QuestionSBA
QuestionChoice
Referring the woman to a domestic abuse support group may be a useful resource for her, but it does not address the key issue here, which is **child safeguarding**.
62260
c
Refer her to a domestic abuse support group
QuestionChoice
In this situation, the patient has disclosed that she is experiencing domestic abuse and that there are children present in the home. This raises safeguarding concern for both the adult and children. Capacitous adults can refuse referral for themselves, but they cannot refuse referrals for child safeguarding concerns. Therefore, the most appropriate course of action would be a child safeguarding referral.
62258
a
Refer to child safeguarding service
QuestionChoice
While the woman may benefit from mental health support due to the domestic abuse she has experienced, it is important to also consider the issue of child safeguarding and take appropriate action. Referring to a mental health service alone is not sufficient in this situation.
62262
e
Refer to mental health service
QuestionChoice
While it is important to respect the woman's autonomy and decision-making capacity, it is also essential to consider the safety and well-being of the children in this situation. Failing to refer to social services for child safeguarding could put the children at risk of harm. Capacitous adults can refuse referral for themselves, but they cannot refuse referrals for child safeguarding concerns. Therefore, the most appropriate course of action would be a child safeguarding referral.
62261
d
Respect her decision and do not refer
QuestionChoice
While providing pain medication may be appropriate to address the woman's physical injuries, it is important to also address the issue of domestic abuse and consider the potential ongoing risk to the woman and her children.
62259
b
Prescribe her analgesia and discharge her
Concept
Chapter
# Overview

One legal defence to breaching confidentiality is the **public interest** defence. This was established by Common Law.

# W v Egdell 1990 

_W v Egdell 1990_: A doctor breached confidentiality to prevent a prisoner getting a transfer while he still posed a risk to others.

# Criteria to fulfil when breaching confidentiality under a public interest defence

1. A risk of harm needs to be identified
2. Patient consent should be gained if possible

   _You do not need to attempt to gain consent if doing so would put you at risk of serious harm, or would prejudice the prevention, detection or prosecution of crime._

3. The patient should be warned that disclosure will be made
4. Disclosure should be made on a need-to-know basis (i.e. only to the relevant people)
5. The disclosures made should be kept to a minimum (i.e. only disclosing relevant information)
6. The information should be anonymised, if possible.
571
586
Disclosing in the public interest
Topic
30
Ethics and Law
12513
A 26-year-old woman presents to the GP clinic with pain and multiple bruises on her arms and face. She tells the GP that she has been suffering from domestic abuse at the hands of her partner for the past year. She has two children, ages 5 and 7, who are currently at home with her. She has the capacity and understands the risks and benefits of seeking help and support. However, she declines a referral to social services or any other support services, saying that she fears what her partner might do if she seeks help.

What is the single most appropriate action in this situation?
a