Orthopaedic Surgery/Interpersonal Violence

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Orthopaedic Surgery

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Interpersonal Violence
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Interpersonal violence

Understanding the social context of our patients with trauma can only help us deliver effective care. Interpersonal violence is seemingly a legacy of our evolution as it is prevalent in chimpazees and in neanderthal remains. Patterns of interpersonal violence seem to be set early in life and relate in all cases to concern for social status, thus stratification within society with regard to economic and social privilege.

The natural man has only two primal passions, to get and to beget. William Osler

With this quote in mind we consider the thinking of Edward O. Wilson (EdwinWilson) who points out that our planet will be reaching what may be a Malthusian limit of 8 billion individuals within the next two decades. It will increasingly be the tendency for all to want the overconsumption of resources that we in the western enclave have come to expect. In view of these facts we can expect that interpersonal violence with increasing sophistication will continue to evolve, terrorism being its most dramatic manifestation; interpersonal violence writ large.






Society begins with the desire for personal security derived from association with a group. Efficiencies are gained such that the individual is free to function productively without the burden of attending to their personal security and that of their family, at least under ideal circumstances.

A collective defense in the form of a military and police establishes an effective monopoly on purposeful violence. The power of this need to live free of the fear of random violence means a willingness at times to accept the potential for a tyrrany imposed by the government. While no system of government is fail safe in this regard, system of government must include provision for the will of the people to be made known and for the mantle of authority to change hands in a peaceful and orderly fashion that reflects that will. Where that right is abridged one can expect the eventual degradation of the government, individual and collective violence against the government which appears to be imposing a tyrrany. Our own government employes a system of checks and balances dividing power between coequal branches

The practice of a collective effort for mutual protection then provides template for all other collective efforts yielding the bulk of what we have come to enjoy as the accoutrements of life in modern society. Little can be achieved by an individual acting alone without the direct or indirect support of others. The shared interests of the group which function in a coordinated fashion towards a mutually agreed end it thereby actuated.

Research in the area of cognitive neuroscience is leading to a greater understanding of the neurological mechanisms that are the underpinnings of our sense of justice and morality. It seems that some aspects are innate and others a function of socialization. Most of our thoughts in a given day are indeed devoted to contemplating interactions with our fellow humans, either retrospectively or prospectively, so our thinking mechanisms are largely employed most of the time towards the analysis or at least contemplation of such matters.