N564 Module 6 assignment: policy and law analysis on mandatory reporting of adult intimate partner violence, a full sample

Protection or Harm? Mandatory Reporting of Adult Intimate Partner Violence and the Forensic Nurse's Advocacy

Student Name

Master of Science in Nursing Program, Aspen University

N564: Advanced Forensic Nursing

Instructor Name

Month Day, Year

Protection or Harm? Mandatory Reporting of Adult Intimate Partner Violence and the Forensic Nurse's Advocacy

A composite 31-year-old woman comes to an emergency department in a state that requires clinicians to report injuries from assaultive conduct to police. She has a fractured finger and tells the triage nurse that her husband twisted it. When the nurse explains that the hospital must notify law enforcement, she stops talking, asks for a splint and leaves before the physician sees her. She does not return for follow-up care.

Most states require health professionals to report suspected abuse of children, and many require reports of abuse of vulnerable or older adults. A smaller number go further, requiring clinicians to report injuries to competent adults resulting from intimate partner violence or other assault, regardless of the patient's wishes. This paper examines the purpose of such laws, the evidence on survivors' views and on the laws' effects, the ethical conflict they create for nurses, and a policy alternative that forensic nurses can advocate for.

The Purpose of the Laws

Mandatory reporting laws for adult intimate partner violence rest on reasonable goals: to hold abusers accountable, to relieve victims of the burden and danger of reporting themselves, to create a record that may support later prosecution, and to signal that partner violence is a crime rather than a private matter. California's law, for example, requires health practitioners who treat a patient for an injury they know or suspect was caused by assaultive or abusive conduct to report it to law enforcement. Supporters argue that without such laws, many assaults would never reach the justice system.

What Survivors Think

Survivors are divided. In a survey of 1,218 women in 12 emergency departments in California and Pennsylvania, Rodríguez et al. (2001) found that 12% reported physical or sexual abuse by a partner in the past year. Among these abused women, 55.7% supported mandatory reporting, while 44.3% opposed it: 7.9% preferred that clinicians never report abuse to police and 36.4% preferred reporting only with the patient's consent. Women who had not been abused were more supportive of the laws.

More recent evidence suggests that the laws deter some survivors from seeking help. In a mixed-methods study of 2,462 survivors contacted through the National Domestic Violence Hotline, Lippy et al. (2020) found that mandatory reporting laws reduced help-seeking for more than a third of survivors, that provider warnings about reporting often kept survivors from receiving the support they sought, and that when reports were made they made the situation worse for most survivors. Experiences differed significantly by gender identity and race and ethnicity, with transgender and gender-nonconforming survivors and survivors of color facing particular risks from police involvement.

What the Laws Have Achieved

Evidence that the laws achieve their goals is weak. Sachs et al. (1998) examined 26,051 domestic violence dispatches by the Los Angeles County Sheriff's Department from 1993 to 1995 and found that California's 1994 reporting law did not increase dispatches to medical facilities; total domestic violence dispatches rose after a highly publicized murder case but not after the law took effect. The study is ecological and dated, and it cannot show whether individual clinicians reported more often, but it offers no evidence that the law brought more cases from health care to police. No strong evidence shows that such laws reduce subsequent violence or homicide.

The Ethical Conflict for Nurses

For nurses, mandatory reporting of competent adults creates a conflict between legal duty and ethical obligations. The code of ethics grounds nursing practice in respect for the dignity and autonomy of each patient and in protecting patients' health and safety (American Nurses Association, 2025). A report made against a competent adult's wishes can override her own judgment about her safety, which she often knows better than anyone, and may provoke retaliation. At the same time, nurses must obey the law in their state, and a nurse who ignores a reporting statute risks legal and professional consequences. The forensic nurse cannot resolve this conflict at the bedside by disregarding the law. The appropriate responses are to practice within the law as transparently and supportively as possible and to work to change laws that the evidence suggests harm patients.

Practice Within the Law

Where reporting is mandatory, nurses can reduce harm. They can explain the reporting requirement early and honestly, before the patient discloses details she may not want reported, so that she can decide what to share. They can involve an advocate before the report is made, help the patient plan for her safety in light of the report, and document her wishes and concerns. They can also make sure that the report states only what the law requires and that the patient receives full medical care whether or not she cooperates with police.

A Policy Alternative and Advocacy Plan

The alternative supported by the evidence is consent-based reporting for competent adults: clinicians must offer to report and must provide information about advocacy and legal options, but report to police only with the patient's consent, while retaining mandatory reporting for children, adults who lack capacity and cases involving certain weapons injuries as defined by state law. This model respects the preference of the 36.4% of abused women in the Rodríguez et al. (2001) study who wanted reporting only with consent, and it avoids the deterrent effects Lippy et al. (2020) documented.

A forensic nurse advocating for this change would build a coalition with domestic violence advocacy organizations, emergency nursing and physician associations and survivor groups; gather state-specific data on how the current law affects help-seeking; prepare testimony drawing on the evidence summarized here; and propose statutory language that pairs consent-based reporting with a mandatory offer of advocacy and a warm handoff to services. The strongest argument for legislators is that survivors are more likely to seek care, and eventually to seek safety, when they control what happens to their information.

Conclusion

Mandatory reporting of adult intimate partner violence was adopted to protect victims, but the evidence suggests it may do the opposite for many of them. A large share of survivors oppose it, it deters help-seeking for more than a third, reports often worsen survivors' situations, and there is no clear evidence it increases referrals or reduces violence. Forensic nurses must follow the law where it exists while minimizing harm, and they are well placed to advocate for a consent-based model. For the woman who left with a splint and no follow-up care, such a model might have kept her in the room long enough to be helped.

References

American Nurses Association. (2025). Code of ethics for nurses. https://codeofethics.ana.org/

Lippy, C., Jumarali, S. N., Nnawulezi, N. A., Williams, E. P., & Burk, C. (2020). The impact of mandatory reporting laws on survivors of intimate partner violence: Intersectionality, help-seeking and the need for change. Journal of Family Violence, 35(3), 255-267. https://doi.org/10.1007/s10896-019-00103-w

Rodríguez, M. A., McLoughlin, E., Nah, G., & Campbell, J. C. (2001). Mandatory reporting of domestic violence injuries to the police: What do emergency department patients think? JAMA, 286(5), 580-583. https://doi.org/10.1001/jama.286.5.580

Sachs, C. J., Peek, C., Baraff, L. J., & Hasselblad, V. (1998). Failure of the mandatory domestic violence reporting law to increase medical facility referral to police. Annals of Emergency Medicine, 31(4), 488-494. https://doi.org/10.1016/S0196-0644(98)70259-8