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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 33  |  Issue : 3  |  Page : 274-279

The trailing trials of humiliation: Legal, social, and medical perspectives of women facing domestic violence in India


1 Department of Oral Medicine and Radiology, A. B. Shetty MemorialInstitute of Dental Sciences, NITTE University, Deralakatte, Karnataka, India
2 Criminal and Civil Advocate, Mangalore, Karnataka, India

Date of Web Publication14-Sep-2017

Correspondence Address:
Kumuda Rao
A.B. Shetty Memorial Institute of Dental Sciences, NITTE University, Deralkatte, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijsp.ijsp_53_16

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  Abstract 


Globally, violence within the home is universal across culture, religion, class, and ethnicity. Despite its widespread prevalence, such violence is not customarily acknowledged and has remained invisible-a problem thought unworthy of legal or political attention. The social construction of the divide between public and private life underlies the major problem of addressing the hidden nature of domestic violence against women. Legal jurisprudence has historically considered the domain of the house to be within the control and unquestionable authority of the male head of household. Thus, acts of violence against members of the household, whether wife or child, were perceived as discipline and essential for maintaining the rule of authority within the family. Except for sensational cases, the fear of social isolation and inhibition has caused the insidious everyday violence experienced by huge numbers of women to be hidden in the private domain. In this review, we make an attempt towards briefing the legal, social, and medical perspectives of women facing domestic violence.

Keywords: Dentists, domestic violence, humiliation, judiciary, medical, social inhibition, trails


How to cite this article:
Rao K, Sharma K S, Kumar SU, Bhat K V, Babu SG. The trailing trials of humiliation: Legal, social, and medical perspectives of women facing domestic violence in India. Indian J Soc Psychiatry 2017;33:274-9

How to cite this URL:
Rao K, Sharma K S, Kumar SU, Bhat K V, Babu SG. The trailing trials of humiliation: Legal, social, and medical perspectives of women facing domestic violence in India. Indian J Soc Psychiatry [serial online] 2017 [cited 2019 Oct 19];33:274-9. Available from: http://www.indjsp.org/text.asp?2017/33/3/274/214598




  Introduction to Domestic Violence Top


Domestic violence is the intimidation, physical assault, battery, sexual assault, and/or other abusive behavior as part of a systematic pattern of power and control perpetrated by one intimate partner against another, which includes physical violence, sexual violence, psychological violence, as well as social, financial, and emotional abuse occurring within a household or between family members.[1] It is synonymous with “inter-partner violence,” “inter-spousal violence,” “violence against women.” It includes harassment, maltreatment, brutality, or cruelty, and even the threat of assault-intimidation. It also includes physical injury, as well as “willfully or knowingly placing or attempting to place a spouse in fear of injury and compelling the spouse by force or threat to engage in any conduct or act, sexual or otherwise, from which the spouse has a right to abstain.” Confining or detaining the spouse against one's will or causing damage to property are also considered as acts of violence.[2] The United Nation framework for model legislation on domestic violence states that “All acts of gender-based physical and Psychological abuse by a family member against women in the family, ranging from simple assault to aggravated physical battery, kidnapping, threats, intimidation, coercion, stalking, humiliating verbal abuse, forcible or unlawful entry, arson, destruction of property, sexual violence, marital rape, dowry or related violence, female genital mutilation, violence related to exploitation through prostitution, violence against household workers and attempts to commit such acts shall be termed Domestic Violence.”[3] The Recommendation Rec (2002) 5 of EU[2] the term “violence against women” is to be understood as any act of gender-based violence, which results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women, including threats of such acts, coercion, or arbitrary deprivation of liberty, whether occurring in public or private life in general globally.[4] Reports from countries such as the UK, Russia, and Estonia estimate that approximately 25% of women experience intimate partner violence over their lifetimes,[5],[6],[7] which is lower than that in other countries such as USA (28%), Chile (26%), Kenya (42%), Egypt (35%), India (45%), and Thailand (20%).[8]

There are many barriers to dealing with domestic violence among which misperceptions and false assumptions of the roles of the legal and medical communities, which they hold of one another are the most important and noteworthy.[8]

In the Indian perspective, for the masses among the population facing the abuse, the barriers that exist mainly are first the society at large, second the legal system, and finally, the medical fraternity. The National Crime Records Bureau (NCRB) statistics of India indicates that an Indian woman is most unsafe in her marital home, with 43.6% of all crimes against women being “cruelty” inflicted by her husband and relatives. These numbers exclude incidences of marital rape, as India does not recognize marital rape as an offence as Sec. 375, IPC contains an exception which states “Sexual intercourse by a man with his own wife, the wife not being under fifteen years of age, is not rape.”[9] However, an amendment to the Section 375 in 2013 widened the definition of rape to include nonconsensual sexual acts including anal sex, oral sex, etc. Until this amendment, several sexual acts other than penile-vaginal sex were criminalized only by Section 377 as being “non-procreative” and “against the order of nature.” Based on these laws, “the unlawful and unnatural sexual acts” as well as “marital rape” may be booked under Section 377 and Section 375 (following the 2013 Amendment).[10] Significant proportions of the victims have experienced psychological violence as the most prevalent form of domestic violence. This could be due to fear, anxiety, insecurities perceived among women undergoing domestic violence, and consequences associated with them.[11],[12],[13] Mounting evidence suggests that domestic violence has long-term negative consequences for the survivors, even after the abuse has ended, which can translate into lower health status and lower quality of life.[14] In addition, they often experience difficulty in future relationships, which in turn, not only affects the stability of home and family but also professional relationships in the course of employment.[15]

Because of the large number of reported cases, perceptions surrounding the nature of domestic violence have grown in diversity across the professions attempting to reduce domestic violence. Government organizations and public campaigners have highlighted the need for consistency in responses toward domestic violence as well as to consider the importance of acknowledging its complex nature.[16] The title “The trailing trails of humiliation” in the Indian context implies to the trials of humiliation even after the registration of the case, which may be attributed to the laxity in the implementation of laws in relation to domestic violence.

The Legal Issues

As per the World Report on Violence and Health, intimate partners, often in the context of an abusive relationship, commit 40–70% of homicides of women worldwide.[3] Intimate partner abuse is generally part of a pattern of abusive behavior also known as “wife-beating,” “battering,” or “domestic violence.”[17]

In India, Domestic violence was recognized as a specific criminal offence by the introduction of section 498-A into the IPC only in 1983.[18] Till the year 2005, limited remedies were available to a victim of domestic violence in the civil courts (divorce) and criminal courts (vide Section 498A[19] and 304B[20],[21] of the IPC). Taking this scenario into consideration, an Act to provide for more effective protection of the rights of women guaranteed under the Constitution who are victims of violence of any kind occurring within the family and for matters connected therewith or incidental thereto was implemented which came to be known as The Protection of Women from Domestic Violence Act (PWDVA), 2005 [No. 43 of 2005] on 13th September, 2005.[22] The Protection of Women from Domestic Violence Act 2005 Domestic Violence Act (2005) was the first significant attempt in India to recognize domestic abuse as a punishable offence, to extend its provisions to those in live-in relationships, and to provide for emergency relief for the victims in addition to legal recourse.

Domestic violence is currently defined in India by the Protection of Women from Domestic Violence Act of 2005. According to Section 3 of the Act, “any act, omission or commission or conduct of the respondent shall constitute domestic violence in case it[22]:

harms or injures or endangers the health, safety, life, limb, or well-being, whether mental or physical, of the aggrieved person or tends to do so and includes causing physical abuse, sexual abuse, verbal and emotional abuse, and economic abuse; or

harasses, harms, injures, or endangers the aggrieved person with a view to coerce her or any other person related to her to meet any unlawful demand for any dowry or other property or valuable security; or

has the effect of threatening the aggrieved person or any person related to her by any conduct mentioned in clause (a) or clause (b); or

otherwise injures or causes harm, whether physical or mental, to the aggrieved person.”

Jammu and Kashmir, which has its own laws, in 2010 enacted the Jammu and Kashmir Protection of Women from Domestic Violence Act, 2010.[23]

Section 2(a) of the Act helps any woman who is or has been in a domestic relationship with the “respondent” in the case. It empowers women to file a case against a person with whom she is having a “domestic relationship” in a “shared household,” and who has subjected her to “domestic violence.” Children are also covered by the Act; they too can file a case against a parent or parents who are tormenting or torturing them, physically, mentally, or economically. Any person can file a complaint on behalf of a child. Under this, the law considers physical, sexual, emotional, verbal, psychological, and economic abuse or threats of the same. Even a single act of commission or omission may constitute domestic violence-in other words, women do not have to suffer a prolonged period of abuse before taking recourse to the law. Furthermore, it legislates against husbands who throw their wives out of the house when there is a dispute. Section 17 of the law, which gives all married women or female partners in a domestic relationship the right to reside in a home that is known in legal terms as the shared household, this applies whether or not she has any right, title, or beneficial interest in the same. Such an action by a husband will now be deemed illegal, not merely unethical. Sections 18–23 provide a large number of avenues for an abused woman to get relief. She can get, through the courts, Protection Orders, Residence Orders, Monetary Relief, Custody Order for her children, Compensation Order, and Interim/ Ex parte Orders. Despite such stringent law enacted by the Government of India to prevent domestic violence against women, most cases of domestic violence go unreported; until and unless there is death of or some serious injuries leading to hospitalization of women.[22] At an institutional level, this may be attributed to the large number of reported as well as unreported cases and the rampant police corruption that has led to weak enforcement of domestic violence laws; as cases against wealthy or influential suspects are not properly investigated and recorded, and other suspects escape prosecution or civil penalties through bribes. The police are often reluctant to press charges against or investigate influential persons.[24] This widespread police and judicial corruption mainly limit the PWDVA's effectiveness as the implementation of the act becomes deficient.[25]

The Social Issues

Marriage in India is a voluntary union for life of a man and woman to the exclusion of all others. It is a social association where the husband has the responsibility of taking care and maintaining his wife and not neglecting his duties.[26] Women face the threat of violence in various forms throughout their lives. As it is generally accepted that the wife being weaker physically, socially, and with respect to resources, might easily be physically, mentally, sexually, and economically tortured by husband, apart from physical assault, psychological abuse, such as constant intimidation, humiliation, and coercive sex. Another form of abuse is isolating a woman from her family and friends, monitoring her movements, and restricting her access to resources and services.[17] It is one of the most widespread human rights violations, denying women and girls equality, security, dignity, self-worth, and their right to enjoy fundamental freedoms at par with men. When violence occurs within the house, the abuse is effectively condoned by the tacit silence and the indifference by the law-enforcing machinery and the instruments of the state.[27] Domestic violence is usually perpetrated by males who have been or, who are, in positions of trust, intimacy, and power such as the husband, boyfriend, father, fathers-in-law, stepfather, brothers, uncles, sons, and/or other relatives. Many victims of domestic violence refuse to name the perpetrator of the assault or attribute the injuries to other reasons.[28] Moreover, there are many other ever-married women who accept and justify wife-beating.[29] According to the United Nation's Population Fund Report, approximately two-third of married Indian women are victims of domestic violence, and as many as 70% of married women in India between the age of 15 and 49 are victims of beating, rape, or forced sex.[30] Women face problems related to cultural segregation, religion, race, nationality, class, cultural norms and standards socialization, responsibility for family honor, and social integrity of themselves and their children.[31] Greed for dowry, desire for a male child, and alcoholism of the spouse are major factors of domestic violence against women in India.

Medical issues

Over the past decade, considerable effort has been made to increase the responsiveness of the healthcare community to domestic violence. These efforts were initiated by and originally focused on healthcare practitioners and institutions, but have grown to include other sectors acting in collaboration with the healthcare community.[7] Research indicates that victims of domestic violence often have a wide variety of physical and mental health needs.[32] The associated social isolation and inhibitions of the mentally orthodox society adds to the agony of the victims causing numerous physical and mental ailments resulting in crippled quality of life. In addition to the immediate injuries from the assault, battered women may also suffer from chronic pain caused by physical trauma like that of headaches, body pain, gastrointestinal disorders, psychosomatic symptoms, memory loss, broken bones, head and neck trauma, infectious diseases, dental or oral problems, respiratory illness, unhealthy weight loss due to food deprivation and poor nutrition, unplanned or early pregnancies, sexually transmitted infections, pelvic inflammatory disease, kidney infections, and other gynecological problems including pregnancy associated deaths of the victim as well as abortion of the fetus. Although psychological trauma is considered less severe, it has devastating physical and emotional health effects leading to anxiety, post-traumatic stress disorders, and depression.[33],[34],[35] In 1985, the American College of Obstetricians and Gynecologists became the first national medical organization to recognize and address the issue of domestic violence.[36] Later, in 1991, the American Medical Association launched a campaign against family violence.[37] Although current practices and procedures for identifying, evaluating, and treating victims of domestic violence are not flawless, they provide an important foundation to learn from and build upon.[38] Guidelines for domestic violence screening suggest posting signs and literature to supplement routine screening and reinforce the healthcare setting as a safe place to seek assistance. They also recommend conducting all screenings in private settings away from perpetrators who may accompany victims to healthcare settings.[39] Along with these practices, universal screening for domestic violence is recommended across the healthcare field; the majority of guidelines for examination of victims of domestic violence focus on the importance of evidentiary examinations. Evidentiary examinations help in the assessment of the medical needs of victims while collecting evidence for law enforcement purposes.[40],[41] This involves the attainment of a patient's medical history and description of the crime; assessment of psychological functioning; performance of a physical examination; collection, documentation, and preservation of evidence; collection of lab samples; treatment for medical needs; and referral for medical and psychological services.[42] A drawback with regard to the same is that the present medical and nursing syllabi or related textbooks do not include adequate inputs, practical skill development, or lectures to prepare future doctors and nurses to cope with the rising trend of violence against women in our society. This lacunae needs to be addressed because health care professionals are often seeing victims of domestic violence in their day to day practice.[43] Further, numerous tools have been developed to assist with the evaluation of domestic violence. The Domestic Violence Survivor Assessment (DVSA) tool assists healthcare practitioners and patients in identifying psychological processing of the abuse as well as movement toward a violence-free life.[44] Evidentiary exams should only take place after all emergency needs of the victim have been met, including appropriate protective action for victims who are actively homicidal or suicidal,[41],[42],[45] only after obtaining the written consent of the patient,[42] based on culturally competent practices that respond to the cultural needs of the victim and with particular care while conducting examinations on children.[40] Medical records for evidentiary examinations should be kept separate from patients' other medical records to ensure limited access by authorized personnel and the findings should be released to law enforcement only when victims provide consent or when it is mandated by law.[40],[41] Because of these serious and often co-morbid medical and mental health consequences of domestic violence, it is imperative that the healthcare industry begin to establish comprehensive protocols and procedures to integrate them into day to day life. This will help to improve proper identification and provision of appropriate services to the victims of domestic violence.

Role of dentists

Knowledge regarding domestic violence and its effect on orofacial region is known only very few oral healthcare professionals, and many others are not aware of appropriate actions are to be taken. Not many studies on the effects of domestic violence on the head and neck have been conducted across India. A study in Brazil reported that 38.7% of the domestic violence injuries were related to the head and neck region. Of the dental trauma cases, 59.1% were fractures, 27.2% were luxations, and 13.7% were avulsions. The most frequently injured teeth were the incisors;[46] dental professionals may observe visible injuries to the patient's neck including, ligature marks, scratches, abrasions and scrapes, petechia on the neck, face, eyes, mouth, swelling, and difficulty in swallowing, which could be indicators of domestic violence.[47] To combat this hidden epidemic problem, education regarding domestic violence will be helpful for dentists to consider their responsible role in Public Health Dentistry.

The authors of an article titled “Changing dentists, knowledge, attitudes and behaviours regarding DV through interactive multimedia tutorial” developed a tool called “AVDR,” which can be used as a quick and simple way to tackle DV when abuse is suspected.[48] It is an acronym for “asking, validating, documenting, and referring.” Hence, educating dental specialists in identification, intervention, and quick action to refer the patient for medical evaluation and treatment can be a small public dental health step towards major epidemiological problem.[49]

A summative perspective of issues pertaining to domestic violence

The effect of domestic violence on a woman's health or life may be profound and may cause physical and mental unrest even later on. Numerous analyses, studies, and articles also have not only reported the failure of family laws of India currently in force but also their contribution towards the creation of “Justice Crisis” for women stressing the need for the reimaging of current constitution.[50],[51],[52],[53],[54] The NCRB Report of India for the year 2011, 2013 has thrown light at some surprising statistics regarding domestic violence against women in India. The percentage of domestic violence against women as per the report has grown from 3.8% in 2007 to 4.3% in 2011 in the cognizable crime.[27],[52],[55] From 50703 in 2003, the number of reported cases has gone up to 118,866 in 2013, an increase of 134% over 10 years, far out-stripping the rise in population over the same period.[52] Cruelty by husband and other relatives comes at number four under IPC 498A in most of the incidences of cognizable crimes. Other cognizable crimes such as theft under IPC Sections 379-382, Hurt under the IPC Sections 323-333 and Section 335-338; and causing death by negligence under IPC Section 304A are more frequent reported or registered than the domestic violence.[27],[55] There is a pressing need for women's emancipation and the ever increasing numbers of dowry deaths and harassments that need to be stopped. However, sadly, women today are still tortured and the court, which should have been their ultimate refuge, is not reliably protecting them or coming to their rescue.[56] It is very disturbing as well as discouraging to think that a country that praises womanhood through epics and their devotion to goddesses can be so demeaning and indifferent when it comes to the common women living in the country.[57] The response to domestic violence should typically be a combined effort between law enforcement, social services, and health care system.[58] The judicial trials should be made swift to provide a dignified standard of living and quality of life to the victim.


  Conclusion Top


Nowadays, comprehensive norms are stated, however, these are to be put in practice with both governmental and nongovernmental effort as nullifying domestic violence must be considered a true social priority. Violence against women is partly a result of gender relations that assumes men to be superior to women. Given the subordinate status of women, much of gender violence is considered normal and enjoys social sanction. Hence, proactive or holistic efforts are required to address domestic violence through community development schemes, women's self-help collectives, efforts to raise public consciousness, and to empower women economically and politically. The efforts of the government are toward enacting relevant legislations and launching various women welfare schemes. These are the efforts that can potentially reach the vast majority of women who can come forward to complain of domestic violence. Overall, the lack of real urgency in the recognition these issues shows the ignorance of the Indian legal system in total to implement the respective laws and to resolve the various problems faced by destitute and deserted women of India. Therefore, women deserted primarily by the family, tend to be secondarily deserted by the law and finally by the society as a whole. What needs to be of significance is the implementation of the law by the legal system toward providing timely justice to the victims of domestic violence, which is of utmost importance. In view of the above facts, the society and legal system at large needs to ensure a safe and secure environment for all women, ironically within their own homes, irrespective of the country in which they reside; as a country cannot prosper by keeping the better half of its population under unlawful coercion or constraint. In short, India must target deeply rooted institutional and cultural problems like corruption and patriarchal social norms by adopting multifaceted legislation in addition to combating domestic violence per se.

Financial support and sponsorship

Nil.

Conflicts of Interest

The authors declare no conflicts of interest.



 
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