West Bengal is teaching doctors taekwondo to repulse attacks by patients’ kin. Is it ethical?

For about a year, Kolkata third-year medical student Rituporna Mukherjee has been taking a course that is so important to her, she has barely missed a class. She is learning taekwondo.

Mukherjee is among 150-odd medical students and five doctors at the Nil Ratan Sircar Medical College and Hospital who have been training in the Korean martial art since March last year. The training is meant to help doctors defend themselves against relatives of patients who may turn violent if they are not satisfied with the treatment. It was introduced after several doctors in the state and around the country were assaulted by irate relatives of patients.

At Nil Ratan Sircar Medical College and Hospital itself, junior doctors went on strike after one of them was attacked by a patient’s relatives on September 4, 2017. Previously, in February 2017, a mob had kicked and slapped a doctor at Seth Sukhlal Karnani Memorial Hospital, a premier multi-specialty facility in Kolkata. The two cases were widely reported and caused uproar, but doctors being attacked is not uncommon, particularly in public hospitals.

That is, in fact, why the state’s health department readily agreed to start taekwondo training at Nil Ratan Sircar Medical College when Dr Dwaipayan Biswas, the college’s deputy medical superintendent and taekwondo practitioner, proposed training in the martial arts discipline as a way to motive doctors and help them manage stress, besides imparting self-defence techniques. The pilot project has since been replicated at the All India Institute of Medical Sciences in Delhi.

The West Bengal government is so impressed, it issued a notification to medical colleges on January 31, 2018, directing them to send proposals for starting taekwondo training “at the earliest”. In April last year, the state’s Director of Medical Education, Dr Debashis Bhattacharya, had “verbally proposed” to the Medical Council of India, which regulates medical education, that it should include taekwondo training in the MBBS curriculum. Bhattacharya was formerly the principal of Nil Ratan Sircar Medical College and had overseen the roll-out of the pilot project.

The government’s interest in training doctors in martial art, however, raises a troubling question. By asking doctors to defend themselves, is the state shirking its duty of providing safe work spaces for them?

Dr Sajal Biswas, general secretary of the Service Doctors Forum, an association of government doctors in West Bengal, said self-defence training could not possibly solve the “problems plaguing the health sector” that are the main cause for such violence. “Assaults take place because there is a dearth of infrastructure, shortage of doctors and beds, and because rural health services are in a pathetic condition,” he added. “People from remote areas have to travel for several hours to reach government hospitals, which are crammed with patients so much so that they have to be treated on floors. The government should focus on improving health services in rural areas so that people can get quality treatment there instead of coming to the city.”

Ethical dilemma

Then, there is the ethical conundrum of asking a doctor, who has taken an oath to heal people, to possibly hurt someone, even if in self-defence. But Mukherjee argued that it was “well within medial ethics” to defend themselves if the situation so demands. “Because the aim is not just to hit somebody but to protect ourselves,” she said. “Taekwondo helps us be calmer and quieter in stressful situations. Doctors in government hospitals are generally overburdened given the huge influx of patients.”

Fellow trainee Dr Mirza Md Tausif, a resident medical officer in the hospital’s radiology department, is more forthright. “Everybody should learn to defend oneself,” he said. “We aren’t celebrities that we would be provided bodyguards. But it is also the government’s job to keep our working place safe so that we can work without fear.”

Their trainer, Pradipta Kumar Ray, said there was more to the martial art than self-defence. “Taekwondo also teaches discipline, courtesy and how to handle difficult situations without stress,” he said. “It increases output by calming the mind and helps develop physical strength as well. The training doesn’t means to hit anybody, but to hit the negative energy.”

Dr Shivshekhar Chatterjee, who teaches microbiology at the college, agreed. “It will really help us prevent the situation from going out of control and leading to attacks,” he said, referring to the training. “The patient’s people get angry when they find negligence in treatment but if the doctor is positive and inclined towards benefitting the patient, then the situation can controlled preemptively.”

Would it be effective though given that it is often one doctor against a group of attackers? Mukherjee wouldn’t give a straight answer but the others maintained that it would help.

Biswas is not so sure. He claimed it would be “very difficult” for one doctor to defend against a violent mob. In fact, he argued, the situation might escalate, leading to law and order problems, “if the assault starts from both sides”.