Ethical conflicts and limitations of medical care for women victims of gender violence

Abstract Domestic violence is the most common type of violence against women, resulting in sequelae in the physical, emotional, family, and economic domains, constituting a public health problem. However, the issue is treated negligently by health professionals, which contributes to its invisibility. Based on a review of the literature, the objective of this study was to identify the main difficulties, including ethical conflicts, found by physicians in the approach to patients who are victims of this type of violence. The basic obstacles are grouped in 3 main axes: issues related to the health professional, to the structure of the health system and to the victims of violence. It is concluded that the greatest obstacle comes from the health professionals themselves, and involves factors ranging from inadequate training to the occurrence of moral and ethical conflicts that culminate in blaming and accountability of the victims for the situation of violence in which they were found.

摘要 家庭暴力是针对女性的最常见暴力类型，会在躯体、情感、家庭与经济领域留下后遗症，已成为一项公共卫生问题。然而，该问题常被卫生从业人员忽视，进一步加剧了其隐蔽性。本研究基于文献综述，旨在厘清医师在接诊此类暴力受害患者时面临的主要困境，其中包含伦理冲突。核心障碍可归纳为三大维度：与卫生从业人员相关的问题、卫生系统架构相关的问题，以及暴力受害者相关的问题。研究结论指出，最大的障碍源自卫生从业人员自身，涵盖从培训不足到道德与伦理冲突等诸多因素，最终会演变为将暴力境遇归咎于受害者本人并要求其承担责任的情况。