Sun, May 21, 2023 page8

• EDITORIAL: Prevention better than punishment

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  The Shilin District Prosecutors’ Office on Wednesday filed a criminal charge against a man who allegedly assaulted a doctor at the Tri-Service General Hospital on May 8. The suspect, a man surnamed Chang (張), was unhappy that the doctor, surnamed Yen (顏), refused to issue a Barthel Index certificate for his mother, which is needed to hire a live-in foreign caregiver. In a video posted online by the doctor, Chang is seen pulling on Yen’s coat, while several nurses try to calm him and hold him back. When Yen tells him that his behavior is in contravention of the Medical Care Act (醫療法), he shouts: “So what if it’s against the law?” and swears at him. Chang then allegedly hit Yen twice in the face.

  The prosecutors’ office said Chang’s alleged offense was serious, as he allegedly hit Yen in the face and kicked his leg in the corridor of a hospital ward, which not only hindered working medical personnel, but also harmed their dignity.

  The incident also triggered discussions about the Barthel Index score requirement and the nation’s long-term care policies. However, is has brought the long-standing problem of violence against healthcare workers back into the spotlight.

  A 2006 Taiwan Society of Emergency Medicine survey of emergency room staff found that 89 percent of doctors and 73 percent of nurses had been exposed to verbal or physical violence at their workplace, while about 37 percent had encountered physical violence.

  The Medical Care Act was revised in 2014 and 2017, to introduce harsher penalties, as well as to expand the range of illegal actions and medical personnel covered. However, threats and assaults against healthcare workers are still often reported.

  The issue is not a local problem, as the WHO says that between 8 and 38 percent of healthcare workers experience physical violence at some point in their careers. A report by the American Hospital Association last year said that since the beginning of the COVID-19 pandemic, healthcare workers have experienced an increase in workplace violence, with 44 percent of nurses saying they were physically attacked and 68 percent saying they were verbally abused.

  In 2021, a 63-year-old man with COVID-19 who had been placed in isolation stabbed three nurses with a knife when they tried to stop him leaving his room. He was sentenced to nine years and four months in prison in March.

  A few Chinese Nationalist Party (KMT) legislators last week said that the law should be revised to introduce harsher penalties, but how effective that would be is questionable. More emphasis should be placed on prevention and response strategies to mitigate harm and avoid such incidents, which can result in physical injuries, long-term trauma, reduced motivation and even death.

  A report by the Association of American Medical Colleges last year said that the UC Davis Medical Center in Sacramento, California, had launched a de-escalation team, comprised of interdisciplinary care providers trained in mental health. Hospital staff can call on the team to calm patients or visitors and explain the situation when they identify signs of aggression. Since its launch in May last year, the team has successfully prevented almost all potential injuries and responded to more than 1,500 calls for assistance, resulting in a 49 percent reduction of inpatient calls to the police department, the hospital said last month.

  The report also cited preventive methods used in other hospitals, such as training staff to identify verbal and nonverbal aggression cues.

  While harsher punishments might deter crime, it would be more helpful to the health system to have more discussions on methods to prevent violence against healthcare workers before it occurs.
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