HEALTH CARE/Joan Retsinas

Physicians Question Gun Safety

Imagine a plausible conversation between a pediatrician and a parent at a child’s check-up. At the end, after the immunization, the advice about diet, and the suggestions for exercise, the pediatrician turns to safety: Do you have a swimming pool? Is there a gate to keep a toddler out? Do you buckle your child up in the car? Do you lock poisons up? Some of these questions have laws behind them (seat belts, gates on swimming pools); all constitute common sense.

So when a physician asks a parent, “Do you keep a gun at home?” the physician is not an FBI agent searching for hidden stashes. The physician is just doing his job, focusing on safety hazards. If a parent answers “yes,” the pediatrician will urge the parent to store the gun out of children’s reach. Again, many states have laws that back up that advice. This is hardly beyond the scope of a physician’s purview. A number of children are injured, or killed, each year because their inquisitive fingers seize a family gun that is not safely stored.

Parents, moreover, can ignore the pediatrician’s advice. Indeed, many parents ignore physicians’ advice about diet and exercise (witness the ballooning girths of America’s children); but most parents accept the wisdom of all those bromides. The bromides make some parents uncomfortable; e.g., admonitions about the dangers of second-hand tobacco smoke, the pitfalls of incessant television, the benefits of fresh vegetables. But nobody wants to muzzle physicians.

Until now. In Florida, two Republican state legislators, supported by the National Rifle Association, have introduced bills to make physicians who ask about guns into criminals. If a physician asks a parent, “Do you own a gun?” the physician risks 5 years in prison and a fine of $5 million. (“Physicians, gun owners tangle over Florida 'don't ask' gun bill," Doug Trapp, amednews, Jan. 31.) The penalty is absurdly draconian. (Similar bills in West Virginia and Virginia died.) Yet the motivation reveals a bizarre contradiction: on the one hand, gun-lovers want government to leave them, and their guns, alone; on the other hand, gun-lovers want government as their ally.

The saga began when a pediatrician asked a mother: “Do you have a gun?” The mother refused to answer; the pediatrician suggested she find another physician. The physician was not going to urge her to give up the guns she may have had, simply to advise on storage and safety. Hardly controversial.

But in this age of cyberspace, the mother feared that the information, once entered into the electronic medical record, might find its way into a police data-base. Hence, her refusal.

At this point the physician-patient dispute would have ended if the mother had sought another pediatrician. Unfortunately for her (and perhaps fortunately for the nation’s children), questions about safety have become routine; a physician who neglects to ask those questions is remiss. So the gun-owning mother may have had to search hard.

Enter the state legislators, spurred to action by this tale of a miscreant physician who dared mention “guns.” Ironically, gun-toters have historically loathed government interference. Name a proposed stricture: bans on automatic weapons, requirements for safety latches, background checks at gun shows. The gun-lobbyists have yelled “no,” that the government is overstepping its authority. The relationship between an owner and his guns is not the government’s concern.

The relationship between a physician and a patient is also privileged. The medical record can be accessed only by court order. Either party can sever the relationship – the patient instantly, the physician provided he gives sufficient notice for the patient to find another physician.

So these Florida bills mark a notable intrusion: the government wants to enter the physician’s office, red-lining “taboo” questions that the physician cannot ask. The legislators are asking for the same kind of government intrusion that they abhor. The bills, which I assume will fail, signal the death of common sense.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, March 15, 2011