First, do no harm.
When a patient is admitted to hospital for physical or mental injury that is a result of physical or emotional abuse of an adult or a child, medical professionals are obliged by the Hippocratic oath to do no harm.
In the case of domestic abuse, doing no harm means doing something to — first and foremost — treat the injury. Secondly, hospital staffers must help authorities in their duty to intervene in family affairs, if necessary, to protect the physical and emotional wellbeing of women or children. Hospital workers adhere to their duty by not just healing wounds, but implementing procedures for reporting the abuse to authorities.
But allow me to set aside the question of when and how authorities are to deal with the “public” interest in “private” family incidents that result in injury, or worse (murder, accidental death, or suicide), that disproportionably affects women and children. Let us simply address how these patients are treated in hospital.
A legal consultant once told me of a woman in the Eastern Province who, after years of physical and emotional abuse, attempted suicide. Thankfully, the doctors managed to pull her through. But then she was simply handed back to her male guardian, her abusive husband, and the cycle of violence continued. To make things worse, she was released into the “caring” guardianship of her husband before she had fully recovered from her self-inflicted injury.
Why was she released prematurely? Why was she handed back to her abusive spouse without an incident report being filed? Does the doctor have the right to intervene in this situation? First, do no harm.
This isn’t just about physical abuse. Emotional abuse leads to misery, psychological duress and even suicide. The number of psychiatric patients is increasing everyday in Saudi Arabia. We should be adhering to the patients’ rights guidelines on the treatment of psychiatric patients drawn up by the Health Ministry in 2001. Since then, nothing has happened.
We should be doing more to protect these patients, because by doing so doctors succeed in doing no harm.
