Executive Summary

Can We Have A Violence-Free Society?

A. Stuart Hanson, M.D.
President, Minnesota Medical Association

February 1993

Violence and abuse fill our newspapers and nightly news programs. Violence in this society overloads our law enforcement and judicial systems. Our health care system is affected, too, as it attempts to heal victims' injured bodies and bruised minds.

As we begin to study interpersonal abuse and neglect, we find it much more prevalent than we had believed. Rape, incest, and physical injury among family members are commonplace. In more than 20 percent of all American homes, an individual is physically injured by another family member each year.

Spouses beat each other. Parents abuse their children. Children purposely injure each other. While the verbal abuse and physical blows occur about equally between sexes, the stronger do more damage. Men rape and injure their partners; parents injure their children; older children injure their younger siblings. The cycle repeats from generation to generation, inflicting deep psychological scars, broken bones, and injured egos. Fear, intimidation, harassment, and physical beatings become a way of life, ending too often in murder or suicide.

The problem crosses all strata of society -- rich and poor, conservative and liberal, white and people of color. The medical community and the health system have seen the after-effects -- the broken bones, bruises, emotional distress, and the psychophysiologic reactions. However, we have not been successful in isolating and preventing the root causes. Health professionals are not well-equipped to identify and help patients who experience these multi-faceted and traumatic behaviors.

Nonetheless, The medical community is beginning to view violence, abuse and neglect as health care problems. The Minnesota Medical Association recently declared its intent to work for a "violence-free society." We have begun to look at our own practices in our own industry and are finding abusive relationships in our own workplaces. Some of our teaching methods rely on fear, intimidation, and harassment rather than example. We see co-workers treated as subordinates rather than as colleagues.

We have begun education programs to create awareness of mistreatment in our workplaces and to build skills in resolving conflict in non-abusive ways. We have learned that employees in the health-care system are subjected to abusive relationships in their homes and that such experiences have a significant effect on their ability to carry out their professional responsibilities at work. Employee assistance programs are beginning to address some of these issues. It is indisputable that healthy health-care workers can better serve the needs of patients who are experiencing abuse and neglect.

Our experience in clinics and emergency rooms, tells us that Health-care organizations are not different from other businesses. We need to determine the root causes of violence, abuse, and neglect. We need to identify and correct the abusive relationships at work and at home that result in the stories of murder, assault, rape, and suicide that lead the evening news. As a society, we need to create environments where conflict prevention and conflict resolution are a natural part of the daily routine.

We have a responsibility, and we can be leaders in solving one of humanity's most tragic problems -- our violence against each another.

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