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Reflecting concern of the Medical Society of New Jersey, the Subcommittee on Violence is dealing with legislative initiatives, physician education, and the development of innovative strategies concerning violence. The Subcommittee is studying the physician's role in the diagnosis and treatment of violence.

This study examines the utilization of police service for domestic incidents. Contrary to the popular image of serious violence perpetrated upon a spouse, the data show that most calls involve less serious incidents that are almost as likely to involve cohabitants as married couples. This finding assumes significance because of the small proportion of the cohabiting population to the married population. Other types of relationships that generate calls to the police include, although to a lesser extent, parent-child, boyfriend-girlfriend, and siblings. Explanation for these findings focuses on relationship issues and provides implications for service utilization.

The ethical dilemma of caring for the patient from a multiproblem family with suspected domestic violence is discussed. An ethical decision making model that organizes patient data and encourages systematic analysis of the case is reviewed to address the responsibility of the emergency physician to intervene and the options available. The analysis explores specific issues related to mandatory reporting laws, discretionary reporting, and factors to be weighed in deciding the best action for protecting various members within a family when abuse is known or suspected.

Family violence is a major public health problem. Battered women present with multiple physical injuries in hospital emergency rooms, clinics, and personal physicians' offices. Yet, they are often not identified as battered and fail to receive appropriate treatment for the nonphysical effects of these events. Instead, only discrete physical injuries are identified. The authors explore the literature to identify barriers in recognizing and treating battered women. These barriers are viewed as a microcosm of the larger public health problem in which battered women fear identifying themselves and often are not recognized by public health professionals. Some barriers pertain to the victims themselves; others can be attributed to the attitudes of medical care providers in emergency rooms, clinics, and private physicians' offices. The many faceted needs of victims require a variety of interventions including medical models, criminal justice intervention systems, and social models for change. Some intervention strategies that are currently being employed in various programs in the United States are described.

The prevalence and severity of domestic violence have illuminated the need for effective justice system responses to this pernicious phenomenon. A remedy that all states now provide is the civil protection order, but the forms of relief available, duration of orders, and processes for obtaining them vary from state to state. Examples of types of relief include prohibitions against further abuse and contact with the protected person; eviction from the residence; and temporary custody of children. Studies of civil protection orders suggest that they can be an effective form of relief if the justice system takes affirmative steps to increase their power, including screening petitioners to identify those who need more elaborate safety plans; provision of specific and comprehensive orders and low cost and effective service of them; stringent enforcement of orders by law enforcement and the court; and linkages from the court to advocacy services, shelters, legal representation, and other services.

Presented the 6-month follow-up findings of an experimental intervention designed to provide postshelter advocacy services to women with abusive partners. The intervention involved randomly assigning half the research participants to receive the free services of an advocate, 4 to 6 hours per week, for the first 10 weeks postshelter. One hundred forty-one battered women were interviewed about their experiences immediately upon their exit from a domestic violence shelter: 95% of the sample were interviewed 10 weeks thereafter (postintervention), and 93% were successfully tracked and interviewed 6 months later. At the 6-month follow-up, participants in both groups reported increased social support, increased quality of life, less depression, less emotional attachment to their assailants, and an increased sense of personal power. Although women in both groups reported some decrease in physical abuse over time, there were no statistically significant differences between those with and those without advocates, and abuse continued to be a problem for many women. Those who were still involved with their assailants continued to experience higher levels of abuse and had been more economically dependent upon the men prior to entering the shelter. Women who had worked with advocates continued to report being more satisfied with their overall quality of life than did the women in the control group.

Physical and sexual violence against women is a public health problem that has reached epidemic proportions. An estimated 8 to 12 million women in the United States are at risk of being abused by their current or former intimate partners. This violence causes serious physical, psychological, and social sequelae for these women and their families.