Introduction
Medical Practitioners face a high and elevated risk of violence against them all over the world. According to a study by World Health Organization (WHO), up to 38% of Medical Practitioners face violence at some stage of their career. Furthermore, a larger section of medical practitioners faces verbal aggression more pervasively. The aggressive parties in such cases are mostly patients or families of affected patients, for whose benefit the practitioner works in the first place. Many patients, bereft of basic principles of emotional management in stress-inducing situations, resort to violence, creating a problem that needs to be addressed on a global scale.
This article seeks to explore the phenomenon of harassing medical staff and the subsequent legal remedies available to the victims of such harassment. Read on!
Forms of Abuse
Increase in violence against medical professionals can happen due to war, or situations of an extreme health scare, such as pandemics, and epidemics, as well as due to scarcity of adequate healthcare resources that instigates violence against healthcare workers and professionals. Other factors that lead to violence may include aspects such as friction in the workplace, farcical compliance measures, lack of socially appropriate response against wrongdoers, and lack of adequate remedies to protect the victims of such violence, i.e. the doctors.
Furthermore, sometimes, healthcare professionals are threatened by coercion and threats to work against principles of ethics, which is categorized as a form of violence. Factors such as pandemics can also factor in various states of aggression against doctors and healthcare professionals. However, generally, violence against healthcare professionals manifests in the form of verbal or physical abuse and mental harassment.
According to a report entitled, “Violence Against Healthcare: Current Practices to Prevent, Reduce or Mitigate Violence against Healthcare”, released jointly by the World Medical Association, in collaboration with ICRC, Geneva. International Council of Nurses, & International Hospital Federation, violence against healthcare professionals can be classified under the below mentioned following three categories-
- Verbal Abuse
- Physical Abuse
- Mental Harassment
Verbal Abuse: Includes instances of verbal aggression by the patients, or the relatives or family of patients, verbal threats to the health-care provider or other ancillary staff, with the World Medical Association stating that 100% of those surveyed had experienced some form of verbal aggression by the patients, and almost 82% of the surveyed, having experienced verbal threats from aggressive patients.
Physical Abuse: Includes instances of hitting a healthcare professional either directly, or with the aid of a weapon or object, which leads to severe psychological effects for the healthcare worker. The World Medical Association stated that 82% of those surveyed had experienced some form of physical aggression by the patients, and almost 27% of the surveyed were targeted with dangerous weapons and were also targeted with shelling, stones, and arson to property. There have also been instances wherein the consequences have led to severely wounding or killing the healthcare professional.
Mental Harassment:
Many doctors and health care professionals, as well as supporting staff such as nurses, midwives, etc. have also experienced instances wherein they were stopped from performing their duty by obstruction of care by the patients and families continuously stonewalling the efforts of the professionals in the required course of medication and treatment, which leads to mental distress to the professionals.
Judicial Pronouncements
In the case of Arun P. v. State of Kerala (2022), it was held that granting bail before arrest to a persona alleged to have committed acts of violence against doctors, would send a wrong message, also stating that even the absence of assault does not entail a person accused of violence against doctors to pre-arrest bail.
Further, in September 2022, the Supreme Court admitted a petition to hear a plea on violence against healthcare workers. In this case, Indian Medical Association (Dwarka) filed a Public Interest Litigation (PIL) at the Supreme Court in order to develop a mechanism for compensating the families and dependents of doctors who have passed away and to obtain complete rules for their protection.
However, at present, there is no substantive law or central legislation providing an all-comprehensive and holistic outlook for dealing with punitive, preventive and compensatory measures to address issues of violence against healthcare workers in India, and thus the legislative pronouncements do not present a unified stand on punishment, compensation, etc. which varies on a case to case basis.
Anticipating Doctor’s Rights
Doctors have various rights, howsoever, in the present scenario, it is imperative to ensure general security-related measures, such as increasing security calls for the deployment of effective security personnel. Additionally, additional security staff hiring as well as organizational adjustments have been mentioned. The quickness of the security staff's intervention is of the utmost significance, thus they must be responsive and accessible in case of an emergency.
To ensure a prompt response to occurrences, the health facility's security focal points must be engaged. If necessary, security personnel from a nearby neighbourhood or from outside the facility can step in to help with in-house security. Last but not least, possible attackers may be discouraged by visible identification of health staff inside the institution (with, for example, newly designated jackets) and signage on the facility itself (such as a "no weapons permitted" sign).
Some of the pertinent actions that can help in anticipating the rights of the doctors in a timely manner can include securing high-risk areas with access control, securing the spaces around the facility, assessing risk and performing risk assessment around the health facility to understand the risks involved, further actions would include analyzing the reported cases of violence against healthcare professionals, and proper staff training.
Where to Complain?
In the Indian context, violence against healthcare professionals has been categorized as a criminal offence and falls under the ambit of the concerned state/UT, which punishes the offenders under relevant provisions of the Indian Penal Code & Code of Criminal Procedure, with the objective of ensuring that doctors and healthcare professionals can function without the constant looming threat of fear or violence.
Furthermore, The Epidemic Diseases (Amendment) Act, 2000, notified by the Indian Government on September 28, 2020, in response to the COVID-19 epidemic, stated that according to the amended act, acts of violence committed against medical staff in circumstances similar to the present epidemic would be crimes that are both cognizable and non-bailable in nature. Thus, a complaint can be made in any police station that falls within the jurisdiction of the concerned state and charge sheet shall be filed by the police officials in this regard, following which the proceedings shall ensue in court.
How to Seek Compensation
The commission or facilitation of such violent crimes is punishable by imprisonment for a period of three months to five years and a fine ranging from Rs. 50,000 to Rs. 2,00,000. If you injure someone severely, you could be imprisoned for six months to seven years and fined between Rs. 1 lakh and Rs. 5 lakh. The offender will also be responsible for paying double the fair market value for property damage in addition to compensating the victim. This compensation can usually be sought from and granted by the courts in the Indian context.
Other Remedies
The Union Ministry of Health & Family Welfare has, in order to prevent violence against doctors and for inculcating an effective sense of security among the doctors on duty, taken several measures including issuing advisories in this regard to all States/Union Territories (UTs) to consider the following-
- Ensuring a Trained & Designated Force to ensure security for hospitals
- CCTV Camera Installation so as to ensure round-the-clock monitoring that can provide evidence in case of instances of violence
- Centralized Control Room and Helpline to assist the Healthcare Professionals and those affected.
- Complete Ban/Restriction on Entry of Wrongdoers to ensure the safety of the healthcare professionals.
- Immediate filing of FIR against assaulters in question
- Appointment of a Nodal Officer, a Grievance Redress Mechanism
The Ministry of Health and Family Welfare has repeatedly emphasized the need to protect the safety and security of healthcare personnel at their living/working premises through formal communications as well as more recently through video conferencing with States and UTs.
Conclusion
Any form of violence against health workers is uncalled for and unacceptable at all levels. It affects the morale and work ethics of healthcare professionals, as well as affecting their job motivation. Instances of such violence also end up with a dangerous compromise on the standards of treatment and health care provided due to friction between stakeholders.
In light of the same, there is a need for intervention in order to prevent violence against healthcare professionals and take every possible effort to ensure the effective management of potentially violent patients as well as high-risk visitors in hospitals. Only such measures shall ensure a safer environment for the hands that aid and cure us and form the backbone of the most crucial facet of human life health.
