【转帖】最新一期《柳叶刀》刊文：Ending violence against doctors in China

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60729-6/fulltextChina"s doctors are in crisis. In recent years, they have faced increasing threats to their personal safety at work. Doctors have been abused, injured, and even murdered by patients or relatives of patients in hospitals and clinics across the country. In a recent tragic case, described in a letter published online today in The Lancet, a male intern at the First Affiliated Hospital of Harbin Medical University was stabbed to death by a patient.山东大学第二医院儿内科柳方娥

Responding to this crisis, the Chinese Government announced last week that it is increasing police vigilance inside hospitals. People who disrupt the daily operation of hospitals, carry dangerous materials, or threaten medical staff will be held legally accountable, according to a joint statement by the Ministry of Health and the Ministry of Public Security. Although turning hospitals into high-security institutions may be a necessary step, it is a short-term solution to this disturbing and desperate situation.

There are many possible reasons why Chinese doctors are under threat. These causes are systemic?poor investment in the health system and in training and paying doctors, which can lead to medical errors, corruption, and poor communication between health professionals and patients. Other factors are societal, and include negative media reports about doctors, poor public understanding of medicine, unrealistic patient expectations about treatments, and catastrophic out-of-pocket health-care expenses for familes.

Whatever underlies the violence, the impact on medicine in China is of great concern. As Li Jie, a medical student at China"s Ningbo University, writes in his letter, the new generation of Chinese doctors feels lost: “they do not know whether to continue to study medicine or not, and how to face the complex and uneasy relationship with their patients.”

Doctors in China were once revered, as they still are in many other Asian countries. China needs to make medicine an attractive, respected, rewarding, and safe profession again, to protect the doctors of today and those of tomorrow, for the benefit of patients. The first step should be a government inquiry to examine the causes of the violence and find ways to end it.