Domestic and Sexual Violence __________________________________________________________________
LEGAL INTERVENTIONS Domestic violence victims can obtain protective orders through a civil proceeding [167]. Until the enactment of Pennsylvania’s Protection of Abuse Act in 1976, only two states had protective order legislation [167]. Protective orders prohibit the abuser from communicating with the victim and/or other family members in a threatening manner. The order also prohibits the abuser from going to the home or place of employment of the victim or family members. Violations of protective orders can result in fines, imprisonment, or a combination of both [167]. Protective orders do not require the involvement of the police and involve actions intended to protect the victim, including ensuring continuation of health insurance and removal of firearms [168]. In an analysis of 607 protective orders issued in Arizona, the most frequent request was that the petitioner’s home be protected [168]. Victims can file for a temporary or permanent protective order. A temporary protective order does not require the abuser to be present. These orders last about 30 days or until a court date is scheduled. A permanent protective order requires both the victim and abuser to be present in court. Permanent protective orders last for about 12 months [169]. Laws for dating violence are different. All 50 states and the District of Columbia have state laws related to dating violence. However, the term “dating violence” is not used. Instead, the following terms are used: “sexual assault,” “domestic violence,” and “stalking” [170]. All 50 states and the District of Columbia have some form of protection order provisions, including no contact, peaceful contact, stay away, move out, firearms, and counseling [171]. The National Center for Victims of Crime is a resource to obtain additional information about state laws [172]. For more information about legal interventions, state coali- tions for domestic violence can be contacted. The American Bar Association has compiled a list of domestic violence state coalitions. Although, the American Bar Association Commis- sion on Domestic and Sexual Violence suggests victims do Internet searches for local domestic violence resources, they caution them to use a local library or go to a friend’s home where they can access a computer without the abuser being able to track Internet and email activities [166]. CASE MANAGEMENT Because abused women often suffer physical injuries, they will likely seek care from a healthcare professional who can make referrals to counseling services. Some women seek counseling on their own. After identifying victims and their abusers, mental health professionals should immediately implement a plan of action that includes providing referrals for available community services and safe havens to assist the victim and the victim’s family.
• When possible, victims should save some money in a private bank account or hide money for escape. Victims should be informed that if the abuser finds out about a separate bank account, they could be in danger. • Encourage victims to keep a bag packed with necessities and stored in a safe place in the event leaving must be immediate. • Advise victims to work out a code word or signal with the children so they will know when to implement an escape plan. • Encourage victims to keep a list of important phone numbers in their packed bag. Memorizing important numbers provides more safety. • Recommend that copies of important documents and necessary items be available. • Victims should check security settings on devices and change passwords. Although safety planning may be advocated, it does not neces- sarily mean victims will employ safety planning guidelines. Ideally, the victim of a sexual or physical assault should be offered a formal forensic evaluation; this requires written documentation of informed consent. Injuries should be documented in photographs, diagrams, or sketches. A growing number of hospitals now employ dedicated forensic nurses, including SANEs, as part of a multispecialty sexual assault team [153]. SANEs have completed specialized training in the medical forensic care of the patient who has experienced physical violence, abuse, or sexual assault. An important component of the care offered by the SANE is the medical forensic exami- nation. This consists of a medical forensic history, a detailed physical and emotional assessment, written and photographic documentation of injuries, and collection and management of forensic samples. The SANE is trained to ensure that evi- dence is collected and documented according to established protocol and local jurisdiction procedures and that the “chain of custody” is properly maintained in the event of later legal proceedings. Evidence collection kits designed for this purpose are available commercially or, in some states, may be obtained through designated distribution centers. Medically trained rape crisis advocates typically accompany SANEs to provide support, information, and follow-up guidance to victims [166]. Often, however, these trained specialists are not the first professionals to interact with the patient. Consequently, all healthcare professionals, particularly those in an emergency care setting, should have an understanding of the principles that govern proper collection and preservation of evidence during the examination of an assault victim. At stake is the successful prosecution of the assault perpetrator, which often is compromised by insufficient or improperly collected evidence or by not following evidence through the chain of custody.
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MDCT2026
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