(Re)Thinking Violence in Health Care Settings

Edited by D Holmes, T Rudge and A Perron
Ashgate Publishing Ltd, Farnham, Surrey, UK
Burlington, Vermont USA (2012)
366 pp., US$119.95
ISBN: 978-1-4094-3266-1

To the uninitiated the notion of publishing an edited collection of essays on the topic of violence in health care settings might appear a trifle perplexing and esoteric. After all, hospitals and allied health facilities are usually viewed as places where the sick and injured seek medical care and treatment, rather than experience violent behaviour. The very word ‘hospital’, derived from the Latin ‘hospes’, referred originally to either a visitor or the host who received the visitor and has associations with other terms like hospice, hospitality, hospitable, hostel and hotel.

As demonstrated in this book the unfortunate contemporary reality is that hospitals are in fact all too frequently far from being welcoming and hospitable places. While physical violence is still comparatively rare, psychological violence, like bullying, intimidation and verbal aggression is all too common. Thus the three editors – Dave Holmes and Amelie Perron from the University of Ottawa and Trudy Rudge from the University of Sydney – have set out to enumerate, define and explain this reality in fresh terms. Each of the editors, like the other contributors to the collection, come from health backgrounds in academia and general practice in Australia, Canada, the United Kingdom and the United States. Their work is strongly influenced by the work of critical theorists, ‘notably Michel Foucault, for whom the nexus between violence and power is an instrumental one; that is, violence is an instrument of power. As a consequence, violence means more than inflicting harm or injury (in all their forms) to individuals’ (Introduction: 7).

Adopting a wide range of critical approaches in the fields of anthropology, cultural and gender studies, political philosophy and sociology, the collection examines violence in three streams: institutional violence and managerial violence against health care workers; horizontal violence among health care providers and toward patients; and violence by patients toward health care providers. The collection includes chapters that are likely to be somewhat controversial on topics like the swearing experienced by nurses, the policing of pornography in high secure care, bullying among nurses, and the ‘violence of tolerance’ in multicultural health workplaces. Overall the book does, at it claims, provide new and unique insights regarding violence in health care, which should stimulate fresh dialogue and debate on a phenomenon that has such detrimental effects on the delivery of health services. If there is any deficiency in the book it may lie in the omission of any authors from the developing world where the manifestations of violence can be far more direct and disturbing in nations ravaged by war, famine and disease.

Duncan Chappell
Institute of Criminology
Faculty of Law
University of Sydney