Routinely asking women about domestic violence

Editor—Taket et al debated the value of routinely asking about domestic violence¹. Although no one would disagree that domestic violence is a major health problem and that health care offers opportunities to identify a largely hidden problem, the statement that routine inquiry in healthcare is acceptable to women is far from proved.

Figure 1.

Work from primary care studies, including the authors' own work, has shown that sizeable proportions of women, ranging from 51% to 15%, object to routine inquiry about domestic violence²,³.

The adverse consequences of routine inquiry to a woman who found it unacceptable should not be underestimated. A dysfunctional consultation could result, and the healthcare professional would become extremely reluctant to conduct future inquiries.

Interestingly, similar work from the prenatal setting indicates a much higher rate of acceptability⁴. The reasons for this are not clear, but may be related to age, the increased feelings of responsibility that pregnant women feel, or the status of the healthcare professional. More work is needed to identify in which healthcare environments routine inquiry is acceptable and the characteristics of women who find routine inquiry unacceptable.