Ethicolegal considerations of screening for brain injury in women who have experienced intimate partner violence

Abstract

The vast majority of women who experience physical intimate partner violence (IPV) will likely suffer a brain injury (BI) as a result of the abuse. Accurate screening of IPV–BI can ensure survivors have access to appropriate health care and other supports, but screening results may also impact them receiving fair and equitable treatment in the legal system, and the justice they deserve. We used semi-structured interviews, combined with a contrastive vignette that described a realistic but hypothetical scenario involving IPV with or without BI, to explore the impact of BI on parenting disputes. Participants were lawyers (n = 12) whose focus is family law. Results highlight the potential adverse consequences of a positive BI screen that are influenced by the legal responsibility of counsel, the legal aid status of the woman, ongoing family dynamics, and the expectations of society while the focus on the best interests of the child is retained. Taken together, the findings reflect the legal vulnerability of women in decision-making about their capacity to parent after a BI. We conclude with recommendations for the future of IPV–BI screening aimed at mitigating risk and equipping women to navigate a legal system that has disadvantaged them, both historically and in the current context.

Characterizing Possible Acute Brain Injury in Women Experiencing Intimate Partner Violence: A Retrospective Chart Review

“…Such benefits should be contextualized within the sociocultural and legal-ethical environment. Ongoing work from our group ( Boyle et al, 2022 ) suggests BI screening has the potential to be weaponized in family law parenting disputes as a means to undermine and minimize the perception of a mother's ability to parent. As such, the potential benefits of BI screening must be carefully measured against possible harms.…”