When Elena attempted to break up with her abusive boyfriend, he beat her horribly, saying he would leave her with scars by which to remember him. Although badly injured, she did not contact the police to report the domestic violence. Nor did she seek medical care for her open wounds or the ringing in her ear. She had heard news of President Trump's expanded immigration enforcement policies and stories of immigration agents arresting domestic violence and human trafficking victims inside courthouses. She had also learned that her state, California, requires medical professionals to report domestic violence and sexual assault to the police, and she feared deportation more than she desired medical care.
Elena's case is hardly unusual. In the domestic violence clinic I direct at UC Irvine Law, I've witnessed how mandatory reporting laws, which were meant to increase documentation of domestic violence injuries and hold abusers accountable, have had the unintended consequence of discouraging immigrants here illegally from seeking treatment. States can and should repeal these laws as they apply to domestic violence; they simply do more harm than good.
Immigrant women and girls are highly vulnerable to abuse and are statistically twice as likely as non-immigrant females to experience domestic violence. Many of my clients' U.S. citizen spouses refuse to sponsor them for citizenship, instead threatening deportation if the victimized individual calls the police. Rampant sexual abuse and trafficking also occur, with citizen spouses telling non-citizens that it is an immigrant's duty to sexually submit. Unsurprisingly, abuse often causes extensive physical harm as well as mental anguish.
Forty-five states and the District of Columbia have statutes that mandate or encourage medical professionals to report certain injuries to law enforcement, and some states specifically require them to report domestic violence. For example, California, Colorado and Kentucky require medical professionals to notify police about injuries caused by physical abuse or sexual assault. In such states, at a minimum, a medical provider who suspects domestic violence must report to police the patient's name, location and injuries and the name of the suspected abuser. A health practitioner can face misdemeanor charges for failing to relay this information.
Despite their ubiquity, the American Medical Assn. believes that such laws "violate the basic tenets of medical ethics and are of unproven value." In a California study of more than 500 physicians, a majority of doctors indicated that domestic violence mandatory reporting laws create barriers to healthcare, can escalate abuse and violate patient confidentiality and autonomy. Research shows, moreover, that abuse survivors are best served when doctors and nurses offer supportive and ongoing access to medical care, protect patient confidentiality, address safety concerns and provide patients with a range of options while allowing patients to control decision making.
Ideally, the Trump administration would explicitly agree not to send immigration agents to courtrooms, and would vow not to use domestic violence reporting against vulnerable abuse victims. But that's obviously not the direction the administration is going.
It is therefore up to the medical, legal and social service communities to protect abuse survivors who come to them in need and to shield them from fears of deportation. We must recognize that individuals in abusive relationships may need and want medical care without police involvement.
Jane K. Stoever is clinical professor of law at UC Irvine School of Law and director of UCI's Domestic Violence Clinic.