Home
Current Issue
Past Issues
Support
About IJME
Oct-Dec2001-9(4)
EDITORIAL
Doctors and
violence
Sanjay Nagral
Violence against doctors is in the news with
increasing frequency. Many reports concern medical professionals being roughed
up, even killed, by patients' disgruntled relatives. (1) A new dimension was
added to such incidents recently.
On August 25, Shiv Sena leader Anand Dighe was
admitted to Thane's Singhania Hospital following injury in a highway accident.
Singhania is the biggest private sector hospital in this Mumbai suburb, with
speciality services otherwise not available in the area. Mr Dighe was stable
following an operation for a leg fracture but a few hours after the surgery he
suffered cardio-respiratory arrest - believed to be a sudden cardiac event or a
pulmonary embolus - and died. Following news of his death a mob of Sena
followers went on a rampage, destroying all furniture and equipment. Staff and
patients fled the premises while a small posse of policemen looked on. The
damage to the hospital is estimated to be around Rs 10 crore. The management is
considering shutting the hospital down permanently. (2)
The rampage went far beyond a spontaneous response
to what may have been perceived as a sudden unexplained death - though even
spontaneous violence cannot be condoned. The Shiv Sena has regularly flexed its
muscles in this fashion - and got away with it. Many of its leaders derive their
strength from such lumpen behaviour. The mob may have been incited by a section
of the leadership to settle scores with the hospital's management, and also to
assert the party's authority.
The medical community's
reaction
Many medical organisations declared that medicine
had become a 'dangerous' profession, and doctors should be provided 'security'.
Some stated that 'doctors should stop treating politicians'. Interestingly, the
event registered as an attack on doctors as much as it was on Singhania
hospital, a corporate body. This is a reflection of the strong economic bond
that has emerged in recent decade between corporate bodies and doctors.
Politicians regularly take to violence to
demonstrate their clout, a trend which has reached grotesque forms with the
increasing criminalisation of politics. While we must condemn such actions, is
it a sufficient response?
The doctor-politician
nexus
First, we should remember that many of our
colleagues bend over backwards to please political bigwigs to maintain their
positions, or for personal gain. Getting ICU admission for a cardiac problem has
become such a standard ploy of politicians avoiding the law, it may soon be
recognised as a medical syndrome. Surely this is done with doctors' collusion.
When diamond merchant Bharat Shah - under arrest but in a Mumbai five-star
hospital - threw a birthday party in the hospital, surely it was with the
management's support. Some time ago, several doctors from the JJ Group of
Hospitals in Mumbai were indicted for helping criminals escape the law. One can
also see the broader doctor-politician nexus in the running of private medical
colleges. There are many other examples. For all the talk of 'boycotting
politicians', many of us are in fact colluding with them in illegal activity.
Such complicity can of course be dismissed as a
part of a larger indifference by civil society towards the criminalisation of
politics. But as members of a profession which is supposed to respond to human
suffering, we have a special social responsibility. It has often been argued in
the pages of this journal that our ethical responsibilities extend beyond the
doctor-patient relationship. It is our ethical responsibility to fight such
political violence. We must also be clear that in opposing the 'criminalisation
of politics' we don't shun 'politics' in toto. Any meaningful change in the
health care system can only come from political changes. The medical profession
in many parts of the world has a glorious record of active resistance to
corruption and oppression. It can serve as an example to the rest of society.
Starting small
It may be asking too much of doctors to be so
active, given the present state of affairs. We can begin small, by promoting
ethical and honest voices from our profession. We can also increase our
credibility by condemning colleagues who collude with criminal politicians.
As this edit is being written comes the news of the
terrorist bombings in the US. Things may snowball into a further vortex of
violence. Violence dominates our lives as never before. Again it is our ethical
responsibility to respond. A violent society is detrimental to the practice of
humane medicine; it negates all the 'achievements' of modern medicine. Going
back to the Singhania hospital incident, the medical profession must do more
than just condemn such violence; it must reflect on the ethics of its own
practice. For doctors, this means not perpetrating violence through their
practice, through the medical system or through collusion with the perpetrators
of violence. It also means practising an active social ethics, being at the
forefront of preventing violence and caring for all victims of violence,
irrespective of their crimes and ideological affiliations.
References
1. Bal Arun. A doctor's murder. Issues in
Medical Ethics 2001: 39.
2. Anonymous. Police watch as Sena men go on
rampage in Thane. Indian Express, August 28, 2001.
Dr Sanjay Nagral,
consultant surgeon, Jaslok Hospital and Research Centre, Mumbai, 400
026.
E-mail:nagral@bom3.vsnl.net.in