Should Doctors Talk To Patients About Guns? They Talk About Other Risks, Don’t They?

This week Dr. Garen Wintemiute and several colleagues published an article that detailed both the legal and clinical issues involved in counseling patients about guns. Not only did the article summarize the current legal environment surrounding doctor-patient communications, but it also presented a schema for helping doctors to determine how to respond to a patient’s access to guns based on factors such as depression, substance abuse and other known causes for violence against oneself or others.

docs versus glocks           The article received significant exposure both within and without the medical community, so it didn’t take long for a few physicians whose self-appointed task is to defend gun-owning America against the evil intrusions of gun-grabbing physicians to respond.  The first response was by a physician in California who claims that asking patients about gun ownership infringes on their 2nd-Amendment rights.  So, according to this logic, the 2nd Amendment only allows Americans to own guns, it prevents any discussion about guns.

This gun-loving doctor, Arthur Przebinda, agrees with Wintemute that doctors should be allowed to engage in gun counseling if the patient “shows signs of mental illness,” but he nevertheless finds Wintemute’s report ‘misleading’ because – are you ready for this one? – it is based on Wintemute’s own research. [My italics.]

Is this guy serious?  Does he expect a single medical professional to take him seriously because he claims that Wintemute’s article is in error because it is based on Wintemute’s own research?  What should a peer-reviewed article in a medical journal be based on?  No research?

But the truth is that Przebinda isn’t interested in communicating his nonsense to the medical community; his sole agenda is to try and influence the thoughts of gun owners, some of whom might otherwise be tempted to actually take seriously what medicine believes to be the problem with guns.  And the problem with guns is very simple: they constitute a risk.  How much of a risk?  This remains a subject of debate because thanks to the twenty-year freeze of CDC gun research, a freeze that Dr. Przebinda wholeheartedly supports, sufficient research has not been accomplished to determine exactly the degree to which gun ownership increases the possibility of deaths or injuries from intentional or unintentional use of a gun.

“They’re trying to identify gun ownership as a risk factor, the same way they would define smoking inside the house,” says Przebinda, and that’s exactly the point.  Because smoking is harmful. And so are guns. Period. End of story.  What does Dr. Przebinda think happens to human tissue when it is struck by an ounce of lead travelling faster than the speed of sound?

Now don’t get me wrong.  I’m not saying that it’s wrong to own a gun.  And if someone believes, massive evidence to the contrary, that keeping a gun in their home makes them safe from crime, then they can believe it all they want.  And they can also own a gun. But when was the last time doctors made a decision about what constitutes medical risk based on whether a marketing organization like the NRA agreed with them or not?  Did doctors refrain from asking patients whether they smoked before cigarette companies admitted that smoking causes cancer and other serious disease?

A rational and reasonable medical response to Pzrebinda’s pro-gun stance is provided by Dr. Eric Fleegler from Boston Children’s Hospital who says that discussions about guns should be “delicate conversations.”  But let’s remember that many discussions between doctors and their patients are delicate, which is exactly why such conversations are protected from public disclosure no matter what the NRA and their pro-gun acolytes would like gun owners to believe.

Physicians engage in very private and very delicate discussions all the time: an elderly parent is losing his mind, a teenage child is into drugs. These are medical risks that only doctors can evaluate and help patients to better understand. Which doesn’t mean the patient has to ever go along with what the doctor says. But it still has to be said. Guns are a risk.

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