The Unyielding Dignity v/s The Sacred Duty: Should Doctors Strike?

Dr Fiaz Maqbool Fazili
The image of a healer struck down while tending to the sick is a profound violation, a clash between the fundamental sanctity of human dignity and the solemn oath to preserve life. When doctors face physical assault on duty – an alarming global phenomenon underscored by numerous cases and prompting initiatives like Saudi Arabia’s strict laws and MOH posters – the question ignites fierce debate: Do they deserve the right to strike? On one side stands the uncompromisable truth: dignity and self-respect are non-negotiable for any respectful individual. On the other, the sacred Hippocratic duty and the stark reality that innocent patients bear the brunt of any work stoppage. Where does the balance lie, and what path leads to true safety?
Proponents of the right to strike rest their case on bedrock principles of human rights and worker safety, fiercely echoing the sentiment that dignity cannot be sacrificed.Physical assault is not a workplace hazard; it is a violent crime, a fundamental violation of a person’s bodily integrity and inherent dignity. To expect any human being, regardless of profession, to routinely absorb such violence as “part of the job” is morally indefensible. Doctors are healers, not punching bags. Their self-respect, as you rightly state, is “uncompromisable.” Tolerating assault erodes this self-respect and signals that their humanity is secondary to their function.
While official complaint channels like ombudsmen and legal systems exist, their failure to prevent recurring assaults—despite strict laws and warning posters—reveals a gap in implementation. Without swift enforcement and cultural change, these mechanisms are symbolic and ineffective. Strikes represent a collective response to institutional neglect, not a disregard for patients. Doctors resort to strikes only after all other avenues—complaints, legal action, public appeals—fail. Their demands are clear: real security, de-escalation training, safer infrastructure, and swift legal recourse. The strike targets state and institutional interventions, demanding tangible measures to ensure a truly safe, respectful healthcare environment for both staff and patients.
Staff safety is inextricably linked to patient safety: A workplace where healthcare workers live in fear is inherently unsafe for patients. Stressed, traumatized, and demoralized staff are more prone to errors, burnout, and ultimately, leaving the profession. Protecting doctors is protecting patients in the long term. A strike, while causing immediate disruption, aims to create a sustainably safer environment for future care.
Unarguably collective action sends an unambiguous message, violence against healthcare workers is utterly unacceptable and will have severe, system-wide consequences. It forces society, institutions, and governments to confront the crisis head-on, moving beyond platitudes and paper laws towards genuine accountability and cultural change. Silence and inaction are complicity.
The weighty counterargument I strongly support, striking harms the innocent and violates the Oath. Opponents acknowledge the gravity of assault but argue that withdrawing care, even partially, is an ethically untenable response that betrays the core mission of medicine and inflicts disproportionate harm on the primacy of patient welfare and the Hippocratic oath.The doctor-patient relationship is sacred, grounded in the fundamental duty to “first, do no harm.” Withdrawing care, temporarily even for non-emergency services, inevitably causes harm. Appointments are delayed, surgeries postponed, chronic conditions neglected. Vulnerable patients – the elderly, the critically ill, the impoverished, people who came from far flung areas in despartive need – suffer most acutely. Striking, regardless of the provocation, directly contravenes this foundational obligation. The patient needing care is not party to the “duel” between staff and institution/system.
While condemning strongly any violence against any worker doctors included at workplace, my powerfully stand on punishing the Innocent, “who suffers is a patient who is not a party to this duel.” Patients seeking care are not responsible for the systemic failures or the actions of violent individuals. They become collateral damage in a conflict they did not create. Denying them access to healthcare as a bargaining tool is seen as a profound injustice, leveraging the suffering of the vulnerable to achieve demands.
Doctors hold a unique position of societal trust. Strikes, particularly over safety (which the public may perceive differently than pay disputes), can erode this trust. It risks portraying the profession as prioritizing its own grievances over patient lives, however justified those grievances may be. This damages the essential social contract underpinning healthcare.Critics argue strikes are a blunt instrument that rarely achieves lasting safety solutions and often alienates public support. They contend relentless pressure through other avenues – sustained media campaigns, seminars ,mass lobbying of politicians, law enforcing agencies , follow up of lawsuits against culprits for unsafe conditions, public demonstrations that don’t withdraw care, alliances with patient advocacy groups – can be equally potent without directly harming patients. The focus must remain on relentlessly pursuing enforcement of existing laws (like KSA’s) and systemic reform while maintaining service.
The Slippery Slope and Essential Service Designation: Granting the right to strike over safety could open the door to strikes over other grievances, further disrupting essential or emergency care. Many jurisdictions legally designate healthcare as an “essential service,” explicitly limiting or prohibiting strikes due to the immediate life-or-death consequences of work stoppages. Patient need creates an inherent asymmetry in the employment relationship.
Beyond the Binary: Seeking Solutions Where Dignity and Duty Converge- The stark dichotomy of “strike or suffer” is a symptom of profound failure. The true solution lies not in choosing one absolute over the other, but in creating systems where such a horrific choice is rendered unnecessary. This demands proactive, multi-faceted action where no patient suffers because of system failures that is the theme of this piece and moot point.
In 2010, the Delhi Medical Council condemned a doctors’ strike at Safdarjung Hospital, calling it unethical and harmful to patient care. Yet, strikes have persisted across India, including a major one in 2012, reflecting deep-rooted issues like poor pay, unsafe working conditions, and systemic neglect. While medical ethics emphasize patient welfare, doctors also face legitimate occupational grievances. This tension creates an ethical dilemma: is it more unethical to strike—or to remain silent amid unsafe conditions?A 2014 Journal of Medical Ethics article outlines criteria for a justified strike: it must be a last resort, minimize patient harm, have transparent public reasoning, aim for systemic reform, and arise from collective consensus. In India’s strained healthcare system, doctor strikes often signal desperation, not disregard. Addressing their root causes through grievance redressal mechanisms, ombudsman oversight, and systemic reform is vital. Ethics and rights must coexist in a system that values both patients and providers.
Zero tolerance for violence in healthcare must be backed by strong enforcement—swift prosecution, mandatory reporting, and decisive action, regardless of provocation. Prevention requires real investment: trained security, panic buttons, controlled access, and thoughtful ED design. Staff must receive de-escalation training and post-incident support. Chronic understaffing and overcrowding, key triggers of frustration, must be addressed. A cultural shift is vital—through national campaigns promoting respect, patient responsibilities, and staff dignity. Assaulted staff deserve immediate medical, psychological, and legal aid without stigma. Independent bodies should investigate incidents, with regular audits and public reporting to ensure accountability and sustained safety in healthcare settings.
Doctor Strikes: Between Ethical Boundaries and Human Rights; Deserving the right but needing a better path. Doctors absolutely deserve to work in safety and defend their uncompromisable dignity. Physical assault is an unconscionable betrayal demanding zero tolerance and radical systemic change. The moral justification for considering strike action not the adrenaline rush response but must be used in a rare circumstances as an absolute last resort, when every other avenue has failed amidst ongoing violence, is powerful and rooted in fundamental human rights. The instinct to say “enough” is deeply understandable. However, the practical and ethical consequences of striking – the direct harm inflicted on innocent patients and the potential violation of the core medical covenant – create an agonizing dilemma. The patient caught in the middle transforms the strike from a pure act of self-defence into a tragic scenario with unavoidable collateral damage.
Therefore, while the right to consider such action stems from an undeniable moral imperative, the optimal solution lies not in exercising this right as the primary tool, but in preventing the conditions that make it seem necessary. Society, governments, and healthcare institutions must move beyond paper laws and posters to enact and enforce truly effective, resourced, and culturally embedded safety measures. Only when doctors feel genuinely protected, respected, and heard through functional systems will the need to contemplate the drastic step of striking over assault fade. The goal must be a healthcare environment where the sacred duty to heal can be performed without sacrificing the fundamental dignity of the healer, and where patients never become pawns in a battle for basic safety.

(Dr. Fiaz Maqbool Fazili is a practicing surgeon with deep expertise in healthcare policy analysis. He is a strong advocate for patient and family rights and is widely recognized for his contributions to promoting healthcare quality, safety, and ethical medical practices.)