Saturday, February 25, 2006

Legislation in Virginia to Prevent Physicians Asking About Household Guns

From The Virginian-Pilot on February 23,2006,

A pediatrician who asks a child's parent about firearms in their home could lose his or her license or be disciplined under legislation being considered by a [Virginia ]Senate committee today.
The bill would prohibit health care professionals from asking a patient about gun possession, ownership or storage unless the patient is being treated for an injury related to guns or asks for safety counseling about them.


The bill was passed in the Virginia state lower legislative chamber last week 88 to 11. The article continues:

The legislation is opposed by The Virginia Chapter of the American Academy of Pediatrics because it blocks a common practice by medical professionals to inquire about gun ownership and safety when they go over a safety checklist with parents during a child's regular checkups from birth to puberty. ?
The National Rifle Association supports the bill because it will protect gun owners "from intrusive, unnecessary questions from medical professionals," according to the NRA Institute for Legislative Action Web site.


Here is my response to this likely unconstitutional (denial of free speech) but also irrational political action:

I think that the Virginia bill represents either meddling into the practice of medicine for the legislator's
own personal political benefit or that they are totally unaware about the process or value of medical history taking as practiced by physicians and as responded to by patients. Physicians take a medical history, both a present illness and past history to attempt to get facts that may or may not be immediately useful in making a diagnosis or in teaching the patient about health matters. The past history may include a variety of psycho-social questions and other questions including questions about understanding about risks for physical injury including controlling those risks. These may include not wearing helmets, not using seat belts, using ilicit drugs, sexual behavior, unlocked medicine cabinets accessible to children and risky management of guns in the household. These are only what the physician believes are pertinent questions for the patient to answer if the patient wishes to. Note that the responses are not made under oath. Patients may refuse to answer or may provide an answer to the physician that is inaccurate or intentionally a lie. But for the physician to be punished simply for asking a question that could in the individual case have profound significance ("oh, I keep my loaded gun under my bed so I will be ready for an intruder at night!") is beyond rational belief regardless of what the general risk statistics show and represents irrational lawmaking. Do the legislators know that at my medical school we actually teach our students to ask the patient about the number of individuals the patient has had sex with over their lifetime, whether with men, women or both, about sexual practices and more sensitive questions? Some argue that physicians should not lecture to patients about issues in medicine that have not been proven by research study. However, physicians often deal with issues that have not been statistically studied with regard to pertinence to a specific outcome but possibly may be of great physical/psychologic and social importance to the life of the individual patient. I think we should all face the fact that what physician advise or carry out is not all evidence-based medicine and often we may end up saying and doing what we think is the best for the patient in our own judgment based on our knowledge and experience. Now I will get off my soap box and will be eager to read what my visitors think. ..Maurice.

FOLLOWUP: In yesterday’s news comes the word that the Virginia Senate Education and Health committee voted down legislation that would have made it unlawful to routinely ask patients about firearms.

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