Domestic Violence: Challenges to Medical Practice

Abstract

Over the past two decades, gender-based trauma has emerged as one of the most serious public health problems facing women in this country. For most women the greatest risk of abuse and violence will be from a man they have known and trusted, often an intimate partner. This violence usually escalates in both frequency and severity and has significant social, psychological and medical consequences. Now that the medical community is beginning to address this issue, a number of new questions arise. What are the obstacles that keep health care providers from routinely asking about domestic violence despite the availability of information on its importance? Additionally, what are the potential dangers that come from transforming social problems into medical problems and pathologizing important aspects of our lives as women? By examining the ways in which medicine is both taught and practiced, we can see how the objectification process inherent to its discourse transforms people into patients who only fit medical or psychiatric diagnostic categories. By exposing the ways this model functions through techniques that institutionalize socially sanctioned hierarchies of domination and control—techniques that, in fact, mimic the dynamics of abuse and battering—we begin to see why clinicians trained within that framework may find it difficult to provide the kinds of empowering and advocating responses that are most supportive to women who have been abused.