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Harvard researchers note danger in firearm “gag law”

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jpak Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 02:22 PM
Original message
Harvard researchers note danger in firearm “gag law”
http://www.bostonglobe.com/lifestyle/health-wellness/2011/11/10/harvard-researchers-note-danger-firearm-gag-law/ZaS6DqerQiNiKJuBQVPsCJ/story.html

Florida lawmakers caused a stir among the medical community this summer when they passed a law prohibiting doctors from asking most patients about whether they have a gun at home. Many pediatricians in particular were outraged, saying proper storage of firearms is a critical child safety issue.

The National Rifle Association (edit: morans) supported the law, saying such questioning invades people’s privacy.

The law hit a roadblock in September, when a federal judge granted an injunction, saying the law violates free speech. But that hasn’t squelched concern from a group of Harvard researchers and others.

The law remains on the books in Florida and similar measures have been introduced in several other states.

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aikoaiko Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 02:52 PM
Response to Original message
1. If only a-hole militant doctors didn't refuse medical services to famllies...
Edited on Fri Nov-11-11 03:00 PM by aikoaiko
...who didn't want to talk about nonclinical issues such as whether or not there was a firearm in the home.

http://www.ocala.com/article/20100724/ARTICLES/7241001?p=1&tc=pg


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spin Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 04:09 PM
Response to Original message
2. So if my doctor asks me if I own a firearm and I refuse to answer ...
he can tell me to take my business elsewhere.


Family and pediatrician tangle over gun question
By Fred Hiers
Staff writer
Published: Saturday, July 24, 2010 at 6:30 a.m.
Last Modified: Saturday, July 24, 2010 at 11:52 a.m.


It was a question Amber Ullman least expected Wednesday from her children's pediatrician.

Do you keep a gun in the house?

When the 26-year-old Summerfield woman refused to answer, the Ocala doctor finished her child's examination and told her she had 30 days to find a new pediatrician and that she wasn't welcome at Children's Health of Ocala anymore.
http://www.ocala.com/article/20100724/ARTICLES/7241001?p=2&tc=pg


A simple solution to the problem would have been when the his patient refused to answer the question, the good doctor might have explained that he respected her privacy rights but if she did have a firearm in the house that she consider several excellent methods of storing it to prevent access by a child. He might have given her some literature on the subject and mentioned that a locking gun box will allow quick access for an adult but will deter children.

He might have showed her an advertisement for this gun box from Amazon.com for only $34.98 which is far less than a visit to his office.



Instead he became a pompous asshole and told her to find another doctor and another clinic. It was totally unnecessary and unwarranted to react in the manner the doctor did.

Of course it could be argued that the mother should have merely lied as many people do if asked if they own firearms. She chose not to lie which is commendable.

Note: thanks to aikoaiko who provided the link to the article in post #1





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Hoopla Phil Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 04:21 PM
Response to Original message
3. There is NO "gag law". Doctors are free to distribute safety literature. What they cannot
Edited on Fri Nov-11-11 04:23 PM by Hoopla Phil
do is ask if there are guns in the home when there is no valid reason for such a question. Remember, this was the result of pediatrician (edit: moron) "fireing" a patient for refusing to answer the question when there was no valid reason to ask it. In other words. The patient was "fired" over a political issue.

The gun controllers asked for this fight. Now they bitch because it would appear that they lost.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 04:54 PM
Response to Reply #3
4. the patient was "fired"
because she chose not to cooperate in the care for which she presumably took her child to the doctor.

While physicians may not terminate their relationship with a patient, or refuse to take on a patient, based on legally prohibited grounds of discrimination, they may indeed terminate the relationship otherwise.

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8115.page

http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/patient-physician-relationship-topics/ending-patient-physician-relationship.page

http://www.aafp.org/fpm/2005/0900/p34.html

the rules for the process in Ohio: http://codes.ohio.gov/oac/4731-27


refusing to answer the question when there was no valid reason to ask it

In the patient's opinion. The patient is free to have an opinion different from the physician's. The patient is not free to demand that care be provided from a physician after rejecting the physician's assessment of the care that is needed. Or any other time.

Non-compliance is a perfectly valid and undoubtedly not uncommon reason for termination. A physician is unable to determine whether a patient is complying with child safety practices without enquiring about them.

If a physician enquires about swimming pools at patients' homes and a patient refuses to answer, or informs the physician that the children are allowed to use the pool unsupervised and the parent plans to continue along that path, the physician may terminate the relationship. Right? In fact, the physician may terminate the relationship for any reason that comes into their head, as long as (a) it is not based on a ground of discrimination prohibited by a law governing the provision of professional services, and (b) the termination does not "abandon" the patient.

Physicians in Florida would be hamstrung by this law, forced to continue providing care for patients who have demonstrated that they do not trust the physician either personally or professionally. That makes for an excellent physician-patient relationship, I'm sure.
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TheWraith Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 05:12 PM
Response to Reply #4
5. So then, would you feel okay if a doctor demanded to know if a single woman was sexually active?
And then refused her care if she weren't married? Or how about refusing care for someone who replied that yes, she'd had an abortion?

Being a doctor is not an open invitation to try and run your patients lives or press your moral values on them. Getting an MD doesn't make them either moral guardians of the universe, or safety experts.
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Fri Nov-11-11 07:29 PM
Response to Reply #5
7. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Nov-12-11 12:08 PM
Response to Reply #5
11. so then, you feel okay about posting nasty insinuations
alleging that I or anyone else thinks things that you can be 100% sure I/they do not think?

That's sad, isn't it?
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aikoaiko Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 05:53 PM
Response to Reply #4
6. This is not necessarily true. All we know is that she wished to maintain privacy concerning
Edited on Fri Nov-11-11 05:59 PM by aikoaiko
a nonclinical issue. And in fact the Dr could still provide the "care" (aka. information about safe gun storage) regardless of the answer.

I don't support restricting the questions well intentioned drs wish to ask, but I do think they need to respect the privacy of their patients and continue to serve them as best as possible.


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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 07:30 PM
Response to Reply #6
8. if the patient and doctor disagree on that point
then each of them is free to terminate the relationship.

Simples.
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petronius Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-11-11 08:31 PM
Response to Reply #8
9. I don't agree that it should be that simple. Physicians are licensed by the state
to provide a professional service, and (like pharmacists, JoPs, that firearms instructor down in Texas, etc) I don't think they should have the easy option to decline service based on non-professionally-related grounds (and even for relevant topics, I think it should be difficult). IOW, if you want the job, you have to do the job...
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Nov-12-11 12:01 PM
Response to Reply #9
10. indeed they are
And they practise as independent professionals, unless they are employed by another professional or a corporation of some sort.

Their conduct is regulated, generally, by the authority in charge of their self-governing profession, whose rules and actions are governed by legislation.

They are subject to the general laws of the jurisdiction, such as the ones I mentioned: anti-discrimination legislation. That legislation, for example, sets out the grounds on which services may not be denied in the private sector: usually, race, religion, sex, and other things like national origin, marital status and sexual orientation, depending on the jurisdiction.

A physician who terminates a physician-patient relationship based on the patient's refusal to disclose information that the physician considers relevant to their professional care of the patient is not violating professional ethics (as defined by the authority in charge of the self-governing medical profession and then set out in legislation or regulations) as long as no overriding legislation, such as anti-discrimination legislation, is violated.

A physician who required that any patient disclose sexual activity would not be violating ethics, unless they did so in a discriminatory manner such as the one described here (applying the condition as a way of discriminating against (unmarried) women, or against gay men, for example). These things aren't always simple. Demanding that a gay man who was not out disclose sexual activity could be perceived as discriminating against gay men, since special sensitivity to some gay men might be needed and failing to exercise it could amount to discriminating.

Pharmacists refusing to fill prescriptions for contraceptives are plainly discriminating against women and on the ground of religious belief, since they claim their own religious belief as the justification for their refusal. (A pharmacist may, however, refuse to fill prescriptions for various other reasons based on their professional judgment.)

But firearms ownership, and political views about anything at all, have nothing to do with discrimination. There are no laws prohibiting discrimination on the basis of political opinion, and I doubt that many people think there should be. There are certainly no laws prohibiting discrimination on the basis of ownership of random objects not related to, say, religion.

Firearms ownership by parents is relevant to children's health -- in the professional opinion of many physicians and in the opinion of associations of physicians and in the opinion of academics in various fields of medicine.

Declining service based on refusal to discuss that subject is NOT "to decline service based on non-professionally-related grounds".

And the fact remains that a physician does not have to have "professionally-related grounds" for declining service. They have ethical obligations not to abandon a patient with whom they have a relationship, but they are not indentured servants of any patient. They may select and de-select patients at will, as long as they do not break any laws by doing so and as long as they meet the requirements for doing so without leaving the patient without necessary medical care.

This doctor gave the patient 30 days to arrange other care. Had the patient been genuinely unable to do so, he would likely have had a continuing obligation to provide care until she did.

The characterization of the incident provided by the patient strikes me as a little, hm, bare. It's possible that the doctor said "do you have firearms in your home?", she said "I prefer not to discuss that", he said "please arrange payment on the way out". I doubt that's quite how it went. If she said no more than that, and he said nothing to explain his question and the reasons why he needed an answer in order to continue the relationship, she could have a small point.

He, of course, is prohibited from refuting her version of events by the rule of doctor-patient confidentiality. I'd find her more credible if I knew she had expressly waived that privilege so that he could give his own account of the events.

"IOW, if you want the job, you have to do the job" -- but not free of charge, not when you are on vacation, not for someone who is rude to your staff, and not for someone who is non-compliant with any aspect of the care that, in your professional opinion, is appropriate.
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SteveM Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Nov-14-11 04:26 PM
Response to Original message
12. Old stuff. Dealt with previously. nt
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