EMILY: Did you hear about this? They just passed a law in Florida that says Doctors can’t ask their patients whether there is a gun in their house.
JOSH: That’s weird. Why is the government telling doctors what they can and can’t say to their patients? And why are doctors asking about guns? I could see asking someone if they’ve been shot … but asking if there’s a gun in the house? What medical relevance could that possibly have?
EMILY: They’re concerned about safety. Pediatricians often ask parents if they have a gun in the house, and if so, whether it is stored safely. Haven’t you heard of all the kids that accidentally kill themselves or their friends playing with a gun they found around the house?
JOSH: Are those doctors also trying to get the parents to stop driving? Are they talking to them about pool safety, matches, blankets and plastic bags the kids can suffocate on, stairs, and a million other things? Because all those things are way more likely to kill a kid a kid than an accidental gunshot. Seems to me that, of all the household dangers facing a kid, a gun would be the most obvious to a parent. If they’re not a complete imbecile, they’ve already got it stored properly. And if they are an imbecile, having a doctor up in their face isn’t going to help.
EMILY: Well, the American Academy of Pediatrics says, “the absence of guns from children’s homes and communities is the most reliable and effective measure to prevent firearm-related injuries.” Meanwhile, of course the legislation to muzzle doctors is written by the good ‘ol NRA.
JOSH: Oh, so the pediatricians are open about trying to get guns out of the homes? It seems that we have a right to own guns in this country whether we have kids or not. If I had a gun, I sure wouldn’t want my kid’s doctor giving me crap about it every time I take my kid in.
EMILY: It’s not necessarily to try to get rid of the gun. If they know there’s a gun in the house, and then they later become aware of some other dangerous circumstance, they’ll be informed. “There’s a gun in that house! Do something NOW.”
JOSH: What possible set of circumstances would warrant action with a gun that wouldn’t warrant action without one? If you’ve got a dangerous adult in the house, it seems to me they’re just as dangerous without the gun. Aren’t kids much more likely to be beaten to death by their parents than shot to death?
EMILY: So you’re okay with the law dictating what doctors can and cannot say to their patients?
JOSH: Well, something sure as heck dictates what doctors should and shouldn’t say to patients. Some things are useful to discuss, and some things are a waste of time. Doctors sure as heck better make the best use they can of the limited time they have with their patients, right? Traffic accidents kill 45 times as many kids as gun accidents, and four times as many as all homicides combined. So hopefully doctors are spending way more time lecturing parents about driving as safely — and as little as possible — as they spend talking about guns.
EMILY: There’s something different about guns though. ‘The possession of firearms in the home is a professionally-recognized risk factor for both gun-related homicide and suicide.’
JOSH: Well, sure. And living near a cliff is a risk factor for falling homicides and suicides. A sea-front home is a risk factor for drowning homicides and suicides. A slippery floor is a risk factor for tripping —
EMILY: OK, suppose you have a suicidal teen talking to a doctor. You’re really saying the doctor can’t bring up guns?
JOSH: Actually, it turns out that there’s an exception in the law if the doctor feels the gun issue is directly relevant to the patient’s care or safety. Suicidal teens would be a great example of that.
EMILY: What about the example of a kid being bullied at school. Can a doctor ask if the kid has a gun in the house? If he’s ever brought a gun to school? If he’s though about harming himself or anyone else with a gun? This type of law will have a chilling effect on doctors — force them to try to figure out whether the question they want to ask meets the legal standard for being directly relevant or not. Do you really want doctors to have to keep these legal distinctions in the back of their mind when talking to patients?
JOSH: Everything doctors do is governed by laws. Doctors make these sorts of decisions all the time — often wrongly, which is why we have so many malpractice suits in this country. But I don’t get the example — you can ask a kid if he’s thought about hurting himself or anyone else. If he has, you take action. At that point, telling the parents to make sure the gun is stored safely pretty obviously falls into the legal exception.
EMILY: I don’t know. It still seems wrong for a state legislature to dictate what doctors can and can’t talk about with patients.
JOSH: Look, guns are a touchy subject in our society. But it’s been legally determined that they’re permissible. Understandably anti-gun folks want to continue the fight, but should doctors really be allowed to use their position of power to promote their particular views? We have laws that prevent teachers from spreading their political views to their kids. Why not similar laws for Doctors?
EMILY: Vaccines and abortion are both touchy subjects in society. Are laws that tell doctors what they can say about those things next?
JOSH: Okay, that’s the slippery slope argument. People who are in support of those things will pass whatever laws they can. The existence of this law isn’t going to make much of a difference. But for the record, if anyone passes a law that tells doctors they can’t strongly encourage parents to get their kids vaccinated, I’m moving to Canada.
Thanks to Steve for hashing out this debate with me, and for most of the links above.