Reporting Abuse of Competent Patients-Reply

Oscar W. Clarke, MD; David Orentlicher, MD, JD
JAMA. 1992;268(17):2378. doi:10.1001/jama.1992.03490170049022.
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In Reply.  —In developing its guidelines on domestic violence, the Council on Ethical and Judicial Affairs considered the experience with mandatory reporting in the context of elder abuse. A number of experts oppose mandatory reporting for elder abuse. They observe that it can deter elder adults from seeking medical care and other necessary assistance. In addition, because states often do not provide sufficient funding for meaningful interventions, mandatory reporting may increase the risk of harm without offering any countervailing benefit.1 As discussed by the Council in its report,2 similar concerns apply when mentally competent, non—elder adults are abused by their spouses or other intimate partners.The Council also emphasized the importance of respecting the abused person's decision whether to accept an offered intervention or not. The Council Report recommends that physicians give assurances of safety and confidentiality and encourage their abused patients to consent to helpful interventions. Ultimately,


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