APPENDIX 2
Extract from No Secrets (Section 2 pp.9-10),
March 2000, Department of Health
2.5 What constitutes abuse? It needs to
be recognised that the term "abuse" can be subject to
wide interpretation. The starting point for a definition is the
following statement:
Abuse is a violation of an individual's human
and civil rights by any other person or persons.
2.6 Abuse may consist of single or repeated
acts. It may be physical, verbal or psychological, it may be an
act of neglect or an omission to act, or it may occur when a vulnerable
person is persuaded to enter into a financial or sexual transaction
to which he or she has not consented, or cannot consent. Abuse
can occur in any relationship and may result in significant harm
to, or exploitation of, the person subjected to it.
2.7 A consensus has emerged identifying
the following main different forms of abuse:
— physical abuse: including
hitting, slapping, pushing, kicking, misuse of medication, restraint,
or inappropriate sanctions;
— sexual abuse: including rape
and sexual assault or sexual acts to which the vulnerable adult
has not consented or could not consent or was pressured into consenting;
— psychological abuse: including
emotional abuse, threats of harm or abandonment, deprivation of
contact, humiliation, blaming, controlling, intimidation, coercion,
harassment, verbal abuse, isolation or withdrawal from services
or supportive networks;
— financial or material abuse:
including theft, fraud, exploitation, pressure in connection with
wills, property or inheritance or financial transactions, or the
misuse or misappropriation of property, possessions or benefits;
— neglect and acts of omission:
including ignoring medical or physical care needs, failure to
provide access to appropriate health, social care or educational
services, the withholding of the necessities of life, such as
medication, adequate nutrition and heating; and
— discriminatory abuse: including
racist, sexist, that based on a person's disability, and other
forms of harassment, slurs or similar treatment.
Any or all of these types of abuse may be perpetrated
as the result of deliberate intent, negligence or ignorance.
2.8 Incidents of abuse may be multiple,
either to one person in a continuing relationship or service context,
or to more than one person at a time. This makes it important
to look beyond the single incident or breach . . . to underlying
dynamics and patterns of harm. Some instances of abuse will constitute
a criminal offence . . . Examples of actions which may constitute
criminal offences are assault and rape, theft, fraud or other
forms of financial exploitation, and certain forms of discrimination,
whether on racial or gender grounds. Alleged criminal offences
differ from . . . non-criminal . . . abuse in that the responsibility
for initiating action invariably rests with the state. Accordingly,
when complaints about alleged abuse suggest that a criminal offence
may have been committed it is imperative that reference should
be made to the police as a matter of urgency.
2.9 Neglect and poor professional practice
also need to be taken into account. This may take the form of
isolated incidents of poor or unsatisfactory professional practice,
at one end of the spectrum, through to pervasive ill treatment
or gross misconduct at the other. Repeated instances of poor care
may be an indication of more serious problems and this is sometimes
referred to as institutional abuse.
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