Responsibility of health professionals in the notification of cases of violence

Oliveira, Bruno Gonçalves de; Freire, Ivna Vidal; Assis, Carla Santana; Sena, Edite Lago da Silva; Boery, Rita Narriman Silva de Oliveira; Yarid, Sérgio Donha

doi:10.1590/1983-80422018263260

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RESEARCH • Rev. Bioét. 26 (3) • Oct-Dec 2018 • https://doi.org/10.1590/1983-80422018263260 copy

Responsibility of health professionals in the notification of cases of violence

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Violence, characterized by various forms and manifestations, cannot continue to be seen by health professionals as a matter unrelated to their work. This study aimed to analyze the responsibility of health professionals in reporting cases of violence. The search was performed through the Virtual Health Library, in the period 2008-2013. From the analysis, three thematic axes emerged: “Brazilian legislation”; “health professional’s responsibility in the reporting process”; and “health professionals’ code of ethics”. It is concluded that the majority of articles regarding codes of ethics point to the need to report cases of violence to their respective councils, authorities and competent bodies. Though, it is noted that they do not make explicit the obligation to notify cases of violence. Thus, it is necessary to review each of the codes of ethics in the field of health, considering the importance of referring specifically to violence.

Ethics; Notice; Violence

Títle	Participants	Results
The responsibility of health professionals to report cases of violence against children and adolescents in accordance with their codes of ethics ¹⁴14. Almeida AHV, Silva MLCA, Musse JO, Marques JAM. A responsabilidade dos profissionais de saúde na notificação dos casos de violência contra crianças e adolescentes de acordo com seus códigos de ética [Internet]. Arq Odontol. 2012 [acesso 2 jun 2014];48(2):109-15. Disponível: https://bit.ly/2Pi1pRe https://bit.ly/2Pi1pRe...	Doctors, dentists, nurses, psychologists, physical education professionals, physiotherapists, pharmacists and nutritionists	The codes of ethics governing the health professions, for the most part, do not include mandatory notification in cases of violence. Professionals have a duty to do so and may be penalised for omission or negligence in accordance with the Estatuto da Criança e do Adolescente - ECA (Child and Adolescent Statute)
The health professional and violence in childhood and adolescence ¹⁷17. Magalhães MLC, Reis JTL, Furtado FM, Moreira AMP, Cardoso Filho FNF, Carneiro PSM et al. O profissional de saúde e a violência na infância e adolescência Femina [Internet]. 2009 [acesso 2 jun 2014];37(10):547-51. Disponível: https://bit.ly/2Pjijz5 https://bit.ly/2Pjijz5...	Doctors	It is necessary to communicate to the competent authorities whenever they are under 14 years old and, in some cases, older adolescents. Evidence of ill-treatment constitutes a just cause for breach of confidentiality. The patient should be informed of the possibility of an expert examination at the Medical Legal Institute, capable of performing a more thorough evaluation
Attention by nurses in emergency care services to children and adolescents victims of intrafamily violence ¹⁸18. Thomazine AM, Oliveira BRG, Vieira CS. Atenção a crianças e adolescentes vítimas de violência intrafamiliar por enfermeiros em serviços de pronto-atendimento. Rev Eletrônica Enferm. [Internet] 2009 [acesso 2 jun 2014];11(4):830-40. Disponível: https://bit.ly/2PgLvqt https://bit.ly/2PgLvqt...	Nurses	Nurses were able to identify or suspect intrafamily violence during the care of children / adolescents who were victims. However, few professionals made the notification, even though it was a legal and ethical assignment
Residents of Paediatrics in the face of domestic violence against children and adolescents ¹⁹19. Bourroul MLM, Rea MF, Botazzo C. Residentes de pediatria diante da violência doméstica contra crianças e adolescentes. Interface Comun Saúde Educ [Internet]. 2008 [acesso 2 jun 2014];12(27):737-48. Disponível: https://bit.ly/2OGlUGn https://bit.ly/2OGlUGn...	Doctors	It addresses the perceptions of paediatric residents regarding violência doméstica contra crianças e adolescentes (domestic violence against children and adolescents - VDCA). The VDCA diagnosis was the attribution most recognised by the interviewees. However, half of them cited the notification and few would report it as a medical report
Profile of reported cases of violence in a university hospital ²⁰20. Silva AN, Gomes ET, Melo RLAS, Siqueira RM, Fonteles LS. Perfil dos casos de violência notificados em hospital universitário. Rev Enferm UFPE [Internet]. 2010 [acesso 12 jun 2014];4(3)1457-63. Disponível: https://bit.ly/2th4BTh https://bit.ly/2th4BTh...	Doctors, psychologists, nurses, social workers, dental surgeons	The largest number of cases reported were children (46.5%), while no cases were reported against the elderly. The notification form was used only in 41.8% of cases
Maltreatment of children and adolescents: a study in São Bento Da Una, PE, Brazi ²²22. Granville-Garcia AF, Silva MJF, Menezes VA. Maus-tratos a crianças e adolescentes: um estudo em São Bento do Una, PE, Brasil. Pesqui Bras Odontopediatria Clín Integr [Internet]. 2008 [acesso 2 jun 2014];8(3):301-7. Disponível: https://bit.ly/2vT6YxL https://bit.ly/2vT6YxL...	Dental Surgeons, Doctors, Nurses.	When verifying the occurrence of maltreatment in childhood, health professionals stated that they had knowledge of the subject (domestic violence). In the general group - comprised of 20 dental surgeons, 6 physicians and 22 nurses - 83.3% of professionals would report cases of child violence to the courts and to the Conselho Tutelar (Tutelary Council)
Child maltreatment: perception and responsibility of the dental surgeon ²³23. Granville-Garcia AF, Menezes VA, Silva PFRM. Maus-tratos infantis: percepção e responsabilidade do cirurgião-dentista. Rev Odonto Ciênc [Internet]. 2008 [acesso 2 jun 2014];23(1):35-9. Disponível: https://bit.ly/2MW5o4v https://bit.ly/2MW5o4v...	Dental Surgeons	In general, professionals would report maltreatment (96%): to the Tutelary Council (63%) and to the Juizado da Infância e Adolescência (Juvenile Court) (22%). However, it is also necessary to clarify the ethical and legal responsibilities of the dental surgeon and his obligation to report these cases involving children and adolescents
Dual loyalty of physicians in the military and in civilian life ²⁴24. Benatar SR, Upshur REG. Dual loyalty of physicians in the military and in civilian life. Am J Public Health [Internet]. 2008 [acesso 2 jun 2014];98(12):2161-7. Disponível: https://bit.ly/2MwAFOG https://bit.ly/2MwAFOG...	Doctors	Evidence that physicians should use ethical principles of health care to deal with violence or abuse against the elderly

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[1] Correspondência. Bruno Gonçalves de Oliveira – Universidade Estadual do Sudoeste da Bahia. Grupo de Pesquisa Saúde e Qualidade de Vida/CNPq/Uesb. Av. José Moreira Sobrinho, s/n CEP 45206-190. Jequié/BA, Brasil.