 100 percent in 1995 (25 of 25). The number of donors was 0 in 1994 (0 organs procured), 5 in 1995 (14 organs procured), and 9 in 1996 (32 organs procured).
"Emergency physicians are in a unique position as first caregivers to interact with both potential donors and their families," said Sean O. Henderson, M.D., of the University of Southern California School of Medicine. "This intervention, which involved intensive education about the organ procurement process, shows that organ donation can be increased and maintained, and many more lives can be saved."
Another article presents an overview of liver transplantation in the United States and how improved survival rates and increased transplants have resulted in increasing numbers of liver transplant recipients presenting to the emergency department ("Evaluation of Orthotopic Liver Transplant Recipients Presenting to the Emergency Department"). It also discusses how candidates are selected and describes various complications of liver transplants.
OTHER ARTICLES
-- NHTSA Notes-The article presents findings from the 1996 Motor Vehicle Occupant Safety Survey, conducted by the National Highway Traffic Administration, examined (1) why people don't stop to help motor vehicle crash victims, (2) people's expectations of emergency medical services, (3) crash injury experience, (4) how effects of crash injuries persist over time. The telephone survey of more than 8,000 people found that the single most common concern expressed (16 percent) about stopping to offer assistance at a crash site was not knowing how to help or what to do. Three out of 5 male respondents (58 percent) had no concerns about stopping to help; fewer than half of female respondents (47 percent) felt the same way.
-- COMMENTARY: WHO IS MY NEIGHBOR?-The commentary about the NHTSA survey presents a brief analysis of the survey results.
-- RACE AND SURVIVAL AFTER OUT-OF-HOSPITAL CARDIAC ARREST IN A SUBURBAN COMMUNITY-The study of 1,690 patients (233 or 13-percent black and 1,467 or 87-percent white) found that, after adjusting the data for socioeconomic factors such as income, race was not found to predict adverse out-of-hospital cardiac arrest outcomes in an affluent population.
Copies of articles and the entire table of contents from this issue can be obtained from the Washington office of the American College of Emergency Physicians.
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Annals of Emergency Medicine is the peer-reviewed journal of the American College of Emergency Physicians, a national medical society representing more than 19,000 physicians who specialize in emergency medicine. ACEP is committed to improving the quality of emergency care through continuing education, research, and public education.
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