Spousal abuse/homicide. A current issue in health risk management

Domestic homicides shocked Calgary in 1995. As the year drew to a close, statistics revealed that 5 of the city's 18 murders were at the hands of an abusive spouse, former spouse, or boyfriend. This prompted women across the city to campaign for more protection for women. Press conferences were held in which Calgary's most prominent women's groups called for tougher action against violent offenders. With 1996 over the halfway mark, one case of spousal homicide has occurred. Although statistics are down from this time last year, it is an event that should not have occurred. Although public awareness and pressure led to more women's shelters and programs, these results were tertiary measures. This level of prevention deals with "after the crisis response" to the event and is reactive in its approach. Proactive or primary measures which reduce the risk of the problem starting are now being called for. Throughout history, health care professionals have been called upon to assist the legal system in the prosecution of cases where patient care overlaps with the law, or where the law and physiological realities collide. However not until recently have nurses had the opportunity to study within the field in a formal, organized manner (Lynch, 1995). The shift toward community-based rather than institutional care brings health care professionals in direct contact with cases of abuse and neglect in their natural settings. Early warning signs and symptoms of interpersonal violence will go unreported until nurses are taught to include these in their observations. Nursing programs now prepare nurses for this new specialty practice. Although calls for changes to the restraining orders and greater police protection for women in volatile situations are perfectly understandable, no one pretends they are the answer. The solution begins with spreading the very basic understanding throughout society that women are not property to be exploited or targets for venting anger. To effect change, spousal abuse must be viewed as a primary health care issue that affects us all, as well as being a social and human rights issue. It would benefit our society to become as incensed over spousal abuse as we are over drunk driving. Spousal abuse is a criminal offense and should be treated as such. Ending spousal abuse will require a significant reevaluation of human relationships, a much decreased public tolerance of violence and its depiction, and economic and political conditions that promote equality and a greater ability to control one's own life, but not others (MacLeod, 1994). This analysis of Calgary's response to the domestic homicides of 1995 is a risk-management approach of how the city dealt with this critical problem. With a greater focus on risk management strategies, along with public education and a greater interface with law enforcement agencies, forensic nurses will help reduce the sequelae of human violence; specifically, the fatalities of spousal abuse.