Physician-patient privilege: the legal assault continues.

The confidentiality of patient records, particularly in cases where sexual assault is alleged, has been called into question by two recent Supreme Court decisions. Toronto lawyer Marilou McPhedran discusses the recent Beharriell and O'Connor decisions and how they affect physicians.     

Male victims of sexual assault.

OBJECTIVE--To compare the demographics, physical findings, and assault characteristics of incarcerated, sexually assaulted men with those of nonincarcerated, sexually assaulted men. DESIGN--Case series of 99 adult male victims of sexual assault evaluated over a 3-year period. SETTING--Memphis Sexual Assault Resource Center, a nonhospital-based clinic that serves as the primary resource for sexually assaulted victims in the Memphis and Shelby County, Tennessee, area. PARTICIPANTS--All adult male victims of sexual assault evaluated at the Memphis Sexual Assault Resource Center during the study period were included in the study. Ninety-nine victims were studied, including 80 incarcerated men and 19 men from the community. RESULTS--The victims of sexual assault in the community group were older than the victims in the incarcerated group. Apart from the age difference and weapon use, there were no statistically significant differences between the incarcerated and nonincarcerated victims. CONCLUSIONS--The similarities between the two groups suggest that sexual assault of men may not be unique to prisons, and all men are potential victims. Further studies are required to better understand these crimes and to develop education and prevention programs.     

Wife abuse. The diagnosis and its implications

Wife abuse is receiving widespread attention in the lay press, but its discussion in the medical literature has been rare. Identifying a victim of wife abuse is complicated, since these women will seldom volunteer that information. There are no economic, educational, or class predictors of wife abuse. Suspicion of abuse should be aroused if there is (1) a substantial delay between time of injury and presentation of treatment, (2) evidence of repeated injuries to the face and neck, or (3) a previous history of abuse. Social agencies for the care and counseling of these victims exist and should be used.