Domestic Violence: We Can Live Without It: Rights and Options Available Under the Law
Seeking Medical Treatment:
The Rights & Responsibilities of Patients & Health Care Providers
Sometimes injured people are afraid to seek medical help because of shame or fear. They may be ashamed of the fact that they are being abused or beaten or afraid that if they tell someone else and the abusive person finds out, the abuse will only get worse.
Don’t Let Fear or Shame Prevent a Victim from Getting Medical Help
Victims’ health and safety, and that of their children, are too important to be ignored. Money worries should not be allowed to stand in the way of needed medical treatment. Victims owe it to themselves (and their children if they are parents) to seek treatment as quickly as possible. Broken bones do not always heal properly, and cuts or bruises can become infected if left on their own. Stitches may be urgently needed to close a wound. Head injuries, in particular, can have drastic consequences if not attended quickly. If a woman is beaten while pregnant, her baby may be harmed as well. If a victim doesn’t have transportation to the doctor or hospital, she or he should call a friend, relative, or neighbor for help. If the injuries are severe enough, a victim should call 911 and ask for an ambulance. In the long run, it is better to give full details of how the injury occurred.
Where to Go
If a victim is badly injured, she or he should go to the nearest hospital emergency room. “Badly injured” may mean broken bones, major cuts and bruises, a head injury, or severe bleeding, for example. If a victim is pregnant, a blow to the abdomen could hurt her baby. She should be seen by a doctor without delay, especially if she is bleeding or feeling contractions. If a victim is not sure whether an injury constitutes an emergency condition, she or he should go to the hospital to be evaluated. In the long run, there is no sense in taking chances with health.
Victims who are sure that they can wait to be seen at a doctor’s office or clinic should go there at the earliest opportunity. If they have private insurance or have the funds to pay for care, they can go to a regular family doctor, pediatrician, or OB/GYN, depending on the nature of the injuries. Some insurance plans, such as TennCare, will require a patient to be seen by a specific primary care doctor. Some plans do not pay for emergency room visits unless a true emergency condition exists. If victims have no insurance and no funds, they can call the InterFaith Health Clinic at 315 Gill Avenue, Knoxville, (865) 546-7330, www.interfaithhealthclinic.org.
What to Expect
By law, a hospital emergency room must provide every patient “medically appropriate screening” to find out whether in fact the patient has an emergency condition.12 This is true regardless of whether the patient has insurance or money to pay for care. If the screening procedure determines that an emergency condition exists, the emergency room personnel must stabilize the patient before discharging or transferring her or him. (Transfer may be necessary if the problem cannot be adequately cared for at that hospital.) The initial screening exam may be performed by a nurse, a physician’s assistant, or a physician. Remember that patients will be screened regardless of their insurance or payment status. Hospital personnel are allowed to ask about insurance, however, as their inquiry does not delay screening.
If the screening determines that a patient does not have an emergency condition (or in the case of pregnancy, is not in labor), the patient may be discharged and advised to follow up with her or his regular doctor. This means that the injuries can safely be treated in a less “intense” setting than an emergency room or, perhaps, need no further care. If at all possible, a victim should stay away from the person who inflicted the injury and avoid anything that would prevent healing. It is important to carefully follow all instructions given by medical personnel.
Confidentiality of Medical Records
Patients’ medical records are private, and whatever patients tell nurses or doctors in confidence will not be repeated. Remember, though, that doctors and nurses are required by law to report certain types of injuries to the authorities. In Tennessee, these include the following:
Suspected child abuse must be reported immediately to a juvenile court judge, the Department of Children’s Services (“DCS”), or the Sheriff’s Department.13 Everyone in Tennessee is a mandated reporter under state law. Any person with reasonable cause to believe a child is being abused or neglected must, under the law, immediately report to the Tennessee Department of Children's Services or to local law enforcement. The reporter can remain anonymous. If the physician believes that the child’s life, physical or mental health could be in danger of further harm, he or she may contact DCS to arrange for protective custody, even if the parents do not consent. Reports of suspected child abuse are kept strictly confidential.
Abuse of an Elderly or Impaired Person
Physicians must report suspected abuse against adults who, because of advanced age or mental or physical disability, are unable to manage their own affairs or live without assistance.14
Injuries Inflicted by a Deadly Weapon
Doctors and nurses must report to the police all injuries inflicted by means of a knife, pistol, gun, other deadly weapon, suffocation, other means of violence, or poison. Victims seen at a hospital or a doctor’s office will be asked how they came to be hurt. If a victim is afraid to tell the truth, no one can force the victim to say exactly what happened. (They may be able to guess anyway.) It is better for victims to give full details of how they were injured to ensure accuracy of records. Someday, the records may be needed as evidence to prove that abuse occurred. If a victim feels strongly that reporting the situation to the police will do more harm than good, the victim can ask the doctor or nurse to consider those wishes. Depending on the circumstances, they may be persuaded not to report in rare cases. If a child or an elderly or impaired person is involved, however, the health care provider is required by law to report the abuse.
12 42 U.S.C., § 1395dd.
13 Tenn. Code Ann. §§ 37-1-403 (2014), 37-1-605 (2014).
14 Id. Tenn. Code Ann. § 71-6-103 (2012).