To the Editor.
—We applaud Dr Brookoff and colleagues1 for looking beyond the medical setting to understand the dynamics of domestic disputes. Clinicians who treat victims of domestic violence know that these are episodic events that we only occasionally glimpse. The participants in this study admitted that they had been victims of abuse over time but had not used medical services as a primary means for seeking assistance. To date, much of the research on domestic violence has myopically focused on the clinical arena and has not stressed the potential lethality of these cases.Several sources confirm that many victims of domestic violence eventually succumb to homicide.2 We have had a similar experience with evaluating victims and their use of the 911 emergency system. In a preliminary observational study, we found that of 29 women (aged 13-73 years) who had been murdered in domestic disputes, 17 (59%)