Man Attacks Estranged Wife in Hospital- New Law Should Prevent Re-occurrence

Apparently, violence in health care facilities is a problem in Israel worthy of its own law.

The JPost reported today that a man attacked his estranged wife and hospital staff in the maternity ward. In May they reported on 3 brothers of a woman who was placed in a emergency shelter for domestic violence victims who went to the social worker’s home with clubs and iron bars and beat up her husband and other family members. According to a report at the Health Policy Monitor:

A comprehensive study conducted in 2003/4 on violence in emergency rooms in Israel (Landau et al. 2004) revealed that 75% of the medical staff reported a violent incident in the past year. Most reports related to verbal violence, but 29% reported threats and 16% physical violence...

This problem receives growing media attention; it was debated in the parliamentary committee for work welfare and health in 2007. During 2008, several academic conferences were dedicated to the issue and discussed measures to address it.

A March article in Haaretz reported on a recent study that found:

Among participating personnel, 39 percent reported that their conduct contributed to the violent incident in question. In general, 48 percent of those questioned said the behavior of hospital staff contributed to violent incidents.

Out of 4,047 statements about violence collected, 39 percent were linked to staff behavior, 29 percent to patients and 16 percent to organizational aspects.

In addition, 10 percent of the statements connected violence by patients to prolonged waiting time.

The study found that a nurse in an emergency room is 5.5 times more likely to be violently attacked than a nurse in an internal medicine ward. 

Last year, the Knesset passed The Prevention of Violence in Medical Facilities Law. The law provides that the director of a medical facility may issue a warning to a person who commits violent acts, whether physical or verbal, against hospital staff or equipment. The text of the warning states that if the individual perpetrates another violent act within 12 months, the facility director may ban him from entering the premises, unless it is for his own medical treatment. (The Health Policy Monitor report cited above discussed proposed legislation that would allow doctors to refuse to treat violent patients. Apparently it did not pass.) A verbal outburst or destruction of property within 12 months of the warning notice will result in a 3 month ban and a physical outburst will result in a 6 month ban.

Recently, the Knesset amended the law to include social workers as well. Whereas, a person cannot be refused medical treatment based on his violent history, he can be refused social services. The social services facility director may allow the offender to receive treatment if the director is convinced that to do otherwise may negatively impact the patient's vital needs. The security guards of those facilities are permitted to ask the perpetrator for identification, evict him from the premises, refuse him entry to the premises, or hold him until the police arrive.

I wonder how effective such laws really are. Are there so many repeat offenders who get violent in the hospital? How many times does an average person visit a doctor in a year? I didn't find statistics for Israel but here are statistics for 15 other OECD countries. Even if that number is doubled to include visits accompanying a loved one, how many of those visits turn violent? How many of these people are repeat offenders? I'd like to see some statistics from hospitals about how often they issue these notices and how many times they need to ban someone from the premises.

For an article on the Jewish Law view of doctor's striking see this article by Dr. Fred Rosner. I am not sure the conclusions presented there would encompass a doctor's refusal to treat violent patients. I presume the answer is: it depends.