Ending violence against doctors in China

China’s doctors are in crisis. In recent years, they have
faced increasing threats to their personal safety at work.
Doctors have been abused, injured, and even murdered
by patients or relatives of patients in hospitals and clinics
across the country. In a recent tragic case, described
in a letter published online today in The Lancet, a male
intern at the First A?  liated Hospital of Harbin Medical
University was stabbed to death by a patient.
Responding to this crisis, the Chinese Government
announced last week that it is increasing police vigi-
lance inside hospitals. People who disrupt the daily
operation of hospitals, carry dangerous materials, or
threaten medical sta?  will be held legally accountable,
according to a joint statement by the Ministry of
Health and the Ministry of Public Security. Although
turning hospitals into high-security institutions may
be a necessary step, it is a short-term solution to this
disturbing and desperate situation.
There are many possible reasons why Chinese
doctors are under threat. These causes are systemic—
poor investment in the health system and in training

and paying doctors, which can lead to medical errors,
corruption, and poor communication between health
professionals and patients. Other factors are societal,
and include negative media reports about doctors, poor
public understanding of medicine, unrealistic patient
expectations about treatments, and catastrophic out-
of-pocket health-care expenses for familes.
Whatever underlies the violence, the impact on
medicine in China is of great concern. As Li Jie, a
medical student at China’s Ningbo University, writes in
his letter, the new generation of Chinese doctors feels
lost: “they do not know whether to continue to study
medicine or not, and how to face the complex and
uneasy relationship with their patients.”
Doctors in China were once revered, as they still are
in many other Asian countries. China needs to make
medicine an attractive, respected, rewarding, and safe
profession again, to protect the doctors of today and those
of tomorrow, for the benefi t of patients. The fi rst step
should be a government inquiry to examine the causes of
the violence and fi nd ways to end it.  ■ The Lancet