In his article, “Doctors and patients deserve better” (OpEd page, June 19), Dr. Nagral has given us an understanding of the roots of the pervasive evil of violence against doctors and nurses in India. But as a medical practitioner working overseas for the last 18 years, I can say that such violence is not unusual in western countries. It has become the subject of discussion in medical literature and the lay press in the U.S. The common feature of these attacks is “victim shaming” by administrators and senior management in hospitals. In other words, the doctor or nurse concerned is made to feel that it is they who brought on the attack due to a ‘lack of proper communication’, or ‘insensitivity at a time of bereavement/emotional distress’.
There is now a call for these attitudes to change and to bring in an atmosphere of caring for the victim of the attack. Nothing changes unless systems change.
The writer would agree that this dictum is the basis for a lot of the work that follows audits of unexpected or poor outcomes after surgery. The surgeon cannot be made to shoulder the entire blame, or make the corrections necessary to prevent recurrences. Based on this principle it would behove us to look at what systemic changes would help prevent violence in hospitals. Parliament has to pass laws or amend the Code of Criminal Procedure appropriately to make violence against doctors, nurses and hospital personnel in the line of duty a cognisable offence. Appropriate changes in the Evidence Act that would make video-recorded evidence adequate to prosecute a violent offender and extending the statute of limitations to allow such prosecution to happen up to five years would also be necessary. The prescribed punishment should also be made clear and based on other such laws currently in place in Commonwealth countries.
Dr. Philip G. Thomas,
McAllen, Texas, U.S.
