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February 16, 2016

A national debate: Do armed guards in the hospital increase safety?

Daily Briefing

    In a front-page New York Times story, Elisabeth Rosenthal writes about a growing debate in the health care industry: Should hospital guards be armed with weapons such as guns or Tasers?

    The question comes amid an increase in cases of violence against providers. According to an International Association for Healthcare Security and Safety (IAHSS) survey, health care institutions reported a 40% spike in violence crime between 2012 and 2014—and most of the more than 10,000 incidents were directed at staff.

    There have been several high-profile shootings, too. Upset relatives of patients shot a Brigham and Women's Hospital surgeon last year, for instance, and a Johns Hopkins Hospital surgeon in 2010.

    In response, hospitals have increasingly been arming security personnel. According to a 2014 IAHSS survey, 52% of hospitals said their security officers carried handguns, while 47% said they carried Tasers—more than double the rates reported in a separate 2011 study.

    It's unknown how often such weapons are used on patients, since hospitals are not required to provide that data. However, documents reflect more than a dozen instances in recent years, according to the Times.

    Importance of safeguards, training

    Facilities with armed security personnel, such as the Cleveland Clinic, say that weapons in the hospital can save lives and deescalate dangerous situations— so long as proper safeguards are in place. Some hospitals restrict officers with weapons to higher-risk areas such as parking lots and ED rooms.

    In addition, some hospitals train armed officers in techniques to defuse situations and set clear parameters on when officers could discharge their weapons.

    Scott Martin, security director at University of California, Irvine Medical Center, whose security officers are armed with Tasers, tells the Times that if officers come from the military or law enforcement, he makes a point to "send the message that these are patients, they're sick, the mental health population has rights—and you need to be sensitive to that."

    Another approach: No guns, Tasers

    Meanwhile, other hospitals have elected not to employ armed security guards, although many still coordinate with local police to assist with situations that hospital staff cannot handle.

    For instance, the most dangerous weapon that security personnel at Massachusetts General Hospital carry is pepper spray. At NYC Health + Hospitals, New York City's public hospital system, officers only carry plastic wrist restraints.

    Six steps to curb attacks on providers

    NYC Health + Hospitals EVP for security Antonio Martin tells the Times that he thinks "Tasers and guns send a bad message in a health care facility" and that he has "some concerns about even having [security] uniforms," which he thinks "could agitate some patients."

    Some mental health professionals tell the Times that other means to subdue patients who appear to be dangerous—from talk therapy and seclusion rooms to sedative shorts and restraints—are a more effective approach.

    This debate over guns and Tasers isn't confined to the health care industry, Rosenthal observes. "It kind of reflects the divide in American society right now about guns, whether they make you feel safer or not," she tells "This American Life" (Rosenthal, New York Times, 2/12; "This American Life," WBEZ, 2/12; Friedman, ABC News, 10/16/10).

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