Key points are not available for this paper at this time.
DEFINITION “Domestic Violence” (DV) is defined in the protection of women from DV act as “any act of commission or omission or conduct resulting in physical, verbal, emotional, sexual and economic abuse” and this can range from calling names, insulting, humiliating, controlling behavior, physical violence to sexual violence (PWD A, 2005).1 Domestic violence is more than physical injury from a single incident of assault. It is a pattern of conduct that uses physical battering as a method to inflict trauma (Tripathy and Arora, 2014).2 DV is often used as a synonym for intimate partner violence, which is committed by a spouse or partner in an intimate relationship against the other spouse or partner, and can take place in heterosexual or same-sex relationships, or between former spouses or partners (Ellsberg, 2008).3 “DV” includes elaborately all forms of actual abuse or threat of abuse of physical, sexual, verbal, emotional, and economic nature that can harm, cause injury to, endanger the health, safety, life, limb, or well-being, either mental or physical of the aggrieved person (Choudary, 2013).4 The person who is the abuser may be a man or a woman and the person who is being abused may be a spouse, a child, or a parent. However, most situations of DV involve violence of men against their wives or female companions. DV often involves sexual abuse and it may also be linked to economic deprivation of the wife or other dependent household members. This type of economic abuse coupled with repeated intimidation is a form of DV even if it does not involve physical aggression or harm. DV of men against women is much more common than the reverse, but we must be aware that we may occasionally encounter abused husbands (Ghosh and Choudari, 2015).5 FORMS OF DOMESTIC VIOLENCE Most people think that DV involves only physical assault, harm, and injury. However, there is a need to recognize that DV includes many forms of abuse. Most of the time they occur together and sometimes, there is a progression from one to the other (Raj, 2019).6 Physical abuse is the most obvious form of DV. The perpetrator assaults and injures his wife or other members of the family. He hits, pushes, kicks, pulls hair, and throws objects Sexual abuse may or may not be associated with physical abuse. It may involve pressuring or forcing the partner to have sex against her will, forcing the partner to perform certain sexual acts such as anal or oral sex against her will or intentionally inflicting pain during sex. Preventing the partner to use birth control or refusing to use a condom when the partner is concerned about a sexually transmitted infection such as HIV or gonorrhea is also a form of sexual abuse Psychological abuse comes in many forms. It may be difficult to recognize and to deal with. Often, there has been at least one instance of physical assault and injury. The perpetrator then uses this experience to intimidate his spouse. He may use threats of violence against her, to make her perform acts that are demeaning or dangerous. He may destroy family property, threaten to take the children away, or threaten the spouse with having her admitted to a psychiatric institution. Some perpetrators use repeated threats of suicide to pressure their spouses. This is also a form of psychological abuse Economic abuse or economic deprivation is even more difficult to recognize as a form of DV. It is, however, commonly found in DV situations. The perpetrator may hold back necessary household money, prevent his spouse from earning money, confiscate the money she may have earned, control all household spending, and spend money only to his own benefit. For most perpetrators, these forms of abuse are means of establishing control over his wife or partner. Most DV results from a person’s desire to exert control over another family member Spiritual abuse is by manipulating a person’s religious or spiritual beliefs to dominate or control them. It can include preventing someone from engaging in spiritual or religious practices, or ridiculing their beliefs or using these beliefs as a way to justify the abuse. DOMESTIC VIOLENCE EXTENT IN INDIA National Crime Records Bureau (NCRB) Report reveals that in every 33 min, one Indian woman is being abused by her husband. India’s National Family Health Survey-III, carried out in 29 states during 2005–2006, has found that a substantial proportion of married women have been physically or sexually abused by their husbands at some time in their lives. The survey indicated that nationwide 37.2% of women experienced violence after marriage (National Family Health Survey III, 2004–2005).7 The NCRB has recorded an increase of 40% in the case of social harassment and 15.2% in cases of dowry deaths. The NCRB Report for the year 2011 further highlights some staggering statistics about the DV against women. The percentage share of DV against women in the cognizable crime has grown from 3.8% in 2007 to 4.3% in 2011. The cruelty by husband and relatives under IPC 498A comes at number four in the maximum incidences of cognizable crimes. As per information provided by the NCRB, a total number of 7803, 11,718, and 9431 cases of DV cases under DV Act 2005 were registered during the year 2009, 2010, and 2011, respectively, thereby indicating a mixed trend. The majority of cases registered under crimes against women out of total Indian Penal Code (IPC) crimes against women were under “Cruelty by Husband or His Relatives” (31.9%) followed by “Assault on Women with Intent to Outrage her Modesty” (27.6%) (National Crime Records Bureau, 2018).8 National Family Health Survey-III reveals that 34% of all women aged 15–49 have experienced violence at any time since the age of 15 in India (IIPS, 2007).9 In spite of low registration of crimes committed against women in India, the rate of such crime as per the figure released by the NCRB of Government of India has increased from 13.2% in 2003 to 52.24% in 2013 (National Family and Health Survey – IV, 2015–2016).10 DV is recognized as a major but underreported public health and social problem among heterosexual and same-sex couples. SCOPE OF THE GUIDELINE Medical practitioners are often the first or the only professionals to come into contact with individuals in abusive situations. They have a unique responsibility and opportunity to intervene. Conventionally, health-care practitioners are not instructed in such intervention or in how to respond appropriately when DV affects their patient’s life. It results in injuries and other negative short-and long-term effects on the health of all the family members. Children and young people in families where DV has taken place are at risk of abuse and associated with detrimental health outcomes. DV not only has physical effects but also a lot of psychological effects too. Victims living with their perpetrators have been known to have high amounts of stress, anxiety, and fear. Depression and posttraumatic stress disorder are also quite common, leading to increased incidences of suicide. Even after the victim has left the dangerous situation, the trauma has a long-term psychological impact. Children exposed to DV during their upbringing have a negative impact on their development and psychological welfare. Medical professionals play a vital role in addressing these problems. Early identification can reduce its consequences and may help to prevent further violence. Unfortunately, health-care professionals do not engage with these issues and they do not routinely screen for health risks such as DV. There is a lot of reluctance among medical professionals regarding taking a history of DV. This can be attributed to either lack of knowledge or expertise about dealing with a case of DV; there is also fear of causing discomfort to the patient, or time constraints, no physical indication of violence; at certain times, the partner is present with the patient making it difficult to assess. Thus, set guidelines are required to guide the professional on how to deal with these situations. Guidelines will help in early recognition and intervention which can significantly reduce the morbidity and mortality that result from violence in the home. Intervention by a health-care provider has shown to make a difference in health and outcome. The DV has a very wide and deep impact in life of the victims. A proper medico-societal-legal environment must be built to make the houses safe and secure for the woman. India cannot prosper by keeping half of its population under distress. RECENT STUDIES ON DOMESTIC VIOLENCE IN INDIA Violence against women has become an increasingly salient issue in India, with women at risk for different forms of gendered violence. Table 1 summarizes the findings on research done in India for the last five years on Domestic Violence. There may be universal elements in the international phenomenon of violence against women, but it is a complex and multifaceted phenomenon that takes shape in a particular sociocultural context (Menon and Allen, 2018).111213141516171819202122Table 1: Summary of findings from India since last 5 yearsTHEORIES ON CAUSE OF DOMESTIC VIOLENCE A common understanding of the causes of DV can help therapist and judicial system. Early theories of DV that have focused on the biological/psychological aspects of the offense have highlighted the role of the individual (be that the or the and psychological also the use of violence by the more and have been to be associated with an increased of DV. psychological DV and and theories have the phenomenon of DV the of social and Table the theories of causes of Domestic of causes of The As in this individual the and this is to DV it for development of Violence against Violence Women for violence that family violence is by and that when these risk is Thus, one may need to at risk A history of abuse or of violence in the in a situation, such as being a very young about the role of men and women. are often in the family of Family risk family or that on social for may be at increased risk have a lack of and with a of and the family on one partner, most often the or abuse of any risk A lack of and This may for intervention and the of of This also to the and lack of social for family members in which violence is a that and often or the social risk of violence as a means to and of violence as of physical of women and children The lack of against violence families defined and and of as to and for the of of women, or that have of children to and the resulting and low about role as family A lack of for family violence The of India has women to the and protection of 15 against any on only of or any of them. forms a of of women with men and the from women on the of sex of life and of every person or of in or female and his or her and of and and of to every men and women of any or the of protection against violence in India The in India that deal with DV The Act 498A of the IPC The of Women from DV The Act In the Indian the and were in and The is a that any person who takes or or of The dowry is defined as any or or to be in with the marriage The for or taking dowry is not in case of which are at the time of marriage any having been The is not a Act as certain of the such as and have been to it and Arora, Indian Penal Code This women to against their husbands and relatives for any at their This is a cognizable and is defined as any conduct that to the woman to suicide or to cause injury or to life, or health or or harassment that involves the woman or any person to her to any for any or or is on of by her or any person to her to such also to any conduct that a woman to suicide or causes injury to her life or health health and also includes harassment in the of dowry The of Women from Domestic Violence Act The the of Women from DV Act in It is a that protection to women in a from men in the This not only women who are married to men but also women who are in relationships, as as family members and other dependent women. this women can protection against the to in their and they can from their abuser in case they are living This Act on the to women from violence. The is required to with and on DV The act also the to the must and to to DV in medical and in the of DV 2005).1 of In the with a to the of the that it the to under of the Indian The that 498A to the and that the of is The the that the is defined in the and its not be In of India, the of and that of the that all be However, the may among people on The relationship must be between the aggrieved person and to DV The in the case has that if the wife the share with husband to her own the relationship comes to an a under DV Act cannot be against husband or his In that if at the time of of the wife has been there cannot be any relationship and as a wife cannot be for protection under DV The Report on the that 498A the wife the husband in a DV it a and individuals are and leading to and mental and physical to the or to the as a result on of Government of India, of In of that in a case where a young a are and is on the In to prevent of the out with that every by the must be to a Family the can the perpetrator It also that this the of the since and of can be women too. then the has been from the DV The of India in and case has that is not to the case of DV The only to women. in India cannot of a to from DV from either men or women. For even a of having a or female from a or protection is not by the and women from violence The after its 2005 in the of their women have an It a that the share as their may The for the not to on of sex when it comes to their The Act in of and also that cannot in of on of the of women for the in is by against sexual harassment at As per this a woman can safe in their and can any It is also a to the economic of women by they safe to come out of their houses to of Women at and OF DOMESTIC VIOLENCE The impact of DV is and wide the family and It can be under Physical health pain Sexual and health sexually transmitted of Psychological can be of to posttraumatic stress or Economic and social impact and social at to in social and economic fear of violence, which the individual to other members in to resulting in fear of into public can often in can their to other of violence to as a result of violence impact on The impact on family and effects or economic and development with health as a result of violence experienced by the during birth or low birth of violence against children in where there is DV effects on children who violence at and low aggression against family and property, increased risk of to be either a perpetrator or a victim of effects of to for her children and to of violence on and their in or negative of a the resulting The impact on the perpetrators by and on their or the of their families of from their families the of violence for which they are the responsibility for violence their partner and to it with their relationship in the home. The impact on on health and judicial to economic and to in the development and of their to social and economic of women to respond to or economic of in social on which and that are of vital in the of in of stress and and OF DOMESTIC VIOLENCE are often the first to come into contact with individuals in abusive situations. in this we are to a to DV in and health-care The and identification can help practitioners make for and guidelines will include for and patient information about and on these with and and with to social situation, that DV is in any relationship It may be a out to engage in long-term the health-care to help to and control in their the of and their children as It is a to conduct DV The must have in DV and to risk and in as as experience in with DV perpetrators, and their children and Table some and for Domestic Some and There may be different of in DV Most often a case may be by the of and can of and In such not only but also in of victim and Psychological have been shown to be in which is a problem than a health or psychiatric The mental health or psychiatric on psychological and use psychological and in to It also includes medical or a physical abuse The proper on individuals for abuse and or The history can be from the victim of DV. The abuse can include and Sexual This is to abuse in that the is to on one This may be an as an for the when there are about a issue of sexual The of this is to the of of on do not routinely screen for DV and it only the issue if DV. they do not DV in and DV in a The summarizes take in and of partner violence to routinely about partner violence in own about violence. patient’s with about the of to and who present with or of DV injuries in of Children who present with or of DV with history of abuse by or their partners with pain history of to in a and safe from The of a female is a must a is the female this cannot be for a must use in a own in a way and to are must issues with the patient The patient may abuse if she is not to deal with the cannot the issue with The to or take to be if any be done any to the patient she the of increase in or of the assaults of threats of or suicide to children of in the home. incident and physical be The to to the patient the of of present and injuries for her in of to be taken be for of present the patient’s and of or history and medical and resulting from violence there been intervention in the the physical any with of and on and with risk to will be in physical have a safe place to type of having any This may need to in of the patient’s has the abuse do do to with the much does the abuser control partner to to or have own money or on health of medical and psychological effects have from of abuse psychiatric pain of abuse on children children shown any of physical sexual abuse that be to abuse. they the not conduct DV for their own The role of the and the therapist is very can some information to or to the if they routinely information from their their role with the may their or their to the may be when are used as an health professionals often do not routinely screen for even the of has at least for DV for all some professionals do not even or not their have experienced DV as a victim or they do not do The professional may think will these issues on their and that if it not then it not In family and cases when DV professionals often that the are to have the in a or case and the for not DV cause more Economic problems. of DV to the health-care provider be injuries Medical of or other problem to stress and psychiatric DV may psychiatric disorder and the psychiatric may also be to and and may the victim is in safe all these have to be taken into in intervention and with of the has to to the of The issue of is of in a victim of and it include in health-care and when the victim if with the issue of of children also to be the of victim of DV over her own life on of the victim and involve than by making women aware of her and and then she making a to intervention the cause of violence in only of women are the and time of the medical practitioners own they may regarding it on the of the victim to share information abusive partner may with the women out with her The the victim and may but in they do not the victim be with the health-care The health-care provider on the victim They routinely for abuse be done the medical and mental health problem as many which are not in 1 or may come out of the abused individual of violence is the first of intervention is not history of psychiatric is the of the patient has been and is there are of psychological which can help these is to be the of forms of and violence are in focused This is for patient of or DV. The about of in this of marriage of not having been to take of children the and of other in the of with the abuser in to of The on negative about and that help to trauma and for and perpetrators in – to and This involves of for The has and on woman and of and trauma This of trauma with and and are is on are also such as and This is 1: establishing and by a and stress on trauma includes and to the present and and and that is no defined by the trauma and its and victim of of violence is the her to about it The patient’s and as as result of and medical and trauma history and social history A of the number of all with children are also being the to the patient and the patient’s is no or she will not the findings and injury and perpetrator is not the but health-care provider a help can be regarding the it is not very which method will but which are common to all about the causes and of DV to and development to trauma on of psychiatric it is to and and for by against women in and in and of the perpetrators Some husband is also it is for fear of being This when a man a young woman. There is no to that perpetrators of DV from any mental but the have been found common in being abused in or having abuse the of an abuse is linked to the act of abuse are often in public but when of abuser high rate of with use type have been found in perpetrators of The dependent type violence is the family They are and dependent on their partners Violence is by threat of or actual The They are and the family and Violence is often associated with or use and high rate of at the of men who has shown some in violence. who need are very to but who help do They come for if by the The involves the men to take responsibility of their of the in the use of violence in the relationship to to For time and from partner is For the of the a by Medical can for women in in Table for women in (National for Women – DV is any the of which is to and control over a spouse, partner, or intimate family It is and out in which can over a of time and of for the There have been many to DV there is no one A common understanding of the causes of DV can help therapist and judicial system. The is a for the therapist to It on and than and Indian judicial has many for and DV. However, the is the victim and a Even there is no for the victim and the be the of the and of There are no of
Raveesh et al. (Tue,) studied this question.