Attitudes and Practices of Doctors toward Spouse Assault Victims: An Australian Study
Easteal, Patricia W., Easteal, Simon, Violence and Victims
The attitudes and practices of 96 doctors toward spousal assault victims in the Australian Capital Territory, Australia, were investigated by questionnaire surveys distributed to general practitioners. The results indicate that although most doctors believe that members of their profession should play a role in prevention and treatment, many doctors may be failing to do so. In general, the sample was fairly homogeneous attitudinally, although long-serving practitioners tend to have more conservative attitudes about the causes of spousal assault and about doctors' role in prevention; and female doctors have more liberal beliefs than males about some aspects of causation and intervention. However, the latters' responses are less sympathetic when questioned about their own feelings and practices. Very few of the doctors had received any training on domestic violence issues, and for those that had, such training was minimal. There is nevertheless an indication that training has influenced some beliefs. The findings are not surprising in the context of the historical and current Australian ethos which perpetuates traditional gender stratification and wife battering.
There is a growing awareness that wife battering is a serious problem in western industrial societies. Medical practitioners are often the first professionals to whom domestic violence victims turn (Dobash & Dobash, 1979; 1985; Walker, 1979); as such they could potentially play an important role in both epidemiological data collection and intervention. However, generally they appear not to be effective in either respect. They fail to identify a large proportion of the victims that consult them, and they often either fail to treat or treat inappropriately those they do identify.
Similar findings with respect to doctors' interactions with domestic violence patients have emerged from studies in the USA (Stark, Frazier, & Frazier, 1979; Davis & Carlson, 1981; Johnson, 1985; Saunders & Rose, 1985; Rose & Saunders, 1986; McLeer & Anwar, 1987; Kurz, 1987), the UK (Borkowski, Murch, & Walker, 1983; Dobash & Dobash, 1979; 1985; Pahl, 1985), Canada (Canadian Standing Committee on Health, Welfare, and Social Issues, 1982; Bums, 1984) and New Zealand (Mullen, 1987) First, physicians, in contrast to other professionals, identify an extremely small percentage of the victims they encounter. This appears to be attributable largely to the doctors' failure to recognize 'the masked presentation of violence', i.e. to look beyond physical injuries, depression, anxiety or drug abuse to the cause of these symptoms. This in turn may be due to inadequate training.
Second, even when victims are identified, doctors' attitudes about the etiology of battering and their perception of the limited role they should play mitigate against effective intervention. In contrast to other professional groups, doctors exhibit a greater degree of victim blaming. They more often apportion responsibility for the violence equally to both spouses (Davis & Carlson, 1981), blame even being attributed primarily to the victim's personality or mental state (Borkowski, Murch, & Walker, 1983). In addition, patients who express no desire to leave their husbands and/or those who do not have pleasant personalities have been found to receive less sympathy and fewer referrals, while those who have been drinking and/or are evasive are treated less supportively (Kurz, 1987).
It is not surprising that victims tend to rate medical professionals as unsatisfactory sources of support (Dobash & Dobash, 1979; 1985; Pahl, 1985; Johnson, 1985), reporting that doctors treat physical injuries and prescribe tranquilizers for psychological problems, but fail to look for or to understand the underlying cause of these - spousal assault.
In Australia, there have been no surveys of doctors aside from the Western Australian Task Force on Domestic Violence (1986), Scutt (1983), and the New South Wales Task Force (1987) in which physicians' comments and attitudes were not differentiated from other professional groups. …