To the Editor.
—The article by the Council on Ethical and Judicial Affairs of the American Medical Association1 contains a contradiction regarding mandatory reporting of domestic violence. First, the authors note, "Almost every state requires physicians to report suspected child and elder abuse and neglect to local protective services or law enforcement authorities." But they conclude, "For mentally competent adult victims, physicians must not disclose an abuse diagnosis to spouses or any other third party without the consent of the patient."What happens in the case of a competent elderly woman who is being battered? State laws mandate reporting of elder abuse, regardless of the competency of the abused elderly person. Perhaps investigators need to explore the impact of mandatory reporting of abuse of competent elderly people. If this reporting contributes to the safety of competent older people or facilitates their access to appropriate resources, then why should mandatory
Wiseman E. Reporting Abuse of Competent Patients. JAMA. 1992;268(17):2377-2378. doi:10.1001/jama.1992.03490170049021