مستندات پروژه2012 خشونت خانگی

One in four women presenting to Emergency Departments in Australia have experienced domestic violence in their lives but there are no specialist services for victims of domestic violence in the state of New South Wales, population of 7.25 million. Fundamental forensic medical and nursing skills developed for the comprehensive assessment of complainants of sexual assault were utilised in the examination of victims of domestic violence in a trial project at Nepean Hospital, Sydney. The project was then reviewed via a series of qualitative patient and police interviews along with an analysis of court outcomes. Assessment by specialists in forensic documentation and interpretation of injuries with the provision of balanced expert opinions for court purposes can result in a number of benefits for the victims and the criminal justice system, including an increase in the rate of successful prosecutions.

Domestic violence is defined, by NSW Health, as a range of violent and abusive behaviours perpetrated by one partner against another. It may occur within the context of marriage, de facto relationships and includes couples who are separated or divorced. The NSW legislation (Crimes (Domestic and Personal Violence) Act 2007) adopts a far wider definition of what constitutes a domestic relationship (section 5) and includes married partners, de facto partners, when there has been an intimate relationship (even if not sexual), when both victim and offender live or have lived in the same household or been long term residents together at a residential facility, been in a carer relationship or part of an extended family as identified by Aboriginal and Torres Strait Islanders. It also applies if the offender and victim are related including in-law relationships, half or step relationships. For the purpose of the study we adopted an inclusion criteria if the offender/victim were or had been in a partnership relationship of any kind or if they were related to each other and living together. NSW Health has elucidated several aims with regards to domestic violence and these included the reduction of the incidence of domestic violence and the minimisation of the trauma of those people living with it.2 Their domestic violence policy states that ‘one in four women presenting to Emergency Departments in Australia have experienced domestic violence in their lives’ yet acknowledges ‘there is no specialist service for victims of domestic violence’.2 This is despite the fact that an Australian survey of women, aged 18–69, who identified as ever having had an intimate male partner found that one third of them had experienced physical violence from their partner in their lifetime (34%).3 Assistant Commissioner Mark Murdoch, NSW Police Force corporate spokesperson on domestic and family violence, said NSW police attended 120,000 domestic violence incidents in 2011 – an average of 330 per day.4 The cost of violence against women was estimated to have cost the Australian economy $13.6 billion in 2009.8 For every experience of violence to women that can be prevented, over $20,000 in costs can be saved. If current rates of violence to women could be reduced by 10% over the next decade, it is estimated that $1.6 billion in costs could be avoided.9 Across the border, in Victoria, intimate partner violence contributes 7.9% to the total disease burden of women aged 18–44 years.5 This makes it the leading contributor to morbidity and premature mortality in this age group, outstripping other known risk factors such as obesity, smoking, high blood pressure, alcohol and illicit drug use.5 Women affected by violence require more operations, spend more time visiting doctors and have lengthened hospital stays when compared to women who do not have a history of violence.6 “While it is clear that ordinary, healthy people may become entrapped in prolonged abusive situations, it is equally clear that after their escape they are no longer ordinary or healthy” 7 Domestic violence does not only affect women. It affects men and children. The Australian Bureau of Statistics has estimated that at least 1 million Australian children by 2005 have been personally affected by Domestic Violence.10 In the National Crime Prevention Survey, almost one quarter of Australian youth reported witnessing physical domestic violence against their mother.11 Some women, unfortunately, pay the ultimate price for such violence. During 2007–2008, of all female homicide victims in Australia, 55% were killed by their male intimate partner.12 The forensic medical response to domestic violence has, for the most part, been negligible. NSW is the only Eastern State in Australia that has artificially divided forensic medicine into two disparate categories: (1) forensic medicine applicable to victims of sexual assault and/or child abuse and (2) forensic medicine applicable to other areas (e.g. road traffic medicine, custodial medicine, assistance to the Coroner, assessment and collection of forensic evidence from persons of interest etc.) Victims of domestic violence, for some reason, did not actively fall into either category. They, instead, were sent to busy Emergency Departments or General Practitioners to have injuries treated and documented. The results were that appropriate documentation of injuries rarely occurred, diagrams of injuries were rarely made and photos were usually not collected. In addition, injuries were not interpreted with relation to the likely causation. Furthermore, cases have been hampered by delay in obtaining the necessary medical evidence or by not meeting the standards required by a court for a successful conviction.