1. OPINION: Courage is contagious: we need to talk about the domestic abuse experienced by female doctors in the National Health Service
As a survivor of domestic abuse and a doctor, I believe the National Health Service (NHS) needs to do more to protect and support staff who experience abuse, says Seema Haider
Domestic abuse affects one in four women,but little is known about domestic abuse among doctors. As we take strides to tackle inequalities within the NHS, we cannot resolve the problem of gender inequality until we acknowledge how it manifests in the abhorrent form of domestic abuse.
The NHS is one of the largest employers of women in the world. Research suggests that healthcare professionals, such as female nurses, are three times more likely to experience domestic abuse than the average person in the United Kingdom. A UK 10-year femicide census showed that “healthcare professional” was one of the most common occupations of victims.
It has been suggested that traits often found in healthcare professionals, such as empathy and compassion, may increase vulnerability to abuse. Being “resilient,” as required in medical roles, can result in people tolerating abusive relationships for longer. Yet research into domestic abuse among doctors has been largely ignored, which suggests that it remains an uncomfortable, emotive, and highly stigmatised issue. When marginalised in this way, the voices of those who experience abuse are silenced.
We must remember this affects our colleagues in all areas of medicine. The façade of those experiencing abuse can be almost impenetrable; only skilled people readers might notice a lapse as the mask momentarily drops. Domestic abuse needs secrecy, silence, and shame to continue. We must do more to provide psychologically safe spaces for our colleagues to seek help.
Firstly, we need to dismantle the false constructs of what a victim of abuse looks like. Domestic abuse is indiscriminate and traverses all people and intersections of society. Stereotypes hinder us from seeing the vulnerability of our colleagues. It also feeds into the shame narrative, whereby doctors experiencing abuse may feel judged, blamed, and “othered.”
Secondly, we need to understand the barriers doctors face when reporting abuse. Domestic abuse can be extremely destructive to a doctor’s identity and wellbeing. There is anguish in holding two incongruent identities: one where the doctor is the advocate for vulnerable patients and another where the doctor is vulnerable themself.
Doctors experiencing abuse can face threats of being reported to the General Medical Council (GMC); a strategy used by perpetrators to exert control and yield power. This is a callous attack on a doctor’s identity, which intimidates and discourages them from reporting abuse.
Complex dynamics can unfold when both victim and perpetrator are doctors, creating further barriers to disclosure… (continues)….
SOURCE: BMJ https://www.bmj.com/content/386/bmj.q1800, 15 August 2024 ; VISUAL
2. EDITORIAL: Violence against women and girls
Violence against women and girls is a national emergency in England and Wales according to a recent disturbing analysis by the National Police Chiefs’ Council (NPCC), which described an estimated 3,000 violent offences against women and girls daily. Every three days, at least one of these offences is likely to be homicide. Considering that many crimes go unreported, the NPCC’s findings probably underestimate the full scale of the problem.
Intimate partner violence is the most prevalent form of violence for women worldwide, with 27% of ever-partnered women reporting lifetime experiences of physical, sexual, or psychological abuse by intimate partners. The prevalence of intimate partner homicide in England and Wales seems to be higher than in other high-income countries such as Sweden, France, and Germany. Country comparisons must be treated with caution, however, because of missing data and varying definitions of violence; even when a woman is killed, her death may not count towards estimates of femicide. Less well studied forms of violence can be especially heterogeneous across countries… (continues) ….
SOURCE: BMJ, https://www.bmj.com/content/386/bmj.q1791, 16 August 2024