Sean Philpott, MSB’06, PhD, acting director of the Center for Bioethics, is a regular commentator for WAMC Northeast Public Radio. His most recent segment (below), aired on February 21^st. It addresses domestic abuse, given the news that famed Olympian and Paralympian Oscar Pistorius was arraigned on charges of murder in a South African court of law.

A public health researcher and ethicist by training, Dr. Philpott is also chair of the U.S. Environmental Protection Agency’s Human Studies Review Board, which reviews all research involving human participants submitted to the EPA for regulatory purposes. He can be heard every other Thursday afternoon on WAMC. For a list of channel frequencies and past segments recorded by Dr. Philpott, visit: www.wamc.org.

Protecting the Victims of Domestic Violence

Last Friday, famed Olympian and Paralympian Oscar Pistorius was arraigned on charges of murder in a South African court of law. Nicknamed the 'Blade Runner' after the carbon fiber blades that this double-amputee uses to run, Mr. Pistorius is accused of fatally shooting his 30-year-old girlfriend Reeva Steenkamp.

Ms. Steenkamp's death may have been the result of a tragic accident. Home invasions are common in South Africa, and Oscar may have mistaken her for an intruder.

Sadly, it is also possible (even likely) that Reeva's death is the result of a premediated or passionate act of violence. According to preliminary reports, the police in South Africa have been called to Mr. Pistorius' house on more than one occasion to deal with domestic abuse complaints.

Also known as intimate partner violence, domestic violence is sadly commonplace in the US and around the world. It can take several forms, from physical and sexual assault to emotional and verbal abuse. Victims may also be subject to more passive or covert forms of abuse, such as neglect or economic deprivation.

More often than not, women are the primary victims. A recent survey of 16,000 people by the US Department of Justice found that nearly a quarter of women have been abused by a spouse or partner. The number of American women who are the victims of domestic violence is likely far greater, as the survey asked only about physical or sexual assault. It did not examine some of the more insidious forms of intimate partner violence like verbal, emotion and psychological abuse.

This is not to say that men cannot be victims of domestic violence as well. In the same Justice Department survey, over 7% of men reported a history of abuse. However, women are far more likely to be harmed or killed as a result of domestic violence. Data are spotty, but domestic violence appears to the leading cause of injury among women aged 15 to 45. It is estimated that 1,000 to 1,600 American women die each year from injuries sustained at the hands of an abuser. Many suicides may also be the result of domestic abuse; in one study of women who attempted suicide, researchers found that nearly a third reported a history of intimate partner violence.

Rates of domestic violence also differ by race and ethnicity. In the African-American community, for example, intimate partner violence occurs at a rate that is 35% higher overall. The statistics for Native American women are even more disturbing. Sixty percent of American Indian and Alaska Native women will be physically assaulted in their lifetime. Thirty-five percent will be raped.

The consequences of domestic violence are far reaching. In addition to the lives lost to domestic violence, it costs the American health care system nearly $5 billion a year to treat injuries sustained as a result of abuse. Economic productivity also suffers, with over two million workdays lost when abuse victims must take sick leave to recuperate. Many abuse victims lose their jobs and some even lose their homes as a result; research suggests that domestic violence is the primary cause of homelessness for half of the homeless women in the United States.

Combating domestic violence has proven to be difficult, in part because victims are often reluctant to press charges or to seek medical care. Even when they do, law enforcement agencies and health care providers may be loathe to interfere. For too long, domestic abuse has been viewed as a private matter to be handled within the family.

That is changing, albeit slowly. While police have been reluctant to intervene in domestic disputes in the past, for example, nearly half of US states now have policies that mandate arrest of the perpetrators of domestic abuse, regardless of whether or not a police officer witnessed the crime; the remaining 26 states that lack such laws will hopefully pass them soon. More and more medical schools are also training doctors and nurses recognize and address domestic abuse in their patients.

But while progress is being made at the state level, a coordinated federal response to the domestic violence epidemic is somewhat lacking. One key piece of federal legislation is the Violence Against Women Act, signed into law by then President Bill Clinton in 1994. The Act provides for federal investigation and prosecution of violent crimes against women. It also provides for a coordinated community response to domestic abuse via grant funding and support offered by the federal Office on Violence Against Women, including money to help the states implement mandatory arrest policies.

In recent years, however, some in Congress have tried to gut the law or have refused to reauthorize it. Some legislators object to provisions that would extend the Act's protections to same-sex couples or undocumented workers. Others reject the inclusion of American Indians living in reservations, which would give tribal authorities jurisdiction over crimes involving non-native Americans on tribal lands. These objections come despite the fact that intimate partner violence is common among these three groups.

Whatever the root cause for these objections -- legal concerns about the adequacy of tribal courts or ideological opposition to protecting the health and well being of lesbians and illegal immigrants -- these politicians are doing themselves and the American public a grave disservice. It's time to renew the Violence Against Women Act and extend its protections to all. Domestic violence is a problem that affects us all. All victims, be they gay or straight, white or Native American, a US born citizen or an undocumented worker, deserve the full protection and support of the government.