Violence Towards Healthcare Professionals

All day
Through September 18, 2013

Begins
Sep. 17

Violence towards healthcare professionals is not a new phenomenon – it is a significant problem in countries around the world, and recently it has been receiving increasing attention in China.  This conference, which featured discussion and presentations by physicians and scholars from the U.S., Europe, and China, including the Asia-Pacific region, explored violence associated with the delivery of healthcare. Healthcare violence is a problem that has been present for years in healthcare around the world, but has become a more important problem as social expectations have changed regarding healthcare.

About the Conference

In June 2010, a doctor and a nurse were fatally stabbed in Shandong Province by the son of a patient who died of liver cancer 13 years ago, and a pediatrician in Fujian Province was injured after leaping out of a fifth-floor window to escape the angry relatives of a newborn baby who had died under his care.  Thus, it is not surprising to see that in July 2010, police officers were invited to be the vice-presidents of 27 hospitals in Shenyang.  With hospitals turned into battlegrounds, being a doctor has become a dangerous job in China. (Lancet Aug 28, 2010, page 657.  “Chinese Doctors Under Threat”)

Although the problem of healthcare violence has reached a troubling level in China, it is certainly not the only country with such problems.  As of August 2009, 10 U.S. states had recently passed legislation addressing violence in healthcare setting and 3 other states had legislation pending.  (50 State Survey- Workplace Violence Laws Protecting Health Care Professionals).  Whereas in the U.S. most of the violence is focused in three areas:  mental health, emergency and “front line” providers such as nurses, in China the violence is more frequently focused on physicians.  Europe and the rest of the world have also identified violence directed toward healthcare workers as a significant problem.

The conference on “Violence towards Healthcare Professionals: An Assessment of Causes, Frequency, Prevention and Solutions” from September 17 – 18, 2013 will examine the issues of violence in the healthcare setting by assembling a multi-disciplinary group of experts from the U.S., China, and the rest of the world.  The conference will address the drivers of violence in different healthcare settings and countries by examining the social and ethical context of providing care primarily in China and the U.S.

The conference is a collaborative effort from Peking Union Medical College Hospital (PUMC Hospital), the MacLean Center for Clinical Medical Ethics, and the University of Chicago Transplant Center.   We are most grateful to Dr. Yilei Mao at PUMC Hospital.  Without Dr. Mao’s generous support, this conference wouldn’t have been made possible.

关于本次会议

2010年6月,山东省的一名医生和一名护士被一个13年前死于肝癌的病人之子杀害;福建省的一名儿科医生也在躲避一群愤怒的家属时不慎失足从五楼窗户摔下致死,之前,他照料的新生儿刚刚死亡。因此,2010年7月,当全国有27家医院邀请警察出任各自医院的副院长时,这也就不足为奇了。随着医院纷纷成为医患间的战场,在中国当医生就变成了一份相当危险的工作。(《柳叶刀》2010年8月28日刊,657页,“受到威胁的中国医生”)

尽管针对医务工作者的暴力在中国已经发展至非常严重的水平,但中国绝不是唯一一个受此问题困扰的国家。截至2009年8月,美国10个州已通过法案来解决医疗工作环境下的暴力问题,同类法案也在另外3个州准备通过(美国50州调查——保护医务工作者在岗安全的法案)。在美国,暴力主要集中在3个领域:精神健康、急诊,以及一线工作人员,例如护士;在中国,医生是暴力行为的更常见受害者。欧洲和世界其他地区也已将针对医务工作者的暴力视为重要问题。

2013年9月17-18日举行的“针对医务工作者的暴力——对产生原因、发生频率、预防和解决方案的评估”国际研讨会,将通过集聚一批跨学科的中、美及其他国家和地区的专家,探讨在医疗工作环境下的暴力问题。会议将以中、美两国为重点,旨在通过挖掘相关国家提供医疗服务的社会与伦理背景,来研究在不同医疗服务环境下暴力的起因。

本次会议由北京协和医院、MacLean临床医疗伦理中心及芝加哥大学移植中心共同主办。特别鸣谢北京协和医院的毛一雷医生为此次会议提供的慷慨支持,没有他的宝贵支持,会议将无法顺利举行。

 

TUESDAY, SEPTEMBER 17

SESSION I

14:00     J. Michael Millis     Welcome and Introduction of Keynote Speaker

14:15     Neil Munro     “The effects of performance evaluations and trust on popular strategies for dealing with unethical behavior by health professionals”

15:00      Ruiping Fan      “A principal factor contributing to the physician-patient tension  in        current China”

15:30      Break

16:00    Ruiping Fan      Case Presentation and Discussion                                              

17:30     Dinner

WEDNESDAY, SEPTEMBER 18

SESSION II

08:30     Bernard Lo (University of California)      “Ethical issues concerning workplace           violence against healthcare workers”

09:15     Yali Cong (Peking University Health Science Center)     “Conflict of Interest in clinical practice in China”

10:00     Break

10:30     Bernard Lo & Yali Cong     Case Presentation and Discussion

11:30     Lunch

SESSION III

12:30     Mark Siegler     (University of Chicago Medicine)     “Workplace violence against physicians and nurses in the United States”

13:00     Lijun Zhang (Beijing Tongren Hospital)     Violence in the Surgical Setting – Case Studies

14:00     Mark Siegler     Case Presentation and Discussion

14:30     Break

SESSION IV

15:00     Jahanzeb Effendi (Dow University of Health Sciences)     “Saving Lives in a Violent Environment – Assaults on Physicians and Paramedics in Pakistan”

15:45     Dali L. Yang (The University of Chicago Center)     “Chinese governance in the age of rising expectations”

会议议程

2013年9月17日(星期二)

第一节               

14:00     J. Michael Millis ( 芝加哥大学医院移植中心主任)      欢迎辞介绍主旨报告发言人

14:15     Neil Munro     关于对医务工作者不道德行为的通用处理措施评估的影响        

15:00     范瑞平(香港城市大学)     造成目前中国医患关系紧张的一个主要因素分析

15:30     茶歇

16:00      范瑞平     案例分析与讨论

17:30     招待晚宴

2013年9月18日(星期三)

第二节

08:30     Bernard Lo (加州大学旧金山分校)     针对医务工作者在岗时的暴力行为的伦理问题研究                              

09:15     从亚丽 (北京大学医学部)      中国临床医疗中的利益冲突

10:00       茶歇

10:30       Bernard Lo & 丛亚丽     案例展示与讨论

11:30       午饭           

第三节       

12:30     Jahanzeb Effendi     在暴力环境中拯救生命—医务工作者在巴基斯坦受到的攻击

13:00       张立军    (首都医科大学附属北京同仁医院)      如何避免外科诊疗过程中对医生暴力伤害的临床探讨                

14:00       案例分析与讨论

14:30        茶歇

第四节         

15:00      杨大利( 芝加哥大学)     期望增长时代下的中国治理

15:45       Mark Siegler  (芝加哥大学)       美国针对在岗医生和护士的暴力行为

16:15       杨大利 & Mark Siegler      案例分析

17:00       小组讨论

18:00       报告人晚餐 (会议演讲者、组织者、芝大北京中心工作人员参加)

 

Keynote Speaker

Neil Munro is Lecturer in Chinese Politics at the University of Glasgow in Scotland. Previously he has been Visiting Lecturer in Chinese Politics at the University of Edinburgh, and Senior Research Fellow in the Centre for the Study of Public Policy, University of Strathclyde (and during 2005-2011, University of Aberdeen). He has published numerous articles in peer-reviewed journals and is the co-author of four monographs on the politics of post-communist transformation.

英国苏格兰格拉斯哥大学社会与政治学学院中国政治专业讲师,曾任爱丁堡大学中国政治项目访问讲师、斯特拉斯特莱德大学公共政策研究中心和阿伯丁大学(2005-2011)高级研究员。在其所在研究领域的学术期刊上发表多篇文章,并合作撰写了4本有关后共产主义国家转型政治的专著。

 

Conference Speakers

Yali Cong is Professor of Medical Ethics and Vice Director of the Institute for Medical Humanities, Peking University Health Science Center, China. She is the Chair of IRB (Institutional Review Board) of Peking University and Vice president of China Medical Ethics Association. She teaches medical ethics to medical students and supervises both doctoral and Master’s students in medical ethics. Her current research areas involved are medical ethics education, human subject protection and medical professionalism

丛亚丽教授现为北京大学医学部医学伦理学教研室教授,北京大学医学人文研究院副院长。医学伦理学方向博士生导师。

主要的社会兼职为中华医学会医学伦理学分会副主任委员。2000年获国家教育部留学基金委资助,于2001年3月至7月在芝加哥大学临床伦理中心做高级访问学者。2009年11至2010年2月 美国杜克大学全球卫生研究所做高级访问学者。

迄今为止,主办多次国际国内研讨会和师资培训,发表中英文文章40余篇。

Jahanzeb Effendi is 26 year old physician from Pakistan who aspires to be trained in Cardiac Transplantation Surgery. He is currently working as a Medical Officer at the Department of Surgery, Dow University of Health Sciences. A Bachelor of Medicine and Bachelor of Surgery graduate from Dow University of Health Sciences in 2012, Dr. Effendi has a passion for saving lives.

He is the Co-Founder and Acting President of the First Response Initiative of Pakistan, F.R.I.P. an organization that has challenged trauma management system in Pakistan. With the aim of reducing death and disability due to secondary injuries, Dr. Effendi, has trained hundreds of medical students as First Responders who are now training the general public.

Dr. Effendi is a prolific writer who believes in writing for social change. His letters and articles have found places in mainstream newspapers that have exposed issues like state corruption, encroachment, violation of human rights and occupational safety. He is also the Founder of Donate Life Pakistan, and is working to make Deceased Organ Donation an acceptable practice in Pakistan. Dr. Effendi dreams to build Pakistan’s first Organ Sharing Network.

来自巴基斯坦,现年26岁的Effendi 博士怀有一份救死扶伤的热枕,接受过心脏外科移植手术方面的训练。现任巴基斯坦卡拉奇Dow健康科学大学外科系医疗官员。2012年从Dow健康科学大学取得药学和外科学学士学位。

他是“巴基斯坦第一反应行动”组织联合创办者及代理主席。该组织挑战了巴基斯坦传统急救创伤救治操作系统。为了减少第二伤害导致的死亡和残疾,Effendi博士培养了上百位医科学生作为急救员,并且通过他们向巴基斯坦人民普及急救知识。

Effendi博士笔耕不辍,因他相信写作能够带来社会变革。他所写的书信和文章在主流报纸上发表,暴露了诸如国家腐败、贪污、侵害人权及职业安全等问题。他也创办了“巴基斯坦捐助生命”组织,并致力于在巴基斯坦推广死者器官捐赠成为广泛认可的做法。他的梦想是建立巴基斯坦首个器官分享网络。

Ruiping Fan is a professor of philosophy in the Department of Public Policy at City University of Hong Kong. He serves as Associate Editor of the Journal of Medicine & Philosophy (via Oxford), Co-Editor of International Journal of Chinese & Comparative Philosophy of Medicine (via Global Academic Publications), and Editor of Asian Studies in the Philosophy of Medicine & Bioethics book series (via Springer). He authored Reconstructionist Confucianism: Rethinking Morality after the West (in English, 2010) and Contemporary Confucian Bioethics (in Chinese, 2011). He is the editor or co-editor of Confucian Bioethics (in English, 1999), Confucian Society and the Revival of Dao (in Chinese, 2008), the Renaissance of Confucianism in Contemporary China (in English, 2011), Confucian Constitution and China’s Future (in Chinese, 2012), Ritual and the Moral Life (in English, 2012), and Confucian Constitutional Order (in English, 2013).

范瑞平,包头医学院医学学士、中国社会科学院哲学硕士、美国莱士大学(Rice University)哲学博士。现任香港城市大学公共政策学系哲学教授。兼任美国《医学与哲学杂志》(Journal of Medicine and Philosophy)副主编、“亚洲医学哲学及生命伦理学”丛书(Springer)主编、《中外医学哲学》(香港)主编。发表中文论文50余篇、英文论文70余篇。专著有《重构主义儒学:后西方道德问题反思》(英文,2010)和《当代儒家生命伦理学》(中文,2011)。主编及参与主编著作:《儒家生命伦理学》(英文,1999),《儒家社会与道统复兴》(2008),《当代中国的儒学复兴》(英文,2011),《儒家宪政与中国未来》(中文,2012)、《礼学及德性生活》(英文,2012)及《儒家政治制度》(英文,2013)。

Bernard Lo is President of the Greenwall Foundation, whose mission is supporting bioethics research and young researchers in bioethics. He is Professor Emeritus of Medicine and Director Emeritus of the Program in Medical Ethics at the University of California San Francisco (UCSF).

A member of the Institute of Medicine (IOM), Dr. Lo served on the IOM Council and chaired the Board on Health Sciences Policy. He chaired IOM committees on conflicts of interest in medicine and on confidentiality in health services research and is currently chairing a committee on data sharing in clinical trials.

Dr. Lo serves on the Board of Directors of Association for the Accreditation of Human Research Protection Programs (AAHRPP) and on the Medical Advisory Panel of Blue Cross/Blue Shield. Formerly he was a member of the National Bioethics Advisory Commission, the NIH Recombinant DNA Advisory Committee, and Ethics Subcommittee of the Centers for Disease Control and Prevention.

Dr. Lo and his colleagues have published around 200 peer-reviewed articles on ethical issues concerning decision-making near the end-of-life, oversight of research, the doctor-patient relationship, and conflicts of interest. He is the author of Resolving Ethical Dilemmas: A Guide for Clinicians (5th ed., 2013) and of Ethical Issues in Clinical Research (2010). He continues to care for a panel of primary care internal medicine patients at UCSF.

Bernard Lo博士现为美国绿墙基金会(Greenwall Foundation)主席,该项目旨在支持生物伦理的研究以及从事相关研究的年轻专业人士。他是加州大学旧金山分校医学荣休教授、医学伦理项目荣休主任。

作为医药研究所的成员,任医药研究所理事会委员及卫生服务政策董事会主席。曾主持委员会的议题包括医药涉及的利益冲突与公共卫生研究的保密性问题,Lo博士目前正主持有关医疗纠纷上数据共享问题的委员会。

人类研究保护认证项目董事会成员,以及蓝十字/蓝盾协会医疗顾问委员会成员。

曾任美国国家生物伦理顾问、美国国立卫生研究院重组DNA顾问,及疾病防控中心伦理分会成员。

Lo博士和同事发表了大约200份同行审议型文章,主要涉及医学伦理问题,包括安乐死决定、对研究的监控、医患关系、利益冲突等。著作包括《解决伦理困境:医生指南》和《谈医疗研究中的伦理问题》。他还一直照顾加州大学旧金山分校医学院的接收的内科初级医疗病人。

Yilei Mao (Co-chair and Moderator) is a professor of surgery in the Department of Liver Surgery, Peking Union Medical College Hospital. Having finished his primary medical education domestically, Dr. Mao had his residency training in Australia, earned a Ph.D. degree in Lund University, Sweden, and fulfilled Post-doc training at Harvard Medical School, USA. He joined PUMC Hospital in the year of 1999. He is now serving as a board member of Ministry of Health for the guideline of hepatocellular carcinoma diagnosis and treatment, and the member of specialists for National Nature Science Foundation. He is editorial board members of some 10 major medical journals, including deputy editor-in-chief for the Chinese Journal of Clinical Nutrition. Among many prizes, he was awarded Li-Foundation Heritage Prize of California in the US. He is now the principle investigator of quite numbers of grants, including CMB fund from America, with total amount of some eight million Chinese Yuan. His research team has focused on various important issues in basic and clinical hepatology, among which two have been specially emphasized, they are “tumor markers for the earlier diagnosis of HCC”, and “development of novel liver function evaluation system”.

毛一雷博士,主任医师,教授,博士生导师,现为中华外科协会肝脏学组委员,中华肿瘤学会肝癌学组委员,卫生部肝癌规范诊疗专家组专家,海峡两岸卫生交流协会普通外科专家委员会常务委员,美国营养协会(ASN)会员。擅长腹部外科、主要是肝、胆疾病的诊断和外科治疗,同时对外科疑难和重症疾病的治疗、临床营养支持有较深的研究。

1990在澳大利亚Modbury医院完成住院医训练;1997年获北欧最著名的瑞典隆德大学(Lund University)外科博士学位,师从欧洲科学院院士、国际肝胆胰外科协会主席Stig Bengmark和欧洲外科研究协会主席Bengt Jeppsson。1999年在美国哈佛大学完成博士后训练,师从哈佛著名科学家Robert J. Smith;同时在美国麻省总医院(MGH)肿瘤外科完成临床培训。

2001年获美国“Li-foundation Heritage Prize”杰出成就奖,成为该年度生物医学界唯一获奖者;曾连续三次(第五、第六、第七届)获全国普外科中青年优秀论文一等奖,成为该奖项唯一一个连续三次获一等奖者;从2000年至今多次获北京协和医院医疗成果奖和优秀论文奖。2010年和2011年又分别荣获得卫生部第十届医药卫生青年科技论坛一等奖、中国国家癌症中心研究论文一等奖。主持美国CMB基金、参与国家863项目、国家科技支撑计划课题及国家自然科学基金等多个项目。在国际、国内著名杂志发表100余篇论文,任国内11家核心杂志的副主编和编委。有国家专利两项。目前主持的“GP73肝癌早期诊断”和“GSA肝脏三维立体肝功能评估”的项目处国内领先、国际先进地位。

J. Michael Millis (Co-chair and Moderator) is an internationally renowned expert in pediatric and adult liver transplantation, Dr. Millis has pioneered new techniques of operating on the liver, and has performed more liver transplants than any other surgeon in the region.  He is currently engaged with the former Vice Minister of Health of the People’s Republic of China, Jiefu Huang, to help improve the practice and policy of transplantation in China, which is supported by the China Medical Board.  He has co-authored a Lancet article with Vice Minister, Huang regarding changes in transplant policy in China.  In collaboration with the Vice Minister, Dr. Millis is helping develop a foundation in China to develop the infrastructure necessary to procure and allocate organs from deceased and brain-dead donors.  In addition, he has organized multiple clinical trials in China and is also a member of Chicago’s Sister City Committee.  Dr. Millis has authored or co-authored more than 100 articles in medical journals and has visited and lectured at hundreds of universities and medical centers around the world.

J. Michael Millis 博士是世界知名的儿童与成人肝脏移植医生,发明了多项肝脏移植的新技术,是其所在地区进行肝脏移植次数最多的外科医生。目前正与中国卫生部前副部长黄洁夫进行合作,研究改善中国肝脏移植技术和政策的措施,获得卫生部的支持。与黄洁夫共同撰写的中国器官移植政策变化的文章,在世界权威医学杂志《柳叶刀》上发表。在与前任中国卫生部副部长的合作下,Millis博士正着手在中国创建一个基金会,以推动从脑死捐赠者获取器官并进行分配机制的发展。另外,Millis博士在中国组织过多次临床医疗试验,他还担任芝加哥姐妹城市委员会成员。Millis博士在医学期刊上发表了超过100篇学术文章,并且在全球几百所高校和医疗中心访问及发表演讲。

Mark Siegler (Co-chair and Moderator) is the Lindy Bergman Distinguished Service Professor of Medicine and Surgery at the University of Chicago, Founding Director of the University of Chicago’s MacLean Center for Clinical Medical Ethics and the Founding Director of the University of Chicago’s Bucksbaum Institute for Clinical Excellence.  He has been practicing and teaching internal medicine for more than forty years.

His research interests include the ethics of surgical innovation, organ transplantation, end of life care, ethics consultation, and decision making within the doctor patient relationship. Dr. Siegler has also published more than 200 journal articles, 50 book chapters and five books. textbook, co-authored with Al Jonsen and William Winslade, Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, 7th Edition (2010), has been translated into eight languages and is widely used by physicians and health professionals around the world.

Mark Siegler博士是芝加哥大学Lindy Bergman杰出医学与外科教授,芝加哥大学MacLean临床医学伦理研究中心及Bucksbaum卓越医疗研究机构创办人。从事外科临床及教学工作超过40年。

Siegler博士的研究方向包括外科医学创新的伦理问题、器官移植、临终关怀、伦理咨询,以及医患关系中作出的决定。发表了超过200篇期刊文章,参与撰写了50章书和5本书。其与Al Jonsen和William Winslade共同出版的《医学伦理:临床医学中伦理问题的实用方法,第7版(2010)》一书被翻译成8种语言,并被世界各地的医务工作者广泛使用。

Dali Yang is Professor of Political Science and in the Social Sciences Collegiate Division at the University of Chicago and founding Faculty Director of the University of Chicago Center in Beijing. He previously served as director of the East Asian Institute in Singapore and is former Chairman of the Department of Political Science, former director of the Center for East Asian Studies and of the Committee on International Relations at the University of Chicago.

Among Professor Yang’s books are Remaking the Chinese Leviathan: Market Transition and the Politics of Governance in China (Stanford University Press, 2004); Calamity and Reform in China: State, Rural Society and Institutional Change since the Great Leap Famine (Stanford University Press, 1996); Beyond Beijing: Liberalization and the Regions in China (Routledge, 1997). He is also editor or co-editor of several other volumes and the author of many articles.  He was a team member and contributor to The United States and Rise of China and India, by the Chicago Council on Global Affairs.

Professor Yang has served on the editorial boards of leading academic journals, including American Political Science Review, Journal of Contemporary China, and World Politics. He has been a board member of the National Committee on U.S.-China Relations and a consultant to industry, government agencies, and the World Bank.

杨大利教授是芝加哥大学政治学系教授,现为芝加哥大学北京中心主任。他曾任新加坡国立大学东亚研究所所长、芝加哥大学政治科学系主任、芝加哥大学东亚研究中心主任及国际关系委员会主任。

杨教授毕业于北京科技大学的工程专业,获美国普林斯顿大学政治学博士学位,专攻国际关系和比较政治学。自1992年起执教于芝加哥大学。

杨教授的著作包括《重塑中国巨龙: 市场转型与治理政治》(斯坦福大学出版社, 2004年出版);《中国的灾难与改革:大跃进饥荒与制度变迁》(斯坦福大学出版社, 1996年出版);《自由化与中国的区域》( Routledge, 1997年出版)等。他还是若干份学术期刊的审稿人或联合审稿人,并撰写了很多学术文章。杨教授还是芝加哥国际事务委员会“美国与崛起中的印度和中国”项目成员。

杨教授受聘为《美国政治科学评论》、《当代中国》、《世界政治》等知名期刊的编审委员会成员。他还是美国美中关系全国委员会理事会成员、并为商界、政府机构及世界银行担任顾问。

Lijun Zhang is Chief Physician in the General Surgery Department, Associate Professor, and Supervisor of Master Student at Beijing Tongren Hospital, Capital Medical University of China.  His teaching, research, and practice focus on hepatobiliary, pancreatic, and splenic surgery.

Dr. Zhang graduated from Capital Medical University of China in 1991 and was a visiting scholar at the University of Chicago Hepatobiliary Surgery Center in 2008.

Dr. Zhang is now an expert of the Beijing municipality medical accident appraisal and forensic expert.  He is a reviewer of the Beijing Medical Science Development Fund projects, the editor or co-editor of several journals including Medical Research.  He was awarded with a number of research grants including that by the Beijing Outstanding Talents Fund and is the author of more than 30 academic papers.

张立军博士现任首都医科大学附属北京同仁医院普外科主任医师、副教授、硕士研究生导师。擅长学术领域:肝胆、胰腺、脾脏外科。他1991年6月毕业于首都医科大学;2002年6月,晋升为首都医科大学附属北京同仁医院普外科副主任医师,后任外科学副教授;2008年前往美国芝加哥大学肝外科进行访问学者研究,回国后于2012年晋升为普外科主任医师。

张立军医生现担任北京市医疗事故鉴定专家、司法鉴定专家,北京市医学发展基金评审专家及《医学研究杂志》等多个杂志的审稿专家。曾获得北京市优秀人才基金等多项科研项目,发表学术论文30余篇。

 

Organizers: Michael Millis (Department of Surgery) and Mark Siegler (Department of Medicine) in collaboration with Yilei Mao, Peking Union Medical College.

(Photos by Yuxuan Li)