This story is part of Stopping Domestic Violence, a CBC News series looking at the crisis of intimate partner violence in Canada and what can be done to end it.
Ashley McVean wasn't quite ready to go to police about the abuse she suffered at the hands of her former partner. But when she went to the emergency room with neck pain and evidence of strangulation, she hoped someone would notify law enforcement for her.
That never happened.
Strangulation is one of the most dangerous types of abuse that victims of intimate partner violence can endure. But doctors, nurses, paramedics and other first responders are not required to tell police if they suspect a person has been choked.
Members of the Royal Newfoundland Constabulary's intimate partner violence unit say reporting suspected cases of strangulation should be mandatory.
"It can just be seconds between life and death," said Malin Enström, crime analyst with the IPV unit. "It's a great concern."
There is currently no federal or provincial legislation that requires first responders to report cases of domestic violence involving adults to a relevant third party.
There is, however, a legal obligation under Newfoundland and Labrador's Children, Youth and Families Act to report incidents that place children at risk of abuse or neglect.
People present at the emergency rooms are crying out for help but they don't get it because it's not mandatory for them to report it to us. - Const. Lindsay Dillon
In this province, emergency rooms are obliged to notify police about stabbings and shootings.
Const. Lindsay Dillon and Const. Nadia Churchill say that doesn't go far enough to protect victims of abuse at home.
"Anything to do with the neck is a lethality factor when it comes to domestic violence," Churchill said.
If the unit receives a new case involving a couple and a neck injury is involved, it automatically is given a higher priority.
"The issue with strangulation and choking is that you come very close to death sometimes, and there are many studies out there that show the long-term effects of strangulation," said Dillon.
"When someone presents with a gunshot wound and stab wound and it's reported to us, great, but choking and strangulation should be up there too because when you look at the dangers involved in that, it's huge."
Dillon said they often hear of cases similar to McVean's, where the victim isn't ready to speak to police but hopes the attending medical staff will pass along their findings to the RNC.
"People present at the emergency rooms are crying out for help but they don't get it because it's not mandatory for them to report it to us."
The IPV unit has been working to address strangulation being included in mandatory reporting on both provincial and federal levels of government, including community partners.
'A very complex issue'
The mandatory reporting of gunshots and stab wounds has been in effect in Newfoundland and Labrador since 2015. The House of Assembly passed the law in 2011, but it was not enacted until four years later.
In a statement, the province's Department of Justice said, "The idea of adding strangulation to that list is a very complex issue and one that requires more research and consultation with stakeholders before legislative changes are considered."
The department highlighted a series of other recent initiatives aimed at reducing violence, including electronic monitoring and a suite of legislative changes.
Provincial officials said they are "watching with great interest" the progress of Bill S-249, and noted that the federal approach "will inform our analysis here."
That bill — called the National Strategy for the Prevention of Domestic Violence Act — was introduced in the Senate in 2018.
It was a private member's bill spearheaded by Newfoundland and Labrador Senator Fabian Manning, and would have resulted in the creation of a national strategy or blueprint dealing with the issue of intimate partner violence.
One of the things Manning highlighted during debate was reporting regulations for potential cases of abuse.
He noted that if a woman arrives at a hospital in many parts of the country with a gunshot wound or has been stabbed, it is mandatory to call the police.
"If that same woman arrives at a hospital tonight with two black eyes, a broken nose, her front teeth missing, and evidence of choking or strangulation from the physical abuse of her partner, there is no obligation or law to call the police," Manning said during debate in the Senate in 2018.
"I find that absolutely absurd."
Bill S-249 made it to second reading in the Senate, before being dropped from the order paper when Parliament dissolved in advance of the 2019 federal election.
Manning told CBC News he has since drafted a new bill, along the same lines of the one that had previously been introduced.
But it hasn't been tabled yet, and may not be any time soon, because of the pandemic and possibility of a looming federal election that would send the process back to the drawing board.
He said he continues to meet with individuals who are advocating for legislation to tackle domestic violence.