If you were in a hospital, would you want armed guards roaming the corridors?
It's an increasingly relevant question for patients. Today, medical care is often delivered in close proximity with deadly weapons. From regional medical centers to children's hospitals to world-renowned institutions like the Cleveland Clinic, armed security guards are becoming more common in health care. According to a 2014 study, an estimated 52 percent of hospitals now have hand guns available for security personnel and 47 percent provide Tasers for use. These numbers are considerably higher compared to prior surveys from 2009 and 2011.
Earlier this year, the proliferation of weapons in clinical settings drew national attention when the New York Times and NPR's This American Life reported on the 2015 shooting of Alan Pean. A 26 year-old patient at the time, Mr. Pean was admitted to a Houston hospital while experiencing an acute psychiatric crisis. During his hospital stay, he was noted to be confused, dancing without clothes on, and wandering out of his room.
After nursing called hospital security for assistance, Mr. Pean allegedly assaulted the security officers. He was subsequently shocked with a Taser and then shot in the chest.
Mr. Pean fortunately survived this tragedy, but his story raises a larger question: why have hospitals taken up arms?
Advocates point to the need for self-defense. After all, hospitals can be surprisingly violent workplaces. According to the Department of Labor, healthcare workers suffer between 15,000 and 20,000 annual injuries that require time off as a result of workplace violence; the number of serious violent injuries in health care nearly matches every other industry combined.
In my field—mental health—clinicians are at even greater risk of workplace violence. We often care for patients agitated by psychosis, mania, substance abuse, or other conditions that can cause them to lash out. I’m currently pursuing residency training in psychiatry, and research suggests between a quarter to half of my peers will be physically assaulted during our training.
From this perspective, it might make sense then to have weapons in hospitals. Security officers might better ensure a safe workplace if they have the tools to do so.
Yet, as Mr. Pean's experience shows us, the combination of weapons and patient care can have serious consequences. Security officers who may not be trained to deal with symptoms of mental illness may act rashly, harming the very people who came to the hospital for care.
The wrong hands could get on those weapons. As noted in the Times article, a 2012 study found 23 percent of emergency department shootings involved a perpetrator taking a gun from a security officer. In multiple states, patients have stolen guns from guards and escaped from hospitals, disappearing with lethal weapons and terrifying surrounding communities.
Finally, the presence of guns in hospital settings casts a pervasive shadow over patient care. Clinicians shouldn't have to worry about their own staff shooting patients. Patients shouldn't have to receive care in weaponized environments, where armed guards might exacerbate paranoia, anxiety, and a host of other symptoms for which patients are receiving treatment.
Recognizing these concerns, a number of hospitals have opted for arming security guards with less deadly means, such as Tasers. But these are still dangerous weapons. While often viewed as non-lethal, Tasers have been found to cause cardiac arrest and even death. The use of these instruments also raises doubts about the quality of care provided when hospitals resort to electrocuting their patients with weapons.
Extreme situations like active shooters may necessitate the use of firearms and other weapons to protect hospital patients and staff. However these situations are rare and unpredictable. Police forces can better handle these scenarios, and research hasn't yet shown arming hospital security officers to consistently save lives or improve patient outcomes.
In the meantime, many in the medical community have spoken out against the militarization of patient care. This summer, the American Medical Association passed a resolution urging hospitals to limit the use of guns and Tasers on units where there are patients with mental illness. A petition expressing outrage at the shooting of Mr. Pean in Houston gathered thousands of signatures, largely from healthcare workers. Doctors and journalists are calling for more transparency and research into the use of weapons in clinical settings.
Hospitals should instead employ non-lethal security measures, such as pepper spray or physical restraints. Active shooter plans can prepare hospital staff for emergency situations. In high-risk areas like emergency departments, some medical centers have turned to metal detectors instead for preventative purposes. Clinicians can deliver medications to treat agitated patients, and national medical organizations have released guidelines for managing these types of situations.
In 2010, a man named Paul Warren Pardus brought a semi-automatic handgun into Johns Hopkins Hospital. Distraught over his mother's care, he shot a surgeon, his own mother, and then himself. The doctor survived, but Mr. Pardus and his mother died from their wounds. After unarmed hospital guards and local police secured the scene, Hopkins officials released a statement with these profound words:
"Hospitals are and must remain places of hope and healing that are open to the public. They cannot be turned into armed citadels."
As a young doctor, I can't help but agree.