Suppose 20 children and 6 adults died at a school in a very short time period. And suppose there were clusters of similar deaths, many of young, healthy people, around the country: at a movie theater, a shopping mall, a high school, a house of worship. Wouldn't you expect the Centers for Disease Control to get involved in trying to figure out why these people died and how to prevent similar deaths? Wouldn't you want your own doctor to do all he or she could do to prevent similar "outbreaks" from occurring in your community? Even if the cause of the deaths turned out to be complex, multi-factorial, and overlapped non-medical arenas, such as the law?
I would not have thought that such suppositions would be controversial, but they are.
When I wrote this blog after the Aurora, CO movie theater shootings last summer, I received more comments and mail than I've gotten on just about anything I've written. My point in the blog was that doctors and other health professionals can play a role in preventing gun violence by asking patients if they own firearms, if they are kept locked separately from ammunition, and if anyone else has access to them, especially children and the mentally ill.
Many of the responses suggested that a doctor has no business asking a patient about guns. Some commenters said they would simply lie to the doctor if such questions were asked, and some said they'd find a new doctor. One wrote that it's no more appropriate for a doctor to ask about firearms than for someone to get their strep throat treated at a gun club.
I was surprised by these arguments, and have reflected on them again in the last few days. Did any doctor ask Nancy Lanza: Do you have guns at home? Are they kept locked separately from ammunition? Are they accessible to anyone else, especially children and the mentally ill? Would it have helped? Or, at least, how would it have hurt?
Perhaps health professionals aren't, on average, as knowledgeable about guns as many gun owners, or as versed in constitutional law as many lawyers. But we treat victims of gun violence: their wounds, paralysis, colostomies, brain injuries, depression, chronic infections, and PTSD. A few members of our profession just performed autopsies on 20 first graders.
Doesn't this earn us a place in the national discussion on prevention of gun violence?
Doesn't this justify our asking our patients three simple questions?
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