In its decision upholding the law that stops doctors in Florida from asking patients if they own a gun, the 11th Circuit Court of Appeals wrote, "The practice of good medicine does not require interrogation about irrelevant, private matters."
Gun safety is not irrelevant. Gun safety is relevant to every single one of us.
Part of being a doctor is asking questions about people's homes and lives. It's particularly important in pediatrics, as children and youth don't always make the safest decisions for themselves. Because of this, keeping them safe means making sure their home is safe. Which includes gun safety.
9 children and youth are shot every day in gun accidents. And 80 percent of unintentional firearm deaths of children under the age of 15 happen in a home.
Reading through the decision, you'd think that doctors were on a crusade to report gun owners and take their guns away from them. This isn't true. I understand and respect that citizens have the right to legally own a gun. I just want to do what I can to be sure that no children are hurt with it. Which, in a nutshell, usually involves making sure that families know that the safest way to keep a gun is to store it locked with the ammunition stored (and locked) separately. Then onward to the next topic.
Which might be even more private than gun ownership (given the possibility of public injury, I don't know that gun ownership is such a private matter, but whatever). I practice the very best medicine when I ask about private matters--because private matters have everything to do with health and well-being. Along with all the usual diet and exercise and other health questions, I ask lots of private questions. I ask about depression (because it impacts children, and is treatable), employment status (so that I can connect people to resources if they need them) and other sources of family stress (because stress is bad for people). I ask parents about how they approach discipline and parenting and sleeping arrangements, and whether anybody smokes (so that I can offer advice and safety information). I ask teens about sex and drugs (so that I can help them be safe and make healthy decisions).
The ruling talked a lot about the imbalance of power between doctors and patients, and how people might feel they have to answer questions even if they don't want to. That's a real issue--and there's no easy solution. I strive in every single conversation to ask my questions and give my advice supportively and without judgment. I am sure that I do better in some conversations than others. But none of my questions is ever irrelevant. Honestly, with everything I need to get done in a patient visit these days, I don't have time for irrelevant questions.
I don't know what I would do if I lived and worked in Florida. The ruling does say that doctors can ask if they think it's relevant to the health and safety of the patient, and that I can always exercise my First Amendment rights--but given that the court clearly thinks that sometimes it's irrelevant, and since it also says clearly that I can't count on the First Amendment to protect me, would I risk the penalties (including not just fines or probation but revocation of one's medical license)? It's hard to say.
And that's what's so sad. Because of this ruling, fewer pediatricians will talk about gun safety--which means that fewer families will get the information they need. Which could mean that more people, more children, will be hurt--or killed.
It also opens the door for other restrictions on the speech and questions of doctors. Which is just as scary--more so, even, because it could stop us from saving so many lives.
What I want is what all doctors want: to keep my patients safe and well. This law gets in the way. It's a law that could be more dangerous than a gun could ever be.
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