Judicial judgment and media sensation of violence against medical staff in China: A fuzzy set qualitative comparative analysis (fsQCA).

INTRODUCTION: Violence against medical staff has been prevalent in China over the past two decades. Although Chinese authorities have released many laws and regulations to protect medical staff from violence since 2011, the legal approach alone is unlikely to resolve this complex issue. In particular, several cases of violence against medical staff in China have caused great media sensation. METHOD: This paper proposes an integrated model that combines the environmental stimuli theory, broken windows theory, and rational choice theory. It adopts the fuzzy set qualitative comparative analysis (fsQCA) to untangle the causal relationship between violence against medical staff, media sensation, and judicial judgment. We examined reports of medical violence on media and news websites from January 1, 2010, to January 31, 2020, and selected 50 cases with detailed information for this study. RESULTS: The results show that each condition is not sufficient for the absence of judicial judgment, but when combined, they are conducive to the outcome. The conditions of hospital level, medical cost, and media sensation play important roles. The providers, patients, and environmental factors are indicators of inadequate or lack of judicial judgment, which corresponds to previous expectations. CONCLUSIONS: The integrated model greatly enriches the extant theories and literature, and also yields implications for preventing violence against medical staff in China. We suggest that sustainable and innovative healthcare reform should be initiated. For example, public hospitals should remain the cornerstone of national public health security. Medical staff in public hospitals must be regarded as "civil servants". Therefore, the current legal system should be improved. The media should objectively report events concerning medical staff and improve public healthcare knowledge.

Developing and Implementing a Patient Behaviour Risk Screening, Communication and Care Planning Intervention for Hospital Settings.

Workplace violence prevention of patient behaviours is a primary safety focus in hospital settings. In response to provincial mandates, a multi-site tertiary care hospital system developed the Behaviour Safety Risk Communication and Care Planning Program. Components include patient risk screening, communication tools and care plans that outline mitigation strategies. The program has been implemented at six sites using the following strategies: educational and planning meetings, formation of steering committees, identification of champions, educational materials/training, facilitation and consultation, and audit and feedback. Our paper can guide program development and implementation in similar contexts.

Factors associated with physical injury or police involvement during incidents of workplace violence in hospitals: Findings from the first year of California's new standard.

BACKGROUND: Workplace violence in healthcare settings is known to be a costly and often underreported problem. In California, hospitals are required to report incidents of violence towards workers to the California Occupational Safety and Health Administration (CalOSHA) using an online reporting system that went into effect in 2017. METHODS: Reports submitted to CalOSHA from July 2017 to September 2018 pursuant to this new requirement were analyzed using descriptive methods and logistic regression. RESULTS: Four hundred eight hospitals submitted reports using the new incident reporting system. Behavioral health units had 1.82 times the odds of the reported incident resulting in physical injury compared to inpatient medical units, and investor-owned facilities had 2.43 times the odds of the reported incident resulting in physical injury compared to city or county-owned facilities. Inpatient and behavioral health units had significantly reduced odds of a reported incident resulting in police involvement when compared to other locations within the hospital. CONCLUSIONS: These findings indicate that protections for healthcare workers deserve ongoing attention from stakeholders and legislators and provide insight into how healthcare facilities report incidents of violence towards workers.

On the absence of a doctor's dilemma in India: Reflections on impatient violence.

On June 10, 2019, Mohammed Sayeed, a 75-year-old patient was admitted to the Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal (1). He died that night due to a cardiac arrest and this led to a scuffle between the patient's family and duty doctors. In retaliation, the doctors refused to discharge the body, asserting that since the family claimed it was a suspicious death, a post-mortem was required. A mob arrived, and in the confrontation, a doctor was injured. The medicos struck work. Doctors and medical associations across the country have voiced unanimous support for the doctors, and called for protective legislation against the violence of the public. As a consequence of these nationwide doctors' protests, the Supreme Court has now proposed a law that protects doctors by severely punishing those who attack them (2). Meanwhile, it does seem as if such attacks are increasing.

Increased maximum sentences for assaulting nurses.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the provisions of the Assaults on Emergency Workers (Offences) Act 2018.

"Felony assault should stick:" Assaulted EMS responders' frustration and dissatisfaction with the legal system.

INTRODUCTION: The prevalence of violence to first responders is reported in ranges of approximately 40% to 90%. Pennsylvania has a felonious assault statute to address such violence, but the prosecutorial process has been noted to cause first-responder dissatisfaction. METHODS: An exploratory qualitative study using individual interviews with snowball sampling was conducted with the Philadelphia District Attorney's office to understand the prosecutorial process when a first responder is assaulted and injured in a line of duty. The Philadelphia Fire Department provided a list of first responders who sustained a work-related injury from a patient or bystander assault so that particular cases could be discussed during the interviews. RESULTS: Emergent themes fell into two categories: factors that lead to a charge (prosecutorial merit, intent, and victim investment), and the judge's discretion in sentencing ("part of the job" mentality, concern for the defendant, and the justice system's offender focus). Immediately actionable tertiary prevention recommendations for fire departments, labor unions, and district attorney's offices were developed. CONCLUSION: Violence against fire-based emergency medical service (EMS) responders is a persistent and preventable workplace hazard. While felonious assault statutes express society's value that it is unacceptable to harm a first responder, this study found that such statutes failed to provide satisfaction to victims and that support when going through the court process is lacking. Assaulted EMS responders, their employers, and labor unions would benefit from the recommendations provided herein to help them extract a stronger sense of procedural justice from the legal process.

Violence against health professionals and facilities in China: Evidence from criminal litigation records.

OBJECTIVES: This study aims to extend the current understanding of violence against health professionals and facilities in China, with data from an authoritative, national-representative, but under-researched data source - litigation records, and discuss implications for developing violence prevention strategies. DESIGN: We collected all legal cases relevant to violence against health professionals and facilities from criminal ligation records released by the Supreme Court of China from 2010 to 2016. MAIN OUTCOME MEASURES: (i) Characteristics of perpetrators: gender, age, education, occupation, history of mental illness and alcohol; (ii) characteristics of victims: medical specialization, location, type of violence; (iii) outcome of treatment. RESULTS: 140 cases were collected for analysis. Beating, pushing, verbal abuse, threatening, burning mock paper money, placing a corpse in the hospital, hanging banners, blocking hospital gates and doors, and smashing hospital property were the most frequently reported types of violence. Specifically following patient deaths, the interval between a patient's death and violence by the patient's families and friends was short, with 51% happening on the same day. CONCLUSIONS: Our study provides a comprehensive overview of violence against health professionals and facilities in China, which can be used to inform the development of prevention strategies.

La respuesta del Derecho Penal y Administrativo frente a las agresiones a profesionales sanitarios en España / The response of Criminal and Administrative Law on violence in the workplace against health professionals in Spain

La entrada en vigor de la Ley Orgánica 1/2015 ha supuesto la materialización de importantes modificaciones en el tratamiento punitivo de los supuestos de agresiones a profesionales sanitarios. En particular, y junto con la tipificación expresa como delito de atentado (art. 550 CP) de los supuestos de agresiones a profesionales sanitarios, se incluye como novedad más relevante la previsión de una agravación en el delito de homicidio cuando los hechos resulten constitutivos de un atentado (art. 138.2.b CP). Al hilo de lo anterior, el presente trabajo pretende establecer con nitidez el nuevo panorama concurrente en la esfera sancionatoria (penal y administrativa) en dichos supuestos de agresiones a los mencionados profesionales

The coming into effect of Organic Law 1/2015 has involved relevant changes in the criminal treatment of cases of violence against health professionals. In particular, the reform expressly establishes the offence as assault on the authority, its agents and civil servants (Article 550 Spanish Criminal Code) of the cases of aggression against health professionals. It also includes, as a relevant novelty, the prevision of an aggravated modality of homicide when the facts prove to be constitutive of an assault on the authority, its agents and civil servants (Article 138.2.b Spanish Criminal Code). Consequently, the present paper is devoted to clarifying the current legal framework in the punitive sphere (penal and administrative) in cases of aggression against health professionals

Consideraciones acerca de la violencia ejercida sobre el profesional sanitario en el ámbito asistencial y las correspondientes medidas de tutela y seguridad / Considerations about violence against healthcare profesionals in care settings and corresponding protection and security measures

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Los profesionales de la sanidad no son autoridad a efectos penales / Healthcare professionals are not authority in Spanish criminal law

La atribución de la condición de autoridad a efectos penales a los profesionales de la sanidad pública es un error que viene repitiéndose desde antes de la reforma del ordenamiento penal español del año 2015 (LO 1/2015, de 30 de marzo). Este trabajo recoge esta problemática y, en particular, cómo se repite en la actualidad en resoluciones judiciales, literatura científica, manifestaciones de colegios profesionales y medios de comunicación, generando una situación confusa, sobre todo por la diferencia en las consecuencias punitivas que esta apreciación supone. Incluso se reclama la posibilidad de que la consideración de autoridad se extienda al ámbito privado. Esto resulta inviable, puesto que ni es aplicable a la sanidad pública ni los profesionales de la sanidad privada detentan tan siquiera la condición de funcionario público

The attribution of the status of authority in Criminal Law to public health professionals is a mistake that is been repeated even before the reform of the Spanish penal system in 2015 (Organic Law 1/2015 of 30 March). This work describes this problem and, in particular, how it is repeated today in judgments, scientific literature, and demonstrations from professional associations and media. This creates a confusing situation, particularly due to the differences in the punitive consequences. The attribution of the status of authority is even expected to be extended to the private healthcare. This is unworkable, since it does not apply to public health workers, and private health professionals do not even have the status of public servants