There has been much debate over the obligation of doctors not to participate in torture. Fortunately, for nearly all doctors in Western countries, this is an extremely remote challenge to their ethical integrity. But what about their obligation to refuse to be participate in and to denounce and report “forms of abuse that fall short of torture”, asks an Irish doctor in the BMJ.

“Of particular relevance is the role of doctors, nurses, and therapists who witness institutional abuse of older people in healthcare settings, such as nursing homes and hospitals. Institutional abuse can be characterised by poor care standards, lack of a positive response to complex needs, rigid routines, inadequate staffing, and an insufficient knowledge base within the service. Throughout the developed world there have been numerous scandals relating to nursing homes, and it is a striking feature how many doctors and nurses have been tolerant of endemic poor care up to the point of the scandal breaking.” ~ BMJ, Mar 24