Statement: Violence Against Health Professionals
A Statement by the FIGO (International Federation of Gynecology and Obstetrics): Ethical Aspects of Human Reproduction and Women's Health Committee
Background
In many countries, healthcare professionals, including obstetrician-gynecologists, have been subjected to violence, including murder. In some countries, physicians who provide termination of pregnancy under the provisions of applicable law have been assaulted and killed. These physicians have not broken any law. Such assault and killing are criminal acts.
In some countries, during times of military conflict, physicians have been tortured and killed merely because they cared for injured patients who were regarded as the enemy or family members of the enemy. It is well accepted in military medical ethics that the uniform or national or other affiliation is irrelevant; clinical management should be based on triage, a clinical and not political concept. In addition, healthcare facilities have been directly targeted by ground and air attack by insurgents, terrorists, and governments, resulting in injuries and death to healthcare professionals and patients.
It is well understood in military ethics that healthcare facilities are not to be targeted for direct attack. There is also a very high burden of proof in just war theory for attacks on nearby targets that might also damage or destroy healthcare facilities, especially those caring for the wounded and injured, laboring women, and children. Direct attacks on healthcare facilities should be considered crimes against humanity.
Finally, non-governmental healthcare organizations, to fulfill their clinical mission, must position personnel near or in conflict zones. Leadership should not do so recklessly, i.e., when the risk of injury or death to healthcare professionals cannot be responsibly minimized.
Recommendations
- Obstetrician-gynecologists and their member societies have the professional responsibility to advocate for the impartial application of criminal law to perpetrators of criminal violence against healthcare professionals with especially vigorous advocacy in the case of lethal criminal violence.
- Obstetrician-gynecologists and their member societies have the professional responsibility to advocate for the prevention of criminal violence against healthcare professionals, especially when current criminal law is not an adequate deterrent.
- Obstetrician-gynecologists and their member societies have the professional responsibility to advocate against capture, abuse, and torture of healthcare professionals who have done nothing more than discharge their professional responsibilities to their patients, including those who are wounded or sick combatants.
- Obstetrician-gynecologists and their member societies have the professional responsibility to advocate for the prosecution of crimes against humanity in direct or unjustified indirect attacks on healthcare facilities in appropriate national and international courts.
- Obstetrician-gynecologists and their member societies have the professional responsibility to advocate that leadership of non-governmental healthcare organisations make prudent decisions about the insertion into and extraction of healthcare professionals from conflict zones.
- Leaders of healthcare facilities should resist efforts to use their facility as military depots or garrisons, consistent with their responsibility for the safety of their patients and colleagues.
London, July 2018