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Professor Vernellia R. Randall
The University of Dayton School of Law

Introduction

Throughout our history, Americans have remained committed to a social contract that respects the rule of law, that promotes peaceful intercourse among citizens, and that has as its highest value the protection of human life. We are often characterized as being a "violent nation" and clearly we have had some unpleasant chapters in our long history of nation-building. Yet the values passed down to us through the years have consistently been the values of people devoted to peace and the veneration of life.

Our citizens want to live in peace, but each year many thousands of them become the victims of violence. Some are infants, others are elderly and frail. They are abused, beaten, raped, assaulted, and killed. Society has somehow failed them. But such an admission must not be the end of the matter; for those of us in the health professions, that failure signaled the need for a new beginning. The Surgeon General's Workshop on Violence and Public Health, conducted in October 1985, represented that new beginning and encouraged all health professionals to respond constructively to the ugly facts of interpersonal violence.

Identifying violence as a public health issue is a relatively new idea. Traditionally, when confronted by the circumstances of violence, [we] . . . have deferred to the criminal justice system. Over the years we have tacitly and, I believe, mistakenly agreed that violence was the exclusive province of the police, the courts, and the penal system. To be sure, those agents of public safety and justice have served us well. But when we ask them to concentrate more on the prevention of violence and to provide additional services for victims, we may begin to burden the criminal justice system beyond reason. At that point, the professions of medicine, nursing and the health-related social services must come forward and recognize violence as their issue and one that profoundly affects the public health.

[T]his is an awesome challenge to the health [and legal] profession[s], but it is not totally uncharted. For some time, a number of people around the country have been doing the research and conducting pilot demonstrations to further engage the health professions in this issue of interpersonal violence. From the time of the workshop in 1985 to now, the exploration of effective means of public health intervention into elder abuse and child abuse, rape and sexual assault, spouse abuse, child sexual abuse and assault and homicide has continued to grow. I look forward to continued progress in this area that is of such great significance for the health and well-being of all Americans and of our society as a whole. It will be a major contribution toward the strengthening of our nation's social contract.

Foreword, C. Everett Koop, Violence in America: A Public Health Approach, Mark L. Rosenberg and Mary Ann Fenley (1991).