BEIJING — Earlier this month, in the central Hunan province, the family of a cancer patient beat up the attending doctor and a pregnant nurse because they had been unable to save the patient's life. The nurse nearly had a miscarriage afterwards, while the hospital ward facilities were badly damaged.
On June 5, the Chinese Medical Doctor Association firmly denounced the act and demanded that the perpetrators be punished — not the first time it has been forced to publicly pronounce its disapproval of such behavior.
But will such an expression of condemnation work? I fear that only if China achieves greater openness and transparency about medical risks can an end be put to the doctor-patient conflicts and occasional violent acts such as this.
Chinese media has reported more than 60 cases of violence against doctors since 2003. The Chinese Medical Doctor Association's incomplete statistics show that last year there were 16 doctors injured or killed in such incidents. According to my own calculations, between February and June this year more than 11 serious cases of doctors being injured have been registered.
This increasing number of medical-related conflicts demonstrate that the major cause of violence is due to the patient’s or patient's family's lack of medical knowledge and their unrealistic expectations of medical treatment.
Even a nurse administering injections could become subject to an assault. This shows the great importance of dialogue about medical risks between medical staff and patients. Medical risks make up in fact the most entangled factor in doctor-patient conflicts.
Emotions and education
To patients, medical risks imply the uncertainty that may result in injury or disability because of unsafe consequences or professional incompetency during the entire process of medical care. But some treatments, especially for serious illnesses, can sometimes come with known, serious risks, that are not linked to the level of care.
Chinese people are more emotional than informed about both health risks and current medical treatment. But the onus is on the medical establishment to educate the public. If a particular illness, for example, has a cure rate of 70%, the medical staff must be frank with the patient and family members beforehand that there is indeed a 30% chance of failure, and explain exactly what that means.
Those who have lashed out at medical staff attribute the responsibility for the ultimate health condition of a patient to the doctor, often thinking "I spent so much money to be cured." Meanwhile doctors who have done their best don't understand the anger.
Better communication between doctors and patients is the key to reducing such conflicts like we witnessed in Hunan this month. While we condemn violence, we also call for more openness by all relevant parties about risks of treatment and probability of cures.
Revelations of a nationally funded clandestine operation within 10 municipalities in the Netherlands to keep tabs on mosques and Muslim organizations after a rise in radicalization eight years ago.
At least ten Dutch towns and cities have secretly used a private agency to probe mosques and other local religious organizations, Amsterdam-based daily het NRC reports in an exclusive investigation.
The clandestine operation — funded by NCTV, the National Security Services, the Netherlands' leading counter-terrorism agency — was prompted by the social unrest and uncertainty following multiple terror attacks in 2013, and a rise in Islamic radicalization.
The NCTV, which advises and financially supports municipalities in countering radicalization, put the municipalities in touch with Nuance by Training and Advice (Nuance door Trainingen en Advies, NTA), a private research agency based in Deventer, Netherlands. Among the institutions targeted by the investigations, which came at a cost of circa 500,000 euros, were the Al Mouahidin mosque in the central Dutch town of Ede, and the Nasser mosque east of the city of Utrecht, according to NRC.
Praying inside a Dutch mosque.
Broken trust in Islamic community
Unlike public officials, the private agency can enter the mosques to clandestinely research the situation. In this case, the agents observed activity, talk to visitors, administrators, and religious leaders, and investigated what they do and say on social media.
All findings then wound up in a secret report which includes personal details about what the administrators and teachers studied, who their relatives are, with whom they argued, and how often they had contact with authorities in foreign countries, like Morocco.
Leaders of the Muslim organizations that were secretly probed say they feel betrayed.
It is unclear whether the practice is legal, which is why several members of the Dutch Parliament are now demanding clarification from the outgoing Minister of Justice and Security, Ferd Grapperhaus, who is said to be involved.
"The ease with which the government violates (fundamental) rights when it comes to Islam or Muslims is shocking," Stephan van Baarle, member of the leftist party DENK, told De Volkskrant, another Dutch newspaper.
Leaders of the Muslim organizations that were secretly probed say they feel betrayed. Hassan Saidi, director of one of the mosques investigated, said that the relationship with the local municipality had been good. "This puts a huge dent in the trust I'd had in the municipality," he told the Dutch public broadcaster NOS.
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