If you were in a hospital, would you want armed guards roaming the corridors? It is an increasingly relevant question for patients. Today armed guards are becoming more common in health care facilities. According to a 2014 study, 52 percent of hospitals provide handguns for security personnel, and 47 percent have Tasers available. These numbers are considerably higher compared with similar surveys from 2009 and 2011.
Last year this trend drew national attention when the New York Times and This American Life reported on the 2015 shooting of Alan Pean. Admitted to a Houston hospital during a psychotic episode, Pean was confused, dancing naked and wandering out of his room. After nurses called security for assistance, Pean allegedly assaulted the responding officers. He was shocked with a Taser and then shot in the chest.
Pean survived, but his story raises a question: Why have hospitals taken up arms? Advocates point out that hospitals can be surprisingly violent places. Every year, says the Department of Labor, health care employees suffer 15,000 to 20,000 injuries from on-the-job violence that require time off; the number of serious injuries nearly matches every other industry combined.
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In my field—mental health—clinicians are at even greater risk of workplace violence. We often treat patients suffering from psychosis, substance use or other conditions that can cause agitation. I am pursuing residency training in psychiatry, and research suggests that one quarter to one half of my peers will be physically assaulted during our training. So it might make sense then for hospital security guards to have weapons.
Yet as the Pean shooting shows, combining weapons and patient care can have serious consequences. Security officers who might not be trained to deal with symptoms of mental illness can act rashly, harming the very people who came to the hospital for care. These weapons could also get into the wrong hands. As noted in the Times article, a 2012 study found that 23 percent of emergency department shootings involved a gun taken from security. In many states, patients have stolen guns from guards and escaped hospitals, terrifying surrounding communities.
Some hospitals use less deadly means, such as Tasers. But these are still dangerous: Tasers can cause cardiac arrest and even death. Their use also raises doubts about the quality of care provided when hospitals resort to electrocuting patients.
Extreme situations that involve active shooters may necessitate the use of weapons to protect hospital patients and staff. But these incidents are rare and unpredictable. Police forces can handle them better than security guards can, and research has not yet shown that arming hospital guards consistently saves lives or improves outcomes for patients.
Meanwhile many in the medical community are decrying the militarization of patient care. In the summer of 2016 the American Medical Association passed a resolution to limit the use of guns and Tasers in health care workplaces. A petition expressing outrage at the 2015 shooting of Pean gathered thousands of signatures, largely from health care workers. Doctors and journalists have called for more research into the risks.
Hospitals might instead employ nonlethal security measures, such as pepper spray or physical restraints. Active shooter plans can prepare hospital staff for emergency situations. For high-risk areas such as emergency departments, some medical centers have installed metal detectors. Clinicians can treat agitated patients with medications, and medical organizations have released guidelines for managing these scenarios.
In 2010 Paul Warren Pardus brought a handgun into Johns Hopkins Hospital in Baltimore. Distraught over his mother's care, he shot a surgeon, his mother and then himself. The doctor survived, but Pardus and his mother died. After unarmed hospital guards and local police secured the scene, Johns Hopkins officials released a statement that included 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.” I can't help but agree.
