Abuse: An Integrated and Coordinated Health Sector Response Is Needed

In this issue, Drs Ilnyckyj and Bernstein (pages 801-805) conclude that Canadian gastroenterologists should be routinely asking patients about sexual and physical abuse when taking a history. The results of their survey suggest that, on average, Canadian gastroenterologists understand that a history of abuse is relevant to patient management, but only about half of the respondents to their survey include abuse history in their interviews. The reasons for not asking included time constraints, personal discomfort and lack of resources for referral. They conclude that “Gastroenterologists need to find a resolution to their barriers to abuse inquiry”. Ilnyckyj and Bernstein are among a growing number of health care workers calling for an increased response to the problem of abuse. I applaud their effort, and concur with their recommendation that gastroenterologists take up the challenge of routine screening for abuse. A coordinated and integrated response would involve responding in terms of clinical practice, diagnosis and treatment of patients with many health conditions. It would also require clinical and health policy research that contributes to the understanding of the impact of abuse on heath and the role of the health sector in prevention. It should also