forensic nurse - Clinical Update

“While not everyone who abuses animals will become a serial killer, virtually every serial killer first abused animals ...”
— Randall Lockwood, vice president, Humane Society of the United States¹

Jeffrey Dahmer, who confessed to killing, dismembering and occasionally cannibalizing 17 boys and men, impaled dogs and staked cats to trees as a child. “Boston Strangler” Albert DeSalvo trapped dogs and cats in orange crates and shot arrows through them. Columbine shooters Harris and Klebold frequently spoke of mutilating animals.¹ All forms of violence share common characteristics – their victims are living creatures who can display signs of pain with which humans should empathize, and who may die as a result of their injuries.²

Animal cruelty is recognized as a sign of family violence, and one of the earliest and most predictable signs of future violence in children and adolescents by law enforcement professionals, sociologists and psychologists, yet little is done about it by healthcare professionals, particularly those who are on the front lines of violence detection and prevention. Forensic nurses can assist other healthcare providers to understand the implications of animal cruelty, identify the perpetrators and stop this brutal and escalating form of violence.

Animal cruelty is a socially unacceptable behavior that intentionally causes unnecessary distress, suffering or pain, and/or death of an animal.² In a 2001 survey of 1,863 perpetrators of animal cruelty, the Humane Society of the United States noted that, while any animal could be abused, including wildlife and farm animals, a higher percentage (74 percent) of abuse is directed toward companion animals. Teens account for 20 percent of these cruelty cases, children 4 percent, and that the vast majority of all abusers are male.³

Cruelty is usually categorized as neglect, physical abuse, sexual abuse, hoarding, cockfighting or dog fighting. Ascione points out that some people might argue that psychological abuse is also possible. This category certainly should be included when considering acts such as the ongoing teasing of animals or the keeping animals chained or confined at all times.²

Neglect occurs when a person deprives an animal of food, water, shelter and/or veterinary care. It usually happens as a result of ignorance on the owner’s part and is typically handled by authorities requiring the owner to correct the situation. Neglect cases are acts of omission rather than commission and do not give satisfaction to the person whose animals are neglected.

Physical abuse results from malicious torturing, maiming, mutilation or killing. These acts of intentional cruelty are often shocking and usually indicative of a serious human behavioral problem. Persons who commit these intentional acts of cruelty take satisfaction in causing harm.^2-3

Animal sexual abuse, or bestiality, is the sexual molestation of animals by humans and includes a wide range of behaviors, including: fondling, vaginal, anal or oral penetration; oral-genital contact; penetration with an object; and injuring or killing an animal for sexual gratification. Like rape, this is an eroticization of violence, control and exploitation. And unlike most other forms of abuse, it is not deemed illegal in all states.

Hoarding, which is similar to neglect, occurs when a person accumulates a large number of animals, provides minimal standards of nutrition, sanitation and veterinary care, and fails to act on the deteriorating condition of the animals and/or the environment. Unlike most other perpetrators of animal cruelty, the majority of hoarders are female.

Cock fighting is the term used when two or more specialty birds, or gamecocks, are placed in an enclosure to fight to the death, sometimes of both birds. Dog fighting is a contest between two specifically bred, conditioned and trained to fight dogs that are placed in a pit to fight. Usually the loser dies, is left to die or is killed by the owner. Both cock fighting and dog fighting are for the purposes of gambling or entertainment, and both, particularly dog fighting, may be associated with other criminal activity. Pit bulls and pitbull mixes are the most popular among dog fighters, including juveniles and inner city gang members.

Violence breeds violence. The correlation between animal cruelty and child abuse, domestic violence, elder abuse, youth violence and criminal behavior is significant. DeViney, Dickert and Lockwood studied 53 families that met New Jersey state criteria for child abuse and who had pets in their homes. Their results revealed that the occurrence of animal abuse was 88 percent higher in families where physical child abuse was present than in those families with other forms of child abuse.⁴Friedrich, et al, compared a sample of sexually abused children (n=276) with a sample of nonabused children (n=880), ages 2-12 years, and found that the abused children were significantly (p less than 0.001) more likely to have abused animals than the nonabused group.⁵

A survey of 38 women seeking shelter at a safe house in Utah for battered partners demonstrated that 71 percent reported that their partner had threatened and/or actually hurt or killed one or more of their pets. Thirty-two percent reported that one or more of their children hurt or killed family pets.⁶

Flynn reported that 46.5 percent of his study population of 43 battered women in South Carolina reported threats or harm to their pets by their partners, but only 7 percent reported cruelty by their children.⁷

Children from dysfunctional families whose childhoods include neglect, brutality, rejection and hostility are more likely to commit animal abuse. Even in chaotic homes, pets play an important role in children’s lives, and these children rely more on pets for loyalty and love than do other children. However, pets rarely survive past the age of 2 in violent households because they are either killed, die from neglect or run away to escape the abuse. Even when overt human violence does not take place, this constant turnover of animals causes the children to suffer repeated cycles of attachment and loss.⁸

Although statistics are lacking, humane officers have found cases of elder abuse while responding to reports of animal cruelty – a dead dog in a dumpster led to their finding a neglected 90-year-old woman; whimpering from a closet proved to be a battered elder instead of suspected animal neglect. Abusive family members abuse elders’ pets for complex reasons. Perpetrators may abuse or neglect the elder’s pet as a form of retaliation or control, a way to obtain the elder’s financial assets, or as an act of frustration over their caretaking responsibilities. Extreme neglect can also indicate the elder’s inability to provide self-care or care for the animal and the need for assistance.⁹

Animal cruelty has also been associated with violent criminal behavior. In a study of convicted male sexual homicide perpetrators, Ressler, Burgess and Douglas found that 36 percent reported abusing animals as children, while 46 percent abused animals as adolescents.¹⁰In a study of 299 inmates incarcerated for various felonies and 308 undergraduate students, Miller and Knudson found higher percentages of animal abuse in the prison population compared to the college students: hurting animals – 16.4 percent vs. 9.7 percent; killed a stray – 32.8 percent vs. 14.3 percent, and killed a pet – 12 percent vs. 3.2 percent.11 Schiff, Louw and Ascione surveyed 117 men incarcerated in a South African prison. Sixty-five percent of the men who committed aggressive crimes had committed animal cruelty as compared to only 10.5 percent of the nonaggressive inmates.¹²

Little has been done in the healthcare community to address animal cruelty, a problem that is as unsettling as it is devastating. Forensic nurses, known for their commitment to violence prevention, must be on the forefront of policy formation by using their knowledge, skills and creativity to advocate for healthcare and related policies that: require mandatory reporting of animal cruelty; encourage problem recognition and training programs for health care professionals; enforce mandatory assessment and intervention; promote the development of interagency coalitions; support legislation for better anticruelty laws, and foster the creation of programs to teach children compassion for animals.

The number of cruelty cases can only be estimated because there is no nationwide reporting mechanism. An ideal policy would establish a national data bank that could track trends and serve as a baseline to measure the effectiveness of interventions (Ascione, 2001). In the interim, forensic nurses can lobby for mandatory reporting by veterinarians and healthcare personnel.

Veterinarians must be trained to recognize all forms of animal abuse and be mandated to report it. However, most states do not require such reporting. Veterinarians should also be educated on the connection between animal cruelty and human violence as their animal clients may be part of an abusive system in which children may also be victims. Community nurses should be taught the signs of abuse pets (See Box 1) and be responsible for reporting them. Forensic nurses can also encourage policy that would allow for anonymous reporting by the public, similar to what is done for child abuse.

Animal cruelty is associated with several forms of human violence. Nursing education, both entry curricula and continuing education programs, should reflect the nature of this problem, as well as assessment and treatment options. Furthermore, forensic nurses can educate other healthcare providers and the public about juvenile animal abuse, and they can encourage the expansion of professional cross-training so that animal control agents can identify signs of child maltreatment and juvenile delinquency and health care providers can identify signs of animal abuse. The ideal way to reach multidisciplinary professionals is to organize a First Strike Workshop by contacting the Humane Society of the United States (http://hsus2.org/firststrike/workshops/index.html) to have them set up an all day workshop for key members of the animal protection community and their counterparts in human service fields.

Assessing for the presence of animal cruelty must be part of all routine healthcare visits and episodic visits for clients who present with behavioral problems or signs of abuse. Just asking the age of the household pets may prove significant as abused pets rarely live past age 2 because they get killed, die of neglect or run away to escape the abuse. Formal assessment protocols are in their formative stage of development. In the interim, forensic nurses can encourage other health care providers to utilize questions that can easily be integrated into their psychosocial histories (See Box 2). All episodes of abuse, even those done out of curiosity, warrant intervention with referral to a counselor, the criminal/juvenile justice system, or both.

Forensic nurses should support policy that encourages and supports the development of innovative, multidisciplinary interagency programs and collaborations, which aid in early detection and prevention of violence toward humans and animals. Nationally, these agencies could include the Humane Society of the United States, the International Association of Forensic Nurses (IAFN), the American Veterinary Medicine Association, and the Federal Bureau of Investigation (FBI). On the local level, coalitions should form between forensic nurses, police, animal control agents, the district attorney’s office and at least one counseling agency. Interagency coalitions are also more capable of influencing legislators to better the animal cruelty laws.

All 50 states have anticruelty laws that vary drastically from state to state and often go unenforced [www.animallaw.org/] statutes lists the laws for each state). Currently, most states and the District of Columbia have laws making certain types of cruelty a felony. Felony laws send a powerful message and assist the criminal justice community in recognizing animal cruelty as having serious implications for both animals’ protection and society’s welfare. Eighteen states have provisions for counseling as part of a sentence for persons, mostly juveniles, convicted of felony cruelty.

But even in those states with a felony provision, laws remain weak. For example, the cruelty statute in Pennsylvania only considers animal fighting a felony. The willful and malicious killing of someone’s companion animal is a misdemeanor, punishable by a fine of not less than $500 and/or imprisonment for no more than two years. Forensic nurses should lobby for appropriate laws in all 50 states, laws that:

All forms of abuse need to be at a zero tolerance level to break the cycle of violence. In 2001, Rhode Island became the first state to pass a law establishing the definition of “guardian” to be used in the same context of “owner.”15 Viewing animals as living, feeling beings instead of property is a huge step in promoting human compassion.

Humane education is not a panacea, but it helps. Therefore, policies should provide for humane education as part of school curricula to better enable all children to develop compassion for all living.

1. Humane Society of the United States, (n.d.). First Strike Program. Retrieved November 9, 2003 from www.hsus2.org/firststrike.

4. DeViney E, Dickert J, and Lockwood, R. (1983). The care of pets within abusive families. International Journal for the Study of Animal Problems, 4, 321-329.

5. Freidrich V W, Grambasch P, Damon L, Hewitt S, Koverola C, Lang R, Wolfe V, and Broughton D. (1992). Child Sexual Behavior Inventory: Normative and clinical comparisons. Psychological Assessment, 4, 303-311.

6. Ascione F. (1998). Battered women’s reports of their partners and their children’s cruelty to animals. Journal of Emotional Abuse, 1(1), 119-33.

7. Flynn C. (2000). Why family professionals can no longer ignore violence toward animals. Family Relations, 49(1), 87-95.

8. Quinn K. (2000). Animal abuse at early age linked to interpersonal violence. The Brown University Child and Adolescent Behavior Letter, 16(3), 1-3.

9. Humane Society of the United States. (2003). Elder abuse and animal cruelty. Retrieved November 9, 2003 from www.hsus.org/ace/19053.

10. Ressler R, Burgess A, and Douglas J. (1988). Sexual Homicide: Patterns and Motives. Lexington, Mass: Lexington Books.

11. Miller K and Knudson J. (1997). Reports of severe physical punishment and exposure to animal cruelty by inmates convicted of felonies and university students. Child Abuse and Neglect, 21 (1), 59-82.

12. Schiff K, Louw D, and Ascione F. (1999). Animal relations in childhood and later violent behaviour against humans. Acta Criminologica 12, 77-86.

13. Munro H. (1999). The battered pet. In F. Ascione & P. Arkow (Eds.) Child Abuse, Domestic Violence, and Animal Abuse. West Lafayette, IN: Purdue University Press, 199-208.

14. Boat, B. (1998). Abuse of children and abuse of animals. In F. Ascione & P. Arkow (Eds.) Child Abuse, Domestic Violence, and Animal Abuse. West Lafayette, IN: Purdue University Press, 83-100.

15. Animal Protection Institute. (2001). Legislative Update: State Laws Enacted in 2001. Animal Issues, 32(4), 1-2.