Doctors and death

Wary of their patients...

By all accounts Dr Yang Wen was a kind and diligent physician. For 22 years she worked in the emergency department of Beijing’s Civil Aviation Hospital, often on night shifts, despite only being four years away from retirement.

But shortly before 6am on December 24 Yang was the victim of a brutal knife attack at work.

The assailant was Sun Wenbin the 55 year-old son of an elderly woman she was treating.

Yang was rushed to surgery but the injuries to her jugular vein and carotid artery were so extensive that she couldn’t be saved. She was pronounced dead at 7pm the same day.

As readers of WiC will know, many medical practitioners in China have been killed by relatives of their patients – according to a study by Renmin University ‘patient-physician violence’ claimed the lives of 24 doctors between 2011 and 2018. Another survey by the Chinese Medical Doctors’ Association (CMDA) in 2018 found that 30% of the country’s 4.5 million doctors have been attacked by the relatives of people in their care.

“We are beyond fury and strongly condemn the atrocity,” the CMDA said in a statement after Yang’s killing, which also called on administrative agencies and the judiciary to create a “safety net” so that medical workers are better protected in the future.

In fact, the attack on Yang came just a day before lawmakers passed a law making it a criminal offence to threaten or endanger the personal safety of medical and health personnel. Yet the new legislation is unlikely to do much on its own. The root of the problem, say experts, is a breakdown in patient-doctor trust, which stems from the pressing shortage of medical workers in China, fiddly government health insurance policies, and the high cost of out-of-pocket care.

A survey by Peking University found that the biggest rise in patient-doctor violence happened between 2010-2014, when the cost of medical care was also rising at the fastest rate.

Furthermore, Chinese hospitals rarely admit when they make mistakes and their insurance policies aren’t typically broad enough to cover the costs of caring for someone who has suffered as a result of negligent or inappropriate treatment – meaning that many families choose to take matters into their own hands if something goes wrong. In addition to all of that is the fact that China’s population is aging rapidly, placing an ever-greater burden on the health system.

In Yang’s case, she had been treating a 95 year-old woman who had not only had a stroke but fallen into a coma after her cancer treatment. The woman was admitted to the hospital in early December but because of overcrowding in the inpatient ward she was being treated in the emergency unit – which meant that a smaller proportion of her care was covered by her state insurance policy.

Her family refused all treatment apart from an intravenous drip and pressed to get her admitted to the inpatient ward rather than move to another hospital. Over the following weeks relations between the family and the hospital deteriorated and in the days before the attack Sun made threats against the medical staff.

Surveillance video of the attack shows him coming up behind Yang and plunging a knife into her throat. He then stabbed the doctor multiple times in the neck.

Sun was arrested on the spot. Meanwhile his mother was finally transferred to another hospital with an inpatient bed.

“The psychological trauma caused by extreme events cannot be ignored,” wrote the People’s Daily, suggesting that Sun was acting out of stress. But state broadcaster CCTV warned that such attacks have a wider impact because they lead to the “disruption of the normal medical order”. It added: “Patients will become victims because they cannot be promptly diagnosed and treated […] talented people who are interested in becoming doctors will refuse to choose this profession.”

The killing has attracted enormous attention online: there were 2.5 billion views of the hashtag relating to the murder on social media. “If this killer is not punished severely no one will dare to study medicine in the future,” one netizen warned.

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