The phenomenon of physical aggression against health service personnel: different perspectives

The doctor-patient relationship has undergone important changes in recent years. Increasing levels of distrust on the part of patients toward professionals and institutions have led to an increase in the number of conflicts that end in violent actions against health service personnel. The aim of this study is to analyse this phenomenon in the public welfare services of the Region of Murcia (Spain), based on an analysis of accusations presented by doctors in the courts between 2006 and April 2008. The conclusion reached in this study can presumably be extrapolated to the rest of Spain. The violent reactions in question resulted from patients demanding drug prescriptions, the prolongation of sick leave and the demand for diagnostic tests. The Public Health Services provide directives for the anticipation of and abstention from such situations, emphasize the training of professionals in communication skills, the promotion of skills of negotiation and emotional self-control. Other measures include the installation of alarms, intercoms and video cameras, contracting security companies, collaboration with the police and posters in health facilities warning that legal action will be taken. Nevertheless, given the obvious inadequacy of the above mentioned measures Plans of Prevention have been put in place. In addition legal defence has been granted to all such professionals. From a judicial point of view, these aggressions are judged as minor crimes of injury or insult. The most recent view taken on such conduct is to consider it as a crime of attempt or an offence against the authority, which has been confirmed in law by the recent judgment passed down by the Spanish High Court on 4th December, 2007.