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Ethics and Public Policy
April 1999

Family ViolenceA Neglected Epidemic

Author Affiliations

Dr McAfee is a former president of the American Medical Association Board of Trustees.


Dr McAfee is a former president of the American Medical Association Board of Trustees.

Arch Facial Plast Surg. 1999;1(2):133-134. doi:10.1001/archfaci.1.2.133

An obviously well-to-do older woman goes for her yearly physical examination. Her physician asked during the routine history, in a nonpejorative fashion, "Has anyone harmed you in the last year? Do you feel safe at home?" Much to the physician's surprise, she sighs, responding, "Nobody has ever asked me that before. I thought I was hiding it better."

For the past 10 years, the American Medical Association1 (AMA) has identified family violence as an emerging, and now an epidemic, public health problem. Violence, in general, in our society and across the world is now declared a public health priority by the Institute of Medicine, the Centers for Disease Control and Prevention, and the World Health Organization.1 The latter organization identifies violence as a neglected epidemic that soon may surpass infectious disease as the principal cause of morbidity and premature mortality worldwide.1 There is no question that in the United States violence takes its toll more often on young Americans, and, therefore, in terms of years of life lost, rates near the top of those diseases or conditions responsible for premature mortality. The AMA has pledged its resources—its publications, its accreditation activity, its education, and its public policy advocacy—in an attempt to diminish the incidence of violence among our patients. Family violence, which includes child abuse and neglect, spousal or partner abuse, and elder abuse, represents a continuum of behavior that all too often is seen in what should be the safest haven. Family violence—perhaps the greatest oxymoron we know.

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