Domestic Violence: A Handbook for Health Professionals

By Lyn Shipway | Go to book overview

Chapter 5

A critique of existing Healthcare provision

Experts in the field of domestic abuse and healthcare provision, generally agree that one of the challenges to improving the response to clients is the continued use by the professionals of a medical model of care framework. The violence and abuse are frequently reduced by the professional to a physical, psychological or mental health diagnosis and treatment, without due consideration given to the social and political location of violence. In effect, such an approach locates the 'problem' in the individuals sustaining the injuries or presenting with the ill-health aftermath of years of abuse. The clients are 'treated' according to their signs and symptoms and often left feeling as though either the problem is theirs, or alternatively that she or he is the problem.

[The] medical approach reduces male violence-a social process rooted in gender identity-to biological, individual or situational factors and focuses prevention on the individual level. This focus minimises the historical and social dimensions of women's experiences that are so crucial to understanding and responding appropriately to wife-battery. Clinicians learn to catalogue abuse alongside other 'illnesses'. Whether abused women are received like other patients requiring 'treatment' or as 'victims' requiring 'rescue', medical interventions inevitably reproduce and extend female dependence.

(Kurz and Stark 1988:262)

Stark and Flitcraft (1996) advocate a fundamental change in the current philosophical approach of healthcare provision when dealing with the consequences of domestic abuse. Health professionals must recognize that the issues go far beyond the individual requiring 'treatment', they have to acknowledge and challenge the wider political, social and gender constructs which frame our existing interpretations of family violence.

In 1999 Abbott and Williamson undertook an important study to identify the strengths and weaknesses of existing healthcare provision as it relates to domestic abuse in the UK. The study explored the views of members of a community health team, including GPs, health visitors, practice nurses and midwives, of a specific healthcare provider.

The role that healthcare professionals can play is severely limited by their lack of knowledge and understanding. They are not well equipped to empower women and enable them to make informed decisions…. Working within the dominant biomedical model, they individualise the cause, medicalising what is a social problem-

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