SHOULD PHYSICIANS BE REQUIRED TO REPORT ABUSE?

	Forty states now mandate that health care professionals
report injury that has been caused by a knife, gun or other deadly
weapon; five states specifically target domestic violence.  However,
Paul A. Lombardo, director of the Center for Mental Health Law
Training and Research at the University of Virginia's Institute of
Law, Psychiatry and Public Policy, is against such reporting.

	He notes that the criteria used most frequently in deciding
if a patient's confidentiality should be breached concerns
protecting particularly vulnerable people, such as young children or
the infirm elderly.  Physicians also make exceptions to patient
confidentiality when public health is at stake. 

	"Although a victim of domestic violence may have low
self-esteem and may have adopted a feeling of dependency or
helplessness, she is not a child.  It is highly questionable to
consider her so infirm that she is not entitled to confidentiality,"
said Lombardo at a recent public discussion addressing "Violence to
Pregnant Women:  Issues for Health Care Professionals."  "A victim
of abuse can make a police report herself, or can ask a counselor,
shelter worker or physician to make a report if she so desired,"
observes Lombardo, an associate professor of law.

	"I am against mandatory reporting laws because we have no
evidence that they would provide anything other than a deterrent to
health care access by those who need it most and, at the same time,
discard the expectation of confidentiality of one particular type of
patient," said Lombardo, who is responsible for training mental
health professionals and attorneys on laws regarding
confidentiality, civil commitment and guardianship.

	Lombardo also refutes the idea that domestic violence
episodes should require reporting because of the threat to public
health.  "Not all widespread social problems are publicly spread
like infectious disease; rarely do they justify the same measures,"
he noted.  

	For more information, Lombardo can be reached at (804)
924-8300.


January 24, 1996