Diagnosing violence

摘要

Physical violence and its manifestations are frequently found in the medical consultation: the battered wife, the abused child, or the aftermath of a drunken altercation that needs to be sutured back together again. Just as common, though less visible to the eye, are anthropological and sociological concepts of violence. If not sought out, they are missed, and can have a dramatic impact on the health and wellbeing of our patients.‘Structural violence is the violence of injustice and inequity.’ 1 The term was first used by the sociologist Johan Galtung, who defined it as the: ‘… difference between the potential and the actual, between what could have been and what is … Thus, if a person died from tuberculosis in the eighteenth century it would be hard to conceive of this as violence since it might have been quite unavoidable, but if he dies from it today, …