Another Gun Violence Expert Tells Physicians How To Do Their Jobs

Leave a comment

While editorial opinion seemed to be running against the recent 11th-District ruling that reinstated Florida’s gag law, there were some notable exceptions, chief among them being an op-ed that appeared in the Pensacola News Journal written by Marion Hammer. As a career NRA lobbyist, this lady has a long and courageous history fighting for the rights of gun owners in the Gunshine state, as well as for standing up for the oppressed in general, having been responsible not only for Florida’s concealed-carry law but also as the architect of Florida’s Stand Your Ground law, the first of its kind in the U.S.

          Marion Hammer

Marion Hammer

Hammer begins her diatribe by reminding readers that the real agenda of physicians is to rid the country of guns, and she lifts anti-gun statements from the AAP website to support her case. She then goes on to remind physicians that if they “genuinely wish to offer safety information [they] can simply hand out firearms safety and safe storage brochures to all patients. Interrogating parents and children about what they own or have in the home is not only an intrusion but is a violation of privacy rights.”

Now I know that the press is very sensitive to anything that even remotely smacks of censorship, hence, if someone wants to express their opinions the editorial policy usually means that the writer can say more or less anything they damn well want to say. But if Hammer thinks she’s presenting anything other than a total fiction about the role and responsibilities of the physician in counseling patients, then either her own physician never went to medical school, or she simply doesn’t have the faintest idea about what physicians actually do. Her statement that doctors are violating privacy by inquiring about items in the home is a mind-boggling distortion of the doctor-patient relationship and I only hope that she has the good sense to avail herself of medical care that’s a little more aware of the requirements of the Hippocratic Oath than she seems to be.

In a way I can’t blame her for promoting a vision of medical care that’s so at odds with the reality of doctor-patient relationships, because there’s even a physician out there named Robert Young, who basically said the same thing in an op-ed piece published by the Sarasota Herald-Tribune. Like Hammer, Dr. Young also believes that physicians should limit their concern about gun ownership to handing out gun safety brochures developed by the NRA, whose gun-safety program for children, Eddie Eagle, has never been shown to have any positive safety results at all.

I’m not surprised that Ms. Hammer would follow Dr. Young’s lead in advocating the distribution of gun safety materials to patients. After all, she’s a lobbyist for the NRA and all their training courses emphasize safe use of guns. On the other hand, the NRA avoids the issue of safe gun storage like the plague, because the last thing they would endorse are mandatory laws requiring gun owners to lock away their guns. After all, if guns are locked away to keep them from the kids, how will the “good guys” with the guns stop the “bad guys” with the guns?

Physicians need to ask patients if they lock away their guns for the same reason they ask patients whether their children are constrained while sitting in the car. Unlocked guns are a health risk just like unlocked seat belts, and if Marion Hammer wants to dispute the studies which link gun ownership to higher levels of child mortality and morbidity, she’s also has the Constitutional right to promote the idea that the moon is made out of cheese.

 

 

 

 

Why Should Doctors Talk To Patients About Guns? Let The NRA Do It.

Leave a comment

When the 11th Circuit re-instated the Florida gag law on physicians talking to patients about guns I knew that sooner or later we would hear from Timothy Wheeler and his gun-promoting group which believes that 19,000 gun suicides, 11,000 gun homicides and 50,000 (or more) intentional gun injuries each year shouldn’t concern physicians at all. Wheeler is the doctor who began promoting the idea that doctors who inquire about gun ownership are their patients’ worst enemies, and his organization is rolled out by the pro-gun lobby whenever they need additional ammunition to keep America from adopting a common-sense approach to the issue of gun violence.

Wheeler’s organization, for which his claim of having thousands of members has never been verified in any way whatsoever, has just launched a small campaign to support the Florida gag law, at the same time that a coalition of medical associations and advocacy groups are going back to the 11th Circuit to ask the entire court, en banc, to overturn the recent ruling. Which is exactly why Wheeler and his buddies in the gun-blogging community are trying to tilt public opinion the other way.

docs versus glocks In the interests of full disclosure, I should state that I am married to an attending pediatrician, and am also a member and certified gun trainer for the NRA. I have no issue with private ownership of guns but I take personally these indecorous attacks on physicians who are required to speak with patients about any matter which they feel might pose a medical risk, particularly involving something as potentially lethal as a gun. The shabby attempt by physicians like Wheeler to pretend that guns do not constitute a health risk reminds me of the pathetic charades conducted back in the 1950’s by a few physicians and scientists who publicly disavowed any link between smoking and cancer.

Of course Wheeler and his cronies, in this case a psychiatrist named Robert Young, don’t want their audience to believe that they are against safe use and storage of guns. After all, everyone’s in favor of safe gun use these days, just ask the NRA and they’ll tout their gun safety program, aka Eddie Eagle which has “reached more than 26 million children in all 50 states.” The same website that contains this information about Eddie Eagle also states that the NRA is “not affiliated with any firearm or ammunition manufacturers,” which is, simply put, a lie. But Dr. Young seems oblivious to the requirement in his own medical profession to base clinical decisions and strategies on evidence-based information, since he advises his medical colleagues to use the Eddie Eagle handouts in contacts with patients who might or might not own guns.

I saved the best part for last. Although Dr. Young believes in educating children in safe behavior around guns, he also wants to make sure that the safety of children is balanced out by the requirements for self defense. And I quote: “Even the sound practice of storing guns and ammunition in separate, locked places isn’t always right if they are intended to be used for emergency protection.”

This guy’s a physician? This guy took the Hippocratic Oath which requires him to counsel patients about risks to their health? There is not one single piece of credible research which shows that keeping a loaded, unlocked gun around the house creates protection from crime that outweighs the risks of injury or death from the existence of that gun.

People like Robert Young and Timothy Wheeler find media outlets for their destructive ideas because we really are committed to the idea of hearing “both sides” in the public policy debate. But I don’t think that there are two sides when it comes to discussing a health issue which claims 80,000 or more victims each year. Unless, of course, you’d rather believe that mortality and morbidity at those levels has nothing to do with health at all.

Docs Versus Glocks - Round Three And Not Yet Finished

Leave a comment

Remember the Thrilla in Manila? We’ve got Docs Versus Glocks and Round 3 has just come to an end. The epic battle began in 2011 when the Florida legislature passed a law prohibiting physicians from inquiring about ownership of firearms unless the question was “relevant to the patient’s medical care or safety or the safety of others.” [All quotes from the decision posted on the 11th Circuit website.] That was Round 1. The law was then challenged in Federal District Court and overthrown by Judge Marcia Cooke who issued a permanent injunction because it violated physicians’ 1st Amendment free speech by curbing the ability of the doctor to freely inquire into situations that might impact a patient’s health. That was Round 2. The State of Florida then appealed to the 11th Circuit which declared the law constitutional last week. Interestingly, the Circuit Court did not order Judge Cooke’s injunction to be lifted, which means that as of the end of Round 3, it’s something of a tie.

I’m no constitutional lawyer, or any other kind of lawyer for that matter, but I have been following this case very closely because it’s part and parcel of the NRA’s attempt to push physicians out of the discussion about guns, a campaign they have been effectively waging since 1996. That year Congress removed funding for gun research from the CDC budget, a prohibition that was later spread to other federal research agencies and remains in effect to this day. And even though a meeting of the Institute of Medicine following Sandy Hook identified areas of gun research that should be pursued, there’s scant (which means ‘no’) chance that such funding will appear.

glock 23 The ‘official’ reason that the NRA is against research into gun violence is that the research is being carried out by public health and medical scholars who use such research to advance an anti-gun agenda. And if by ‘anti-gun’ the NRA means any form of gun control, they happen to be right. The basic public health research on guns shows again and again that the presence of a gun heightens the possibility of homicides, assaults and suicides, findings that the NRA says are contradicted by the research of people like Gary Kleck and John Lott whose research allegedly proves that more guns equals less crime. But no matter how you shake or bake the data, it’s simply impossible to deny the intuitive judgement of the novelist Walter Mosley that “if you carry a gun, it’s bound to go off sooner or later.” And if the bullet from that gun hits another person, there’s only one group of professionals whose response we really trust.

. The 11th Circuit majority found the Florida law constitutional because they believe that the professional-client communication doesn’t necessarily warrant 1st Amendment guarantees. The law, according to the majority, only prohibits physicians from “inquiring about a private matter irrelevant to medical care.” But what the majority avoided in its decision was spelling out who has the authority and obligation to decide the issue of relevancy, which, according to the dissenting judge in this case, is the responsibility of doctors themselves. The dissent noted that gun violence is considered a public health issue by virtually every medical society, and physicians are performing their “chosen role” by informing their patients about risks that come with the ownership of guns.

I was in the audience at Madison Square Garden when Ali won the Thrilla in Manila because he just outlasted Smokin’ Joe. I think that Docs Versus Glocks will end the same way because no matter how hard the NRA keeps hammering, we value the competence and expertise of physicians and we ultimately expect them to decide what’s best for our health. The majority in the 11th Circuit recognized that “the patient must place his or her trust in the physician’s guidance,” which means listening to what the doctor says even if even it’s something we don’t want to hear. And by the way, there’s no patient in America who ever has to do what the doctor says.

Docs Versus Glocks - Round 2 About To Begin

Leave a comment

In 2011 the Florida legislature passed a law to protect the state’s gun owners from having to divulge any information about gun ownership during the course of a medical exam. The law, which became known as ‘Docs Versus Glocks,’ soon became one of the main poster children of the pro-gun, anti-gun argument that really heated up after the carnage at Sandy Hook. On one side stood the NRA, which touted the law as a defense of 2nd Amendment rights; on the other side was Brady and the medical community which viewed the law as interfering with the doctor’s right to know. The law was struck down in 2012 by a Federal District Judge and was immediately appealed by the Gunshine State to the 11th Circuit which held a hearing in July, 2013. Everyone’s expecting a ruling soon so I thought I would take the opportunity to discuss the case before all the real experts get into the act.

logomdThe law doesn’t completely deny physicians the ability to talk to patients about guns. What the law actually says is that a physician “shall refrain” from inquiring about firearm ownership unless the practitioner “in good faith believes that this information is relevant to the patient’s medical care or safety, or the safety of others….” Yet despite this caveat, the medical community attacked the law, declaring that its language would have a chilling effect on the ability of physicians to talk to their patients about all kinds of safety and health issues, not just about guns. The District Court sided with the docs, calling the law a “legislative illusion” because there was no connection between questions asked about gun ownership and protecting the 2nd Amendment right to own guns.

logo glockWhile arguments over gun control at the federal level get all the headlines, it’s what happens at the state and local levels that really determines whether or not gun owners can get or keep their guns. The Sullivan Law has been in existence since 1908, it’s almost impossible to own or carry a gun in New York City and 2nd Amendment ‘rights’ can go fly a kite. In total dollars the NRA gives out less than half a million to state-level candidates and parties, but this is 30 times more than gun control groups give to the same races. And in a state-level race where 200 or less votes can make the difference, getting your hands on an NRA phone list may carry the day. I’m not sure that the Florida legislators who voted for the gun bill knew or even cared what the law said. But they didn’t want to be ‘scored’ by the NRA in the next election because they voted the wrong way. Before the Tea Party showed up it really didn’t matter whether a Republican toed the line on gun issues because the NRA wasn’t about to support any Blue candidates anyway. But now that a growing number of Republican office-holders face primary challenges from the Right, everyone on the Red side of the aisle is listening to the NRA.

As for doctors, it took them nearly a century after 1850 to become a self-regulating profession whose guidelines for practice and behavior were largely established and maintained by themselves. And even though their professional autonomy has of late come into conflict with the market imperatives of insurors and other for-profit enterprises, they still retain sovereignty over defining how to deliver their services at the point that such services matter most, namely, in consultations with patients. The fact that the Florida legislature didn’t bother to ask their own state Health Department for a recommendation on physicians talking to patients about guns tells me that the motive behind the law had nothing to do with concerns about the delivery of health care at all. For that matter, it wasn’t that the law threatened doctors who talked to their patients about guns per se, it was the fact that any law which infringes on the professional autonomy of physicians to communicate with their patients threatens the validity of the Hippocratic Oath.

Let’s hope that the 11th Circuit understands what this argument is really all about.

Follow

Get every new post delivered to your Inbox.

Join 159 other followers

Build a website with WordPress.com
%d bloggers like this: