Artsen herkennen mishandeling niet [Archief]

Goodnight

22-10-04, 09:00

Uitgegeven: 22 oktober 2004 08:54
Laatst gewijzigd: 22 oktober 2004 09:39

UTRECHT - Duizenden geweldsmisdrijven blijven onopgemerkt, omdat huisartsen niet in staat zijn mishandeling en misbruik bij patiënten te herkennen. Ook beginnen politie en justitie vaak ten onrechte een onderzoek, omdat artsen een valse aangifte niet doorzien.

Dat blijkt uit onderzoek van forensische geneeskundigen van de GG&GD in Amsterdam, die 250 huisartsen hebben ondervraagd. Volgens het onderzoek, dat deze week in Medisch Contact is verschenen, voelt de helft van de artsen zich niet of onvoldoende opgeleid om een goede letselbeschrijving te kunnen geven.

Veel ondervraagde huisartsen vinden letselbeschrijving geen taak van de behandelend arts. Deze taak kan beter worden overgelaten aan onafhankelijke en deskundige forensische artsen.

De letselbeschrijving, meestal opgesteld op verzoek van de politie, wordt toegevoegd aan het proces-verbaal. Het slachtoffer dient daarmee uitdrukkelijk akkoord te gaan. Op grond van de verklaring en het proces-verbaal beslist de officier van justitie of er een strafvervolging wordt ingesteld.

Zwarte Schaap

22-10-04, 15:29

Midwives to ask: does your husband beat you?

By Nicole Martin and Toby Helm

(Filed: 21/10/2004)

All pregnant women are to be asked by their doctors and midwives if they are being abused by their husbands or boyfriends, it was announced yesterday.

The move, part of Government plans to tackle domestic violence, follows research showing that women are more likely to be subjected to violence when they are pregnant.

Critics condemned the plans as "intrusive" and "bureaucratic" and said that doctors, midwives and health visitors should not be forced to ask such personal questions.

Melanie Johnson, the public health minister, said that from next year mothers-to-be would be discreetly questioned about their private lives during health service ante-natal checks.

If they were thought to be at risk, they would be referred to support and counselling services, or to the police if they needed urgent protection or wanted to press charges.

Miss Johnson said: "The fact that domestic violence often starts or escalates during pregnancy and is associated with increases in rates of miscarriage, low birth rate, premature birth, foetal injury and foetal death makes for stark reading.

"By including a routine inquiry when women go for ante-natal appointments, health professionals may be able to establish whether women are at risk or have experienced any violence during their pregnancy.

"This is an effective means of ensuring that the appropriate support and advice is offered at an early stage."

Ann Widdecombe, the Conservative MP and former Home Office minister, attacked the plans as intrusive and said they would do nothing to solve the problem.

"This is carpet bombing everybody for the sake of getting information about a minority," she said. "I would very much prefer to have a system in which we concentrate resources on encouraging people to get out of their homes when there is domestic violence."

Andrew Lansley, the shadow health secretary, said: "We know that there are instances where domestic violence starts during a woman's pregnancy and midwives and GPs during ante-natal care must be alerted to the risk.

"But it is potentially highly inappropriate to pursue questioning to that end."

The Department of Health said an advisory group would be formed to draw up the questions that doctors and midwives should ask. It said women would be questioned in the absence of their husbands and boyfriends.

"We don't want to be intrusive or make anyone feel awkward," a spokesman said. "Domestic violence is a taboo subject that is often shrouded in secrecy. This only serves to help the perpetrator. We want to bring it out in the open."

A survey this year by the Royal College of Midwives found that one in five midwives knew at least one pregnant woman who was the victim of domestic violence.

The poll of 700 midwives reported that one in 10 believed that pregnancy was the trigger. More than a quarter said they had not received the proper training to deal with women who were being abused.

Dame Karlene Davis, the college's general secretary, welcomed the proposals but said it was vital that midwives were trained to tackle such a sensitive issue.

"Midwives are the first point of contact for mothers-to-be and the lead health professional for the first 28 days of a baby's life," she said. "This makes them ideally placed to ensure that victims will be identified and provided with support, advice and referral appropriate to their needs.

"Midwives and other health care professionals will now be better able to identify and help victims of domestic violence as long as the Government follows through with the adequate resources these new support mechanisms require."

Sandra Horley, the chief executive of Refuge, a domestic violence charity, said: "A violent pregnancy is a high-risk one. Refuge supports the Government recommendations to include domestic violence as a priority during ante-natal routine inquiries.

"Health professionals can play a key role in ensuring the safety of a woman and her unborn child. Alongside routine inquiry, Refuge would urge the Government and health officials to ensure that adequate training and sufficient resources are in place to enable professionals to support women who are victims of domestic violence.

"Only then will domestic violence stop being a number one baby killer."

Paul Burstow, the Liberal Democrat health spokesman, said: "To have a blanket policy in which staff always have to ask this question lacks the sensitivity that is necessary in these cases.

"The staff should be - and I am sure are - trained and it should be left to them to use their judgment rather than be subject to what looks like another patronising announcement by the Department of Health."

Bron: http://news.telegraph.co.uk/news/main.jhtml?xml=/news/2004/10/21/nmid21.xml&sSheet=/news/2004/10/21/ixnewstop.html