Opinion : Physician's role in preventing violence
Submitted for a grade as part of my medical ethics class:
There is a serious crime problem in the United States. Crime rates are much higher in the US than in other developed countries. (Mercy et.al., 10). It has been proposed that action should be taken at all areas of society, and that physicians have a significant part to play.(Mercy et.al., 1) To determine this part, it has been proposed that violence should be treated as a public health problem. This distinction of violence as a public health crisis is dubious however, as it misrepresents the purpose of medicine and distracts attention and money away from those whose job it is to fix the problem. Physicians do not have the time, resources, or enforcement power to treat the violence problem, nor do they provide an efficient means to do so.
The role of doctors in treating society's problem is controversial. People are always trying to expand physician's roles past their obvious expertise. It has been suggested in Medicine and Society this year that physicians should try to fix the problems of poor education, wage disparity, drug use, and sexual promiscuity among others; and now we are adding violence. As a caring human being, physicians should certainly be concerned about all these issues, but fixing abstract social problems is not what medicine is about. Medicine is about diagnosing and treating illness acutely, not eradicating the long-term, possible causes of illness. Our society trains and maintains a large number of police officers, social workers, public health authorities, legal advocates, therapists, teachers, and councilors whose job it is to fix these problems. Just as social workers should not administer therapy for lead poisoning or be resetting broken arms, physicians should not be deciding if a child is fit to live in a certain household.
One major reason that physicians should be a focus of violence prevention programs is simply that other trained professionals would likely do a better job working on the problem. The constraints of modern medical practice would make physicians an inefficient resource for identifying, counseling, or intervening in situations where violence is involved. The time limits placed on doctor and clinic visits make physicians unable to provide proper support and counseling to victims (psychologists should do this). Inability to track patients outside of their practices also does not allow physicians to identify of those at risk (social workers should do this).
Some studies claim that physicians should help to prevent gun violence and take steps to help patients who may show risk factors towards violence (Christoffel et.al). This can be counter productive and even unethical for physicians, however. The researchers claim that physicians can help by sharing data on the effects of gun violence and modifying their treatment for those who may be at risk (Christoffel et.al). Sharing patient data violates patient privacy, however. In addition, treating a patient differently because of a risk factor based on other people, or that you are only assuming is discrimination. It is not a physician's place to judge patients or their family's behavior and social situations, and to the extent that it can be avoided, these factors should not influence routine medical care.
Violence is a problem that society needs to deal with, but not by throwing medical resources at it. Society should work to solve the problem through trained dedicated professionals whose concentrate on this area. Physicians should not encroach on the territory of social workers, therapists, and law enforcement. A focused campaign is needed to end violence, with moral support from the community for the directed actions of those trained to intervene.
Labels: medical ethics, opinion
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