Six things to know about the homicides of doctors: a review of 30 years from Italy

Abstract

Background Healthcare workers have a 16 times greater risk of suffering workplace violence than workers in other sectors and around 50% experience workplace violence in the course of their career. The objective of this study is to explore the characteristics and circumstances of work-related killings of doctors. Methods Work-related homicides of doctors over the period 1988–2019 were identified retrospectively through the Italian national statistical agencies. Variables such as perpetrator, motive and location of the crime were obtained through forensic psychiatric work. After classification, the absolute and percent values of the main characteristics of the homicides were calculated. Results Over the period considered, 21 doctors were killed in Italy in connection with their professional activity. In 52% (n = 11) of cases, the killer was one of the doctor’s patients, in 29% (n = 6) of cases it was a patient’s relative, in 19% (n = 4) an occasional patient (first consultation). The location of the homicide was a community clinic in 48% (n = 10) of cases, the street in 19% (n = 4) of cases, the doctor’s home in 14% (n = 3), the hospital in 14% (n = 3) and the patient’s home in 5% (n = 1). In 57% (n = 12) of cases the perpetrator was not affected by any mental disorders. The motive for the homicide was revenge in 66.7% (n = 14) of cases; in 28.6% (n = 6) the revenge was preceded by stalking. Conclusions Doctors should be aware that the risk of being killed is not limited to hospital settings and that their patients’ family members might also pose a threat to them.

Suicide and homicide deaths of PAs

“…How much it may correspond to findings for other healthcare professions, reflect privilege and socioeconomic factors, the partial effectiveness of medical settings' safeguards and security measures, or might be a function of the low absolute numbers or other factors, is not known. The modest number of PA deaths by homicide may indicate that some features of PAs' work, which were not identified by these data, may create fewer sources of conflict with patients that might otherwise escalate to homicide, as has been reported for physicians 12,18. This may be a fruitful focus for future research.…”

“…The modest number of PA deaths by homicide may indicate that some features of PAs' work, which were not identified by these data, may create fewer sources of conflict with patients that might otherwise escalate to homicide, as has been reported for physicians. 12,18 This may be a fruitful focus for future research. The finding of zero job-related PA homicides should not be taken for granted and does not argue for minimizing security measures in healthcare settings.…”

“…For example, more than half of 21 physician homicides in Italy were perpetrated by patients and their relatives. 18 Such reports raise questions about the extent and characteristics of violent deaths of physician associates/assistants (PAs). Burnout, depression, and suicidal ideation have been reported in PA trainees and faculty.…”

“…Homicides of healthcare professionals are not limited to the United States. For example, more than half of 21 physician homicides in Italy were perpetrated by patients and their relatives 18…”

Homicide rates are spatially associated with built environment and socio-economic factors: a study in the neighbourhoods of Toronto, Canada

“…The association between violent crime and communities has long been a focal point of criminological and sociological investigation [ 18 ]. High violent crime rates in cities are associated with various individual, socio-economic and environmental factors [ 19 , 20 ]. The areas with less educated people are associated with more ‘criminogenic’ compared to those with higher education; specifically, areas with a low rate of people with high-school diplomas are more likely to also have many formerly incarcerated people [ 21 , 22 ].…”