Thursday, March 26, 2015

Texas May Ban Doctors From Discussing Guns With Their Patients

doctor


Think Progress

Under a proposed bill currently being considered in Texas, doctors wouldn’t be allowed to ask their patients whether there are any firearms in their homes — and could be subject to punishment from the Texas Medical Board if they do initiate any conversations about gun safety in the office.

The lawmaker who’s sponsoring the measure, Rep. Stuart Spitzer (R), is backed by the National Rifle Association and the Texas State Rifle Association. He believes that the federal government is inappropriately reaching into doctors’ offices to figure out who owns guns.

“Pediatricians are asking children away from their parents, ‘Do you have guns in your house?’ and then reporting this on the electronic health records, and then the federal government, frankly, has access to who has guns and who doesn’t,” Spitzer told the Texas Tribune in a recent interview. He added that asking about gun ownership is “not appropriate” in this setting.

But health professionals have long maintained that, as guns threaten to surpass car accidents as the leading cause of deaths among young Americans, it’s important to be able to broach this subject with their patients. About 10,000 kids are killed or injured by guns each year, many in tragic accidents that could have been prevented with more careful storage. Pediatricians want to have the opportunity to talk about how to safely store legal firearms to ensure they’re out of the reach of young children — especially if there are any signs of mental health issues in the home.

43 comments:

  1. damn right guvmint needs to stay out of legal natural deaths by guns.

    who the hell do these doctor's think they are trying to prevent legal death of children.

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  2. Maybe if the medical profession would refrain from offering such "advice" as training cops to fall down when faced with a potentially lethal threat, people wouldn't think their advice about guns as agenda-driven idiocy.

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    1. I like the part where he said falling down might "confuse the offender". Yep, I could definitely see the attacker being confused by the "fall down defense".

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    2. I believe I recognize the guy in the picture in your article. He's the head of the Minnesota Gun Owners Civil Rights Alliance. A very effective spokesperson for gun rights in the state.

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    3. Here's what Dr. Bezdek wrote (remember this within the context of studying/researching gun violence):

      "First, police use training videos that are designed to test and shorten the defendant officer's reaction time. This is so ingrained in the policeman's psyche that he has come to believe that he must shoot first or be killed. Does this type of training result in a significant increase in unjustified shootings? Might training in which the officer is taught to first fall prostrate to the ground be a more-efficient training exercise? Would falling prone result in fewer accidental killings? Falling to the ground would provide less of a target area, might confuse the offender and would give the officer additional time to evaluate the situation while at the same time studying his shot if needed. Presently there is no data to even begin to analyze these questions."

      It's a fact that we often require our police to enter into unknown and possible hostile situations. As such, an inability to properly assess a situation (whether hostile or not) is critical. That's why we often see police shooting first and making poor decisions. Of course, gunloons are even far more guilty of this.

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    4. I like the part where he said falling down might "confuse the offender". Yep, I could definitely see the attacker being confused by the "fall down defense".

      If the government's hired muscle ever decides to come after me, I definitely hope they follow Dr. Musashi's . . . oops--no, Musashi was an entirely different kind of individual (the kind who wasn't utterly clueless about combat)--"advice."

      That would pad my kill ratio nicely.

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    5. Funny how the gun nut commenters misrepresented the "falling down" thing, which when taken in the context Jadegold provided, had a totally different meaning.

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    6. Funny how the [rights advocate] ommenters misrepresented the "falling down" thing, which when taken in the context . . .

      My article quoted Dr. Bezdek in the entirety of what he said on that subject, so if I had been trying to hide the "context," I went about it in a very . . . peculiar fashion.

      Likewise, since I quoted tactical genius Dr. Bezdek, without editing or abridgment, I obviously "misrepresented" precisely nothing about what he said.

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    7. If you don’t believe getting into the prone position would make an officer more vulnerable to attack, you must at least believe that it would facilitate a suspect’s escape, right?

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    8. Whether it's good advice is not the question. The point is "falling down" doesn't cover it, unless, of course, you want to misrepresent what was said.

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    9. "The point is "falling down" doesn't cover it, unless, of course, you want to misrepresent what was said."

      Mike, Jade's cite of the good doctor's words seems quite clear, "fall prostrate", "falling prone". And he is quite clear in his intent. He seems to think that officers train to react too quickly to what they perceive to be a deadly threat and this results in occasionally being wrong.
      However use of deadly force for law enforcement is pretty much the same as for everyone else and is based on the reasonable man test. Did the officer reasonably believe there was a deadly threat.
      The doctors intent seems to be training officers in a technique to slow down that reaction time in hopes of reducing these mistakes. The problem is that in this kind of situation, reaction time can literally be the difference between life and death.
      This would actually be pretty easy to test with current technology. They have but to have two people using simunitions go against each other in the scenarios that the Dr. describes and see how it works.
      What it boils down to though is there seems to be the expectation that instead of waiting to perceive the threat visually, there should be a new expectation to wait until perhaps the threat is even allowed the first shot.
      And of course, Jade, while suggesting that Kurt has no credibility when compared to the real world experience of the military and law enforcement, defends a retired cardiologist who likely has even less real world experience and training than Kurt.

      "First, police use training videos that are designed to test and shorten the defendant officer's reaction time. This is so ingrained in the policeman's psyche that he has come to believe that he must shoot first or be killed. Does this type of training result in a significant increase in unjustified shootings?"

      "Might training in which the officer is taught to first fall prostrate to the ground be a more-efficient training exercise? Would falling prone result in fewer accidental killings? Falling to the ground would provide less of a target area, might confuse the offender and would give the officer additional time to evaluate the situation while at the same time studying his shot if needed."

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  3. Holy crap, Kurt--did you ever really have to do some sophisticated yoga to misrepresent the views of the medical profession so badly. Even for you.

    BTW, you know the military and many law enforcement agencies also teach getting low (yes, even hitting the ground) is a proper response to a sudden attack. But, hey, who would know about gun fights than someone who has never been in one--like 99.9% of all gunloons?

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    1. Getting low as in behind a vehicle for cover is different than lying prostrate on the ground.

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  4. "BTW, you know the military and many law enforcement agencies also teach getting low (yes, even hitting the ground) is a proper response to a sudden attack."

    They also teach when not to fall down, such as when entering a room and when there's no cover or concealment. Especially at ranges commonly encountered in law enforcement interactions.
    Getting low and using cover and concealment is all well and good when there is time and opportunity, but "falling down" wastes time and completely eliminates any mobility you may have had.
    Though the army usually gives little training time for pistol work with the possible exception of the military police, at engagement ranges commonly seen in civilian law enforcement the army commonly teaches to engage from a standing position with rifle or pistol.
    And since you want to bring up what law enforcement trains and give them credit for real world experience giving them credibility for effectiveness, exactly what kind of credibility does a retired cardiologist have in the area of tactics. In fact, while I don't know what job specialty Kurt was trained in while he served in the army, he at least has some training in the army which you claim to have real world experience. I haven't heard or seen anything that would give the good Dr. similar credibility.

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  5. The post is about the government interfering in the rights of doctors, in the privacy of their examination rooms, to speak to their patients freely. It's unbelievable that the gun-rights fanatics, who continually tell us they're concerned about ALL rights, think this is a good thing.

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    1. It's unbelievable that the gun-rights [advocates], who continually tell us they're concerned about ALL rights, think this is a good thing.

      Actually, I don't support this kind of legislation

      David Codrea has a much better idea. The Physician Liability Form, on which the physician describes his qualifications as a self-defense consultant, etc.

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    2. I never said it’s a good thing. I specifically made a post disapproving of this proposal (as I did for Florida when it came up there). For some reason my post didn’t make it, maybe it got caught up in the spam filter or something happened on my end, but it went something like this: though the people proposing this bill may have a legitimate concern, I don’t think “make a law” is always the solution. If you don’t trust your doctor, don’t answer the question (or answer it incorrectly). And then if you don’t trust your doctor, you should probably find a new one. An awareness campaign by gun rights groups if this information is being incorrectly used would also be in order, and if you absolutely had to make a law, it should be tailored around doctors violating privacy by disseminating this data to the government- not them collecting the data in the first place (or asking the question).

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    3. More tricky bullshit from you and your hero Codrea. How dare you support ANY restrictions on a private conversation between doctor and patient.

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    4. What “restrictions” are being proposed by Codrea? His is giving advice to gun owners on how to handle the question. This falls under the “awareness campaign” that I mentioned above. No laws necessary.

      The next time your doctor asks you if you keep guns in the home, simply smile and hand him or her the form. Let him know you'll be happy to discuss firearms after he establishes his level of expertise, qualifications and liability.

      Keep it friendly. The idea here is to educate, and to get your doctor to pass the form on to the clinic administration.

      As with anything, the success of this working depends on more and more people actually doing it. And that won't happen unless more and more people know about it. So do feel free to spread the word by sharing the link to this article with your gun owner friends.

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    5. For the record, I am not as opposed to doctors discussing gun safety with their patients as you might think. Those new parent “child-proof your home” checklists should include a section on gun safety. Not only do I have no problem with that, but I think it would be a problem not to include it with the household rate of gun ownership being as high as it is. I also have no problem if the doctor were to go over the checklist verbally for emphasis. However, there is no need to ask “do you own a gun?”, and there is certainly no need to record the answer. With gun rights being such a hot-button issue, there is no need to create a divisive situation between doctors and patients by asking/recording. Even still, my only real problem would start if the doctor gave that information to the government or insurance companies violating that patient’s privacy rights. And I would have a problem with the government trying to obtain that information. This is why it’s best to not have that information in the first place. Provide basic gun safety information without asking/recording gun ownership (which doesn't add any value anyway). Can we agree that this is the best approach?

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    6. How dare you support doctors holding conversations with minors outside the supervision of their legal guardian!!!!

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    7. What “restrictions” are being proposed by Codrea?

      A very good question, TS. I do hope Mikeb has a very good answer.

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    8. Kurt, requiring a "form" prior to alowing free discussion between doctor and patient is the restriction Codrea (and you) are suggesting. Ridiculous.

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    9. It is not "required". It is a suggested option by Codrea, not intended to be backed by law, so therefore it is not a "restriction". Would you call this campaign by the Brady Campaign a "restriction" on play dates?

      http://www.bradycampaign.org/our-impact/campaigns/asking-saves-kids

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    10. You know, for someone who insists the word "ban" can only be used to describe the complete confiscation of all firearms with no grandfathering or gradual phase out (must be immediate), you sure have wildly liberal use of the word "restriction".

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    11. You guys are double-talking hypocrites. ANY restrictions on gun rights cause you to freak out. Yet, this "restriction" on doctors' free private speech is not a restriction at all, just a suggestion.

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    12. MikeB: "Yet, this "restriction" on doctors' free private speech is not a restriction at all, just a suggestion."

      Uh, yeah, I do treat a suggestion from a private individual differently than a restriction imposed by the government. Not sure how that makes me a "double talking hypocrite" though. If the only mission of gun control was to offer suggestions, we wouldn't have much of a problem. That's not to say I wouldn't offer my own counter suggestions. Still, stuff like their "ask" campaign- kind of low on my list of gripes about the Bradys (and really no fault with the concept). And again, as I said above, I don't have an issue with gun safety being part of a child-proofing education. So after reading David Codrea's suggestion, I chose to not follow it. I am not going to print out his form and hand it to a doctor should he bring up gun safety. What do you think is going to happen to me, Mike? Is David Codrea going to show up at my house and punch me in the face? Does not following this "restriction" as you call it make me one of your "hidden criminals"?

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    13. And ironically, I would follow the Brady Campaign's suggestion to ask the parents of a friend your child is visiting about guns. The conversation may go a little differently than they hoped, but the concept is true. Don't leave your kids in homes where you see unsafe gun practice. That's a good suggestion.

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    14. "Yet, this "restriction" on doctors' free private speech is not a restriction at all, just a suggestion."

      Actually Mike, this isn't free private speech, but rather professional speech. And with the new popularity of the passage legislation of the so called gun violence protection orders which allows more people to go to court and ask that your right to posses a firearm be restricted, there are valid concerns.
      In fact, I recall we discussed how what seemed to be a clerical error had resulted in a citizen having his firearms confiscated by the government.

      http://mikeb302000.blogspot.com/2015/01/retired-cop-tries-to-get-his-guns-back.html

      Needless to say, if the government expands the obligations for medical professionals to report various activities under the belief that it presents a danger, without some safeguards against potential for either error or abuse, it would have a definite chilling effect on the collection of honest feedback between the doctor and patient. Especially in cases with unsupervised discussions with children.

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    15. "Uh, yeah, I do treat a suggestion from a private individual differently than a restriction imposed by the government. Not sure how that makes me a "double talking hypocrite" though."

      It makes you a double talking hypocrite because the slightest hint of gun restrictions (private individual suggestions included) and you go nuts - lengthy arguments, absolute resistance, etc., etc.

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    16. It makes you a double talking hypocrite because the slightest hint of gun restrictions (private individual suggestions included) and you go nuts - lengthy arguments, absolute resistance, etc., etc.

      But I would not "go nuts" at all, and I bet TS wouldn't either, if what "gun control" proponents were selling were mere suggestions, rather than restrictions, to be enforced by the government's hired muscle.

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    17. Kurt: "But I would not "go nuts" at all, and I bet TS wouldn't either, if what "gun control" proponents were selling were mere suggestions, rather than restrictions, to be enforced by the government's hired muscle."

      [ding, ding, ding]

      Again, in what way do you envision Codrea enforcing this "restriction", as you call it?

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    18. MikeB: “It makes you a double talking hypocrite because the slightest hint of gun restrictions (private individual suggestions included) and you go nuts - lengthy arguments, absolute resistance, etc., etc.”

      And I must point out that in this very thread we have examples of suggestions (not restrictions) from Codrea and the Brady Campaign (Ask program), of which I said I would NOT follow Codrea’s suggestion, and might very well follow Brady’s. But… you have to keep calling me a "double talking hypocrite” no matter what I say…

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  6. Questions the pediatrician never asked me that would be more important than whether I had a gun.

    1. Can your child swim? or Do you have a pool?
    2. Are any poisons/harmful chemicals out of reach for your child?
    3. Does your house have stairs?

    All of these cause more accidental injuries to young children than guns.

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    1. Fair enough, but do you support this law or not?

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    2. Well allowing the doctor to ask about guns is not really going to do anything in my opinion. If the parent does not want the doctor to know that they have a gun then they will just lie to the doctor.

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    3. Was that an answer? "do you support this law or not?"

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  7. Another thought comes to mind. I would bet a lawyer could end up proving liability on the doctor's part if the doctor did ask about a gun and then something happened to the child with that gun. I wonder if the doctor's malpractice insurance has a stance on this?

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  8. A conversation between a doctor and their patient is confidential, personal free speech. Same as if a priest hears a confession of murder. The priest is under no obligation to divulge that information, in fact his obligation is to not divulge the content of that confession. People would quickly stop seeking help from doctors if they know the information discussed would become public.

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    1. "A conversation between a doctor and their patient is confidential, personal free speech. Same as if a priest hears a confession of murder. "

      Not so much anymore Jack. Certainly you've heard of those people designated by law to be mandated reporters. Something which applies directly to conversations between a doctor and minor or vulnerable adults. Plus we have recently discussed a New York man who had his firearms confiscated after seeking treatment.
      Interestingly, the federal government doesn't seem to recognize this,

      "In the United States, the Federal Rules of Evidence do not recognize doctor–patient privilege.
      At the state level, the extent of the privilege varies depending on the law of the applicable jurisdiction. For example, in Texas there is only a limited physician–patient privilege in criminal proceedings, and the privilege is limited in civil cases as well."

      http://en.wikipedia.org/wiki/Physician%E2%80%93patient_privilege

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    2. Then they are wrong and it will stop people from seeking help and I'm not just talking about the gun issue.
      "the extent of the privilege varies depending on the law of the applicable jurisdiction."
      So we just pick and choose what is confidential, or not? You don't really agree with that even if the law says it's OK, do you?

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    3. The problem is that it's hard to tell one jurisdiction leaves off and one starts, so the result will be in my opinion, a general reluctance to discuss sensitive issues and therefor possibly. Result in missed opportunities for effective treatment. A bad thing.
      You often hear of reporters and clergy refusing to divulge information to protect confidentiality, sometimes going to jail rather than violate that trust. You don't hear of doctors doing very often though.

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