How would this affect the right of physicians to recommend medical marijuana in states like California?

As this is a Va. state law, not at all, unless you're asking the result if it is appealed to the SCOTUS and upheld. If that happened, well, state legislatures could script rather a lot of your future medical advice; an outcome, I'll note, which is unfortunately popular on both poles of the US political spectrum.

to throw on some more fuel, does the American Academy of Pediatrics recommend questioning parents about-
1) plastic five gallon buckets. more children under five drown in them than are shot.

2) bicycles. more children under 14 are killed on bicycles than are shot, by a wide margin.

3) swimming pools. more children under ten drown in them than are shot, by a wide margin.

?

Doctors are forbidden to misuse the trust of their patients to advance a political agenda such as gun control.

Even if a doctor flat-out advises all his patients that they shouldn't own a gun, there's a rather large difference between voluntarily choosing not to own a gun and "gun control."

It strikes me as inappropriate to pass legislation like this, especially if it's focusing on one particular type of question having to do with potential threats to kids. Can't adults just deal with this privately, without more government intervention or opening up freedom of speech issues?

That said, as the mother of a kindergartner, I have found some of the questions addressed to my child even when he was 2-3 younger, by medical professionals, to be a bit disconcerting. This is particularly true because sometimes the list of questions have included some things, such as guns, but not others, such as common daily hazards you can't "lock up" (another commenter mentioned some of these, so I won't be redundant).

The other oddity is that the list of questions sometimes vary from nurse to nurse, for example, and the emphasis on and length of safety suggestions seem to vary based not on anything to do with our personal situation but rather on the other individual.

On one particular occasion, one nurse asked about guns, we said (truthfully) that we don't own any, and yet she preceded to go into gun safety at some length. But during the very same conversation, when we shared that our son precociously had gone to a two-wheeler (without training wheels) and was capable of miles-long bike rides regularly, she asked no detailed questions nor offered similarly detailed advice. That was fine, because we had it covered, but this was a decidedly odd encounter.

Eugene -

What's the constitutional hook for this law?

The state's general police power based on its control of licensing?

I don't believe the 2nd Amendment has been incorporated by the 14th. But I seem to recall reading somewhere that the 14th A's privileges &immunities clause was, based on the discussions in Congress before its adoption, broad enough to encompass 2nd A rights.

Where might the SCt's reasoning in United States v. Vuitch, 402 U.S. 62 (1971), fit in here. [Justice Black wrote the opinion.]

There, in affirming the constitutionality of a District of Columbia statute criminalizing abortion, unless necessary to are necessary to preserve the mother's "life or health," the majority remarked:

"Generally, doctors are encouraged by society's expectations, by the strictures of malpractice law and by their own professional standards to give their patients such treatment as is necessary to preserve their health."

Id. at 71.

As an aside, Vuitch rejected a vagueness challenge and allowed the prosecution to proceed on the premise that the word "health" was broad enought to "include[ ] psychological as well as physical well-being." Id. at 72.

That's where the basis for Roe really took root.

As a medical student, I can say that we are trained to ask a whole long list of potential dangers to kids, including gun safety, helmet and seatbelt use, drowning and poisoning prevention, etc. A doctor shouldn't tell a parent to get rid of a gun, but they should ask if the parent has taken measures to prevent accidents, for example storing the gun in a locked cabinet and storing ammo separate from the gun. These type of questions are perfectly reasonable and I think necessary. Legislating against a doctor's ability to ask questions seems very irresponsible. A doctor can recommend but not force parental actions, and a parent can always seek another doctor if they find such recommendations are intrusive. Such a gag rule is completely unnecessary.

Doctors are not merely professionals. They are licensed by the state and granted a monopoly on the practice of medicine.

eng,

Technically you are correct, doctors are licensed by the state to practice the full scope of medicine, but I doubt you'd want me to do a heart transplant on you. But in many states, nurses, physician assistants, psychologists, podiatrists, and optometrists have full prescribing privileges and are considered independent practitioners of medicine. I suppose in VA that the physician can refer the family to a podiatrist who will be allowed to ask about gun safety.

The doctor-patient relationship is entirely consensual (as is the attorney-client relationship). I advise Virginia's doctors to simply refuse to accept as patients any legislator who votes for this bill. Something along these lines, "Hey,politico. You wanna practice medicine? Practice it on yourself, too."

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....

Suppose you are a psychologist (a health care professional in every state) who is evaluating an adolescent that has been referred for several behavior problems, including drawing a picture depicting said adolescent shooting a school official and that picture was found by school officials...you mean the psychologist can't ask the parents if there are any guns in the house and whether the family stores the guns and ammunition in a safe manner? Even a psychologist who is a hunter and supporter of the 2nd Ammendment is going to want to know this information in undertaking such an evaluation.

Even if the AMA has an anti-gun agenda, do we really want the state "protecting" us from such speech? Are our lawmakers truly so wise, everyone of them a vertiable Socrates in Armani, that we should trust them to regulate every aspect of a private encounter? Does the NRA now support the Nanny State, as long as the Nanny prohibits speech they deem offensive?

What I want to know is what does safety agitprop have to do with medicine? Medicine treats disease and injuries and has absolutely nothing to do with physical safety.

Wouldn't a parent be worried that a "wrong" answer to such questions would cause legal problems since the parent is not a patient of the pediatrician (and a third party - the child - may be present). Even if there is a priviledge, it doesn't cover ongoing criminal activity or future crimes. (failure to use a car seat is a crime, though gun storage violations usually are not.)

Don't get me started on the car seat garbage. I actually heard a threat by a health care professional to commit the crime of false imprisonment if any mother with newborn attempted to leave the hospital without a car seat in her possession. That's when a gun would come in handy. Sheer nonsense of course but they repeat these fantasies all the time.

My guns have never been locked up (at home) and never will be.

"Doc, I'd love to lock my guns up but how will Tad shoot a piece of human debris breaking and entering the dwelling house of another in the nighttime with intent to commit a felony therein when I'm not home, if the Mossberg is in a safe in the basement?"

There's nothing inherently anti-gun or pro-gun control in recommending safe handling of firearms. Heck even in the NRA is happy to preach gun safety to anyone who wants to listen.

And the fact that only licensed physicians can practice medicine constitutes a monopoly only if you believe that all doctors are employees of the same corporation.

The AMA is very gun-unfriendly. A quick google for AMA gun ownership brings up as top links quoting and criticizing the AMA for a strong anti-gun stance.

Treating a few gunshot victims could do that to a person. For that matter, police organizations support gun control, for similar reasons perhaps.

I just don't understand the gun owners who are such sissies, they have to run crying to the legislature because their doctor ASKED THEM A QUESTION.

I agree that it is intrusive on the part of a physician to ask about gun ownership if he or she is trying to indoctrinate or change your mind, but there are instances in which this knowledge is vital. For example, if a patient tells you that they are going to harm someone or themselves, you have to ascertain if they are capable of doing so. One of the red flags is the ownership of firearms. If a patient is suicidal (and that is often hard to determine without a lot of talking to the patient) then those guns have to be taken out of the possession of the patient. I usually ask family members (with the permission of the patient) to remove any guns until that person is no longer suicidal.

In addition, federal law does not allow a committed patient to own firearms (I am not convinced this is fair or effective, but it is the law) so a reminder to the patient is often in order (I don't call the police on this issue.) Also, Tarasoff warnings are mandated in many states and are common sense to avoid liability and tragedy. If a patient threatens another person and is armed, then I have to take appropriate measures to protect that person (not to mention protect me from a lawsuit.)

Children who are in danger of physical harm or sexual abuse have to be reported in every state, the presence of guns in these cases is also a tremendous worry.

So I don't think that the statement that gun ownership is none of the physician's business is strictly correct.

Again, I am a strong advocate of gun ownership, but that ownership has to be responsible and safe both for society's sake and for personal safety. When a patient has an illness that might trigger unsafe use of a firearm (such as severe depression, mania, psychosis, etc.) then it becomes the business of a physician. A number of state and federal laws apply, even in Virginia, in these cases, not to mention the always present liability issue.

Maybe you just have to be there to understand.

Here are two traditional ways of dealing with people who you think are asking privacy-intruding questions:

(1) Refuse to answer.

(2) Stop doing business with them.

Why exactly are these two items not enough? Why is a government-imposed restriction on the questioners' speech somehow needed instead?

Might I suggest an editorial point? The original story quoted in the post simply describes "the bill", "the legislation", and a "Senate committee", without telling us whether this was the state legislature or the U.S. Congress. Since only three paragraphs are quoted, it may be that the entire article clarifies this issue, but I suggest that a blogger citing something like this clarify the issue for his readers.

I know that the context suggests that this is a state legislative initiative, but it would be pretty simple to include this information explicitly, especially for non-lawyer readers.

I personally as a physician can not stand any of the professional medical associations some more than others. I refuse to join or give them money. They have been politized regarding social issues and they should know better. Medical Students are taught all kinds of social propaganda now. The APA is very anti-gun. They have in their major textbooks (Randolphs) the Kellerman study and they recommend no firearms at all in the homes where children are. This is tantamount to saying no free speech in homes with children. I refuse to ask the blanket questions put out by these nanny organizations. Fie on them. They are pumping out the idea that gun violence is a disease and guns are the pathogen. Ridiculous. I hope one of these dopy physicians gives someone their professional opinion and that person removes all their firearms then when the family needed them for self-defense and was harmed becuse they did not have them the family sues that professional. IF the nannies really wanted to do some good they would want to fund gun safety courses in schools. I do not mean anti-gun classes I mean real safety coarses on how to handle a firearm responsibily. And for the liberals who would scream about this I would repeat back to them their own advice regarding sex education------They are going to be exposed to firearms and knowledge is what they need not just to be told NO. Did you know that in the state of Arkansas if you are a Foster Family you lose your 2nd amendment rights. No fireams allowed in your home. Where is the ACLU?????????? I even had the wonderful experience to be taught by Joycelyn Elders the author of "Lets teach our children to masterbate" claim of fame. She was very anti-gun. I would also add that the recommended well child exams are excessive and nothing more than a revenue generating scam.

Tom Anger - Since when is gun safety being politically correct? I'd think that its common sense, you keep your guns safe and you keep your kids safe. But somehow that's part of a vast liberal agenda for some people. Unbelievable.

The proposed law has been roundly critisized for all the The fear that an extreme 'nanny state' is going to show up in the next decade or two and pass a law mandating physician reporting of guns over what would undoubtedly be the strong opposition of doctors, health professionals and the NRA is just not plausible.

Despite doctors inclination to more liberal views they aren't stupid and would surely realize the harm to the doctor patient relationship such a requirement would entail. Nor would it go unobserved that such a measure would guarantee every gun owner lies, and perhaps even starts hiding his guns instead of keeping them safely locked up ultimately increasing the gun danger.

Hell, the NRA by itself should be enough to keep pressure off the backs of known gun owning parents and with even a significant chunk of docs worried about these side effects such a law just isn't going to pass.

It always annoys me when people with strong opinions and absolutely no knowledge of a subject blather on and make remarks such as "The psychiatrist who has 2 patients kill themselves but the rest of his patients are way happy is going to feel worse about it than the psychiatrist who plays it safe and has no suicides but most of his patients are still somewhat unhappy."

Psychiatrists deal with mental illnesses which, for the most part, are biologically and genetically determined and usually quite severe. Suicidal patients brought to the attention of a psychiatrist are driven to kill themselves in many cases. These are not the worried well. Studies show that untreated Major Depressive Disorder has a 15% mortality (that means death) rate, so any effort to change that statistic is in the pervue of the physician. To imply that suicide is always a rational option in these cases is evidence of ignorance of the facts.

As for narcotics, for the most part they are not treatments for mental illness, any more than alcohol is even though many people self-medicate with both substances.

I know of no physicians who are willing to abet the government by turning in names of gun owners to government entities just because they own guns. I wouldn't even know who to turn the names into and I certainly would not do it, not just because of my 2nd Amendment stance (pro-gun) but because it would be a good way to lose patients. No doctor likes reporting anything except those things mandated by law (child and elder abuse) and the paperwork alone is daunting not to mention the time it takes to deal with the authorities.

Also, my son just graduated from medical school, and he did not run into any anti-gun diatribes. He was never taught that he had to get guns out of the hands of the people to make a utopia on earth. He was taught (as I was) to "First, do no harm"

Granted, there are professional organizations who have taken up this line but all most doctors are a) conservative politically and b) capable of making independent decisions in spite of some of the rhetoric noted above. The leaders of professional organizations tend to be academics who have more time on their hands than the usual practicing physician. I don't belong to any professional organizations for that reason alone, but mostly because I don't think they do anything worth the dues they ask.

If you think that all doctors are minions of the state aching to take your guns away, the answer is simple: try an alternative, there are plenty of them out there. But the next time you see your doctor at the skeet range, the odds are he is not a spy for the anti-gun crowd.

Dr. Mikeyes writes No doctor likes reporting anything except those things mandated by law (child and elder abuse)

If gun ownership were added to the list (as an independent item, or as part of child protection) would this then fall under the exception of things doctors don't mind reporting?

Would the doctors who didn't speak up when they came for the child abusers[*] speak up now?

[*]In my state, a healthy child coming to school with a facial bruise (received at the hand of a sibling) triggers a mandatory report of suspected child abuse or neglect. The report triggers an involuntary home visit and inspection. The home visit includes questions about the parents' religion, ethnicity, political affiliation, and (HIPAA notwithstanding) medical history.

People 'debunking' the 'state monopoly' argument are being purposefully decietful: We aren't talking about letting anyone who feels like it practice medicine, and it's a lie for you to pretend we are. We are talking about a left-liberal organization using it's government-guaranteed access to doctors to promote harassment of gun owners.

And the last I heard, it was NOT an acceptable argument to tell victims of harassment to go elsewhere if they don't want to hear it.

I guess harassment by left wingers is special that way.

When I visit my doctor or bring my child into a doctor I expect that person to get a medical history and ask me what the problem is. I am there for his professional expertise in the area of curing illnesses or injuries. I am not there for his opinions on gun safety, bicycle safety or car safety since his opinions on these issues are not areas in which he has been trained.

However, since we live in a litigious society, it would be interesting to see if dispensing advice on non-medical issues like gun safety carries with it legal liabilities. If the medical community accepts responsibility for advising parents on bicycle helmets, can a doctor who fails to do so be sued for negligence if little Johnny cracks his skull?

Conversely, can a doctor who tells a parent to sell his guns be sued if that unarmed parent is subsequently injured by an intruder?

The voluntary, even aggressive, intrusion by physicians into previously uncharted areas of advice have the potential for providing the legal profession new ways of making money and insurance companies richer.

If your medical records contain the answer you have a gun registration list. I guarantee you the govt can get access to those records and search them. My last doctor also had the charming policy of marking a nunuvyerbizness answer as a yes.

There's also the charming practice some doctors have of maintaining lists of patients who complain, file lawsuits, etc. and refusing to accept them as patients.

Frank:

The private owbership of machine guns was banned in the 1920s and never reinstated. You must be thinking of a different weapon.

By the way, do lawyers always limit themselves to their areas of expertise?

This was meant to be an attempt at ironic levity and should have read:"By the way, do lawyers always limit themselves to their areas of expertise? "

One of the things I like about this list, and I suspect most of us like, is the reaonalbe discourse that usually occurs outside of the occasional ad hominem argument that always seems to creep in. So next time, I will be a little less subtle. I am perfectly aware that lawyers have no opinions outside of their areas of expertise.

Many a truth is spoken in (G)

If there was an organized campaign to tell doctors to do anything Democratic it would be met with a collective yawn. Individual physicians would possibly buy into that rather stretched logic, but only because they believe it in the first place. Most physicians are far more worried about the possibility of avian flu breaking out. That makes us sweat.

Now if the Democrats promised to get rid af all the paperwork...

Several viewpoints on one particular aspect have been addressed. There are other considerations though:

The American Academy of Pediatrics advocates gun bans. Bans, as in “total prohibition”, not instruction in the safe use and handling of firearms. The AAP's nexus of safety to firearms is (paraphrased) 'guns are unhealthy, all guns gone is best'.

In the few circumstances it's risen, they disagree with firearms instruction for minors on the grounds of acclimatization or desensitization. AAP doesn’t offer advice on firearms handling, nor do they recommend existing programs. [Anticipating counter-claims, “properly securing” is not a safety program]

Claims that AAP questioning is a safety matter are false.

It's the American Academy of Pediatrics that promotes bans and advocates asking children about firearms at home. I'm not sure where 'child' ends, but pediatricians treat people from 6 months to 16 years of age.

In the absence of probable cause, it's totally inappropriate to interrogate children about articles in their parents’ homes. [Or about their parents’ lifestyle, recreation habits, political comments, etc.]

Insurance-mandated HMO/PPO service providers –themselves operating under state rules— alter the balance of free market or choice for patients.

Finally there’s HIPPA, mandatory distribution of patient records, and defacto registration databases.

As a Virginian I welcome the legislature’s attention to this. The law is overbroad and needs to be tuned, but it’s an appropriate response to an outrageous violation of ethics.

It's unfortunate Professor Volokh quoted a newspaper but didn't link to the actual bill, in italics below.

A. The Board may refuse to admit a candidate to any examination; refuse to issue a certificate or license to any applicant; reprimand any person; place any person on probation for such time as it may designate; suspend any license for a stated period of time or indefinitely; or revoke any license for any of the following acts of unprofessional conduct:...
22. Oral or written inquiry to a patient concerning the possession, ownership, or storage of firearms, where such inquiry has no relationship to the practice of the healing arts or the medical condition of the patient, and is for the purpose of gathering statistics or to justify patient counseling, unless such inquiry is the subject of a request, or related to a medical complaint, made by the patient.

It seems many of the comments here are irrelevant to the actual proposal.

A hypothetical: a pediatrician advises her patient's parents to "secure" their firearms, put the guns in a safe, store the ammunition separately. The parents follow the pediatrician's advice exactly. That night, a madman breaks in and, because the weapons are locked up, the parents are unable to defend themselves and the mother is killed. For the sake of argument, assume that the previous means of gun storage (say, in the nightstand) would have virtually guaranteed a better outcome.

The question: is the pediatrician liable for malpractice?

(Perhaps America's famed out-of-control tort system could solve this problem for us...)

I think outright prohibition gets into First Amendment problems, but I also think that regulation of professional licenses can properly impose restrictiosn.

Fact is, that Physicians are in a "power" position with the capability of exercising undue coersion. That is why they, like other professionals (including lawyers) are not allowed to engage in what are clearly otherwise constitutionally protected actions (such as sexual relationships with patients).

If the physicians groups are furthering a political agenda disguised as a public health interest, that in my view can be regulated under professional licensing doctrines such as those related to "boundaries" and whatnot.

The fact that the invasive questioning on gun ownership comes from a polically motivated perspective is well documented. I dare say that if the AMA started encouraging physicians to track patients' status as legal/illegal residents; or their sexual history (including, for example, by pushing a politically motivated "public health" set of bullet points about the increased risks of a homosexual lifestyle, there would be hell to pay and new laws JUST LIKE THIS passed reflexively by many legislatures. Again, its a question of what doctors should be trying to do. By their own admission, they're not just tracking information (which is bad enough), they're engaging in the equivilent of push polling and that's what's got the NRA up in arms.

Amusingly, patients on some prominant gun enthusiast message boards have taken to confronting their busybody doctors with a "release form" like the following. Very funny, indeed:

========snip=========
FIREARMS SAFETY COUNSELING REPRESENTATION:
PHYSICIAN QUALIFICATIONS AND LIABILITY
Part One: Qualifications

I affirm that I am certified to offer (Name of Patient: ), herineafter referred to as "the Patient", qualified advice about firearms safety in the home, having received:

Specify Course(s) of Study:
from:
Specify Institution(s)
on:
Specify Course Completion Date(s):
resulting in:
Specify Accreditation(s), Certification(s), License(s) etc.:

Check one, as appropriate:
___ I represent that I have reviewed applicable scientific literature pertaining to defensive gun use and beneficial results of private firearms ownership. I further represent that I have reviewed all other relevant home safety issues with the Patient, including those relating to electricity, drains, disposals, compactors, garage doors, driveway safety, pool safety, pool fence codes and special locks for pool gates, auto safety, gas, broken glass, stored cleaning chemicals, buckets, toilets, sharp objects, garden tools, home tools, power tools, lawnmowers, lawn chemicals, scissors, needles, forks, knives, etc. I also acknowledge, by receiving this document, I have been made aware that, in his inaugural address before the American Medical Association on June 20, 2001, new president Richard Corlin, MD, admitted "What we don't know about violence and guns is literally killing us...researchers do not have the data to tell how kids get guns, if trigger locks work, what the warning signs of violence in schools and at the workplace are and other critical questions due to lack of research funding." (UPI). In spite of this admission, I represent that I have sufficient data and expertise to provide expert and clinically sound advice to patients regarding firearms in the home.

OR

___ I am knowingly engaging in Home/Firearms Safety Counseling without certification, license or formal training in Risk Management, and; I have not reviewed applicable scientific literature pertaining to defensive gun use and beneficial results of private firearms ownership.

Part Two: Liability

I have determined, from a review of my medical malpractice insurance, that if I engage in an activity for which I am not certified, such as Firearms Safety Counseling, the carrier (check one, as appropriate):

___ will

___ will not

cover lawsuits resulting from neglect, lack of qualification, etc.

Insurance Carrier name, address and policy number insuring me for firearms safety expertise:

I further warrant that, should the Patient follow my firearm safety counseling and remove from the home and/or disable firearms with trigger locks or other mechanisms, and if the patient or a family member, friend or visitor is subsequently injured or killed as a result of said removal or disabling, that my malpractice insurance and/or personal assets will cover all actual and punitive damages resulting from a lawsuit initiated by the patient, the patient's legal reprerentative, or the patient's survivors.

Signature of attesting physician and date:

Name of attesting physician (please print):

Signature of patient and date:
Name of patient (please print):
Note to patient: Indicate if physician "REFUSED TO SIGN." Ask physician to place copy in chart/medical record.
=========================

The simplest solution: Print out two copies of the following form. Hand them to the offending physician, ask him to sign both copies, one for you and one for his file:
http://www.keepandbeararms.com/downloads/gundocform.pdf

It seems to me that the focus of the bill is to address and define one type of unprofessional conduct. Is it the position of Professor Volokh that the legislature of Virginia is prohibited from defining unprofessional conduct by doctors if they persist in the gratuitous inquiry into gun ownership, which is a constitutional right. Incidentally, the medical profession is already a regulated industry and unprofessional conduct is already otherwise defined.

The legislation in no way prevents any doctor from giving a speech or advocating the abolition of guns. What it seems to be designed to do is limit doctors, under color of they professional duties, to collect data on a subject when that subject has no bearing on their professional responsibilities. It seems to me that the Libertarian position would be to reduce rather than increase the amount of data gathered by either the government or licensed professionals about our private affairs – especially if those affairs happen to have specific constitutional protections.

However, Professor Volokh has not addressed the issue of physician liability if it becomes standard practice for doctors to give gratuitous advice not directly related to medical procedures. As someone who operates in the financial field, I assure everyone here that the legal profession is incredibly skilled at finding liability for either actions or non-actions that could possibly lead to bad outcomes.

I, for one, would welcome the creative members of the legal community to find a doctor who either through action or non-action cause a patient to come to harm as the result of a gun incident.

It is still a pretty draconian law, taking a person's livelihood away for expressing a view that if not part of the healing art is then opinion or political speech. If the purpose was to make sure that people are not harmed by physicians and other health professionals it would make sense, but I think that telling someone to secure their guns in the presence of little children is not on the same level as having sex with them. In the latter case undue influence can be a factor and in the case of a psychotherapist probably an illegal act in VA. The former case may be bad manners, but if you are offended, you would probably change doctors. Besides, do you do everything your doctor or dentist tells you? (Studies show that very few people are complaint with physicians suggestions or in taking their medications.) I doubt that my status as a physician is having much sway in this dialogue if you don't agree with what I am saying.

In most states "unprofessional conduct" does not usually include speech but does include being intoxicated, stealing from patients, forced sex, assault, and committing a felony. The state medical board has jurisdiction over these issues under this proposed law, and they could issue a reprimand each time it was reported assuming the investigation would bear out the facts and would probably not do much more than that. Even then it is the board's decision to set a penalty.

The board would also be sued under whatever state or federal statute that assures free speech (the First Amendment?). The most likely in the initial hearing argument would be that the advice was given as part of the exam and treatment and there will be a challenge to the wording involving "counseling" since part of health care is counseling patients about various issues such as smoking and diet. I understand that some of us on this list think it is inappropriate or insulting to ask patients about guns and consider anything that a physician does in this regard as undue influence. I don't think so, but I do object to physicians actively pushing their own agendas, including any pro-gun agenda.

In addition this law means that no research could be done into the relationship of gun presence and illness or injury by a health professional. Thus the present research, which is generally used by anti-gun forces, is the last word.

The AAP has always been very liberal and is not the spokesperson for all of medicine. In fact they only represent about 10% of physicians and I am sure that all pediatricians are not in accord with them. It would be like saying the ACLU represents all lawyers.

For a long time, free speech was seen as the province of liberals but more recently it's claimed as that of conservatives. This thread makes clear that suppression of free speech is no monopoly of the left. Conservatives are just as eager to suppress speech that they find objectionable. IMHO, the biggest problem with this thread is the people claiming that it's somehow ok to limit the speech of doctors because the doctors are biased or wrong in what they say, which seems totally irrelevant to the question. That's what free speech is all about -- the ability to be biased and wrong. Take that away and there's no free speech.

Would you argue that the doctor's right to "free speech" extended to the use of derogatory racial epithets in the presence of the patient (even if not directed specifically at the patient), or simply saying "many blacks lead an unhealthy lifestyle, I need to warn you against these dangerous behaviors", or hectoring the patient about the negative health implications of his religious views, or lecturing him on the negative health effects of the homosexual lifestyle? Does any place of business have an unlimited right to create a hostile or intimidating environment for its customers simply through the right to "free speech"?

Interesting that you chose only to address "sex with patients" issue which is a stark enough difference from the guns issue to make it an easy call.

But what about:

1. A concerted information collection and "public health" campaign attempting to coerce people against homosexual lifestyle itself based on political motivation of the medical group. (i.e., imaging a group of christian physicians not so concerned about health as they are focused on eradication of homosexuality).

2. A concerted campaign relative to illegal migrant workers under the auspices of "public health" again, but as before instituted by a medical association with another axe to grind (i.e., wanting to expose and harass undocumented workers).

3. What about a concerted campaign relative to the circumcision issue but where the medical association pushing it had documented anti-semetic tendeancies.

4. What about a pediatrics group that organizes an information collecting campaign on whether their single-mother patients are having dating partners sleep over when the children are home (there is statistical evidence this is an impact on the children), but where the group pushing this is a "men's rights" group with an agenda puntivie to the mothers and not so focused on the kids.

These examples, I think, would all result in outrage. Its amazing to me that the medical associations issue joint press releases with anti-gun groups about this stuff, and then people are surprised when folks start to question the motivation and medical bona-fides of this information collection and patient lobbying. The issue here is not to constrain doctors from giving good faith input, its to challenge them when they become pawns for zealots of various stripes. The AAP has, I believe it is reported, accepted finacial considerations and partnered in research studies with anti-gun groups. Its the dressing up of an ideological agenda as a "public health" issue (i.e., doctors suggesting to patients that the only basis for their belief is a health or medical issue, when their or their organizations personal politics are actually driving things) that becomes a concern.

GONZO, the answer to your Parade of Horribles is that the patient says to the doctor, "Buzz off," and finds another doctor.

What is *with* you people? Why do you have to protect yourselves from even encountering a different point of view from your own?

>>>>GONZO, the answer to your Parade of Horribles is that the
>>>>patient says to the doctor, "Buzz off," and finds another
>>>>doctor.
>>>>
>>>>What is *with* you people? Why do you have to protect
>>>>yourselves from even encountering a different point of view
>>>>from your own?

Oh, come off of it.

In addition to taking their business elsewhere, many of those consumers in my examples will be in contact with the licensing authorities to discuss just HOW the actions of the physician have anything to do with the practice of medicine. Likewise, they'll be promptly in touch with their liberal democratic politicians who have demonstrated time and again that THEY have no problem overlooking free speech issues in order to protect the liberal shibboleth of the moment.

Speaking of "you people," I for one (as a mall "l" libertarian and Ayn Rand objectives) continue to be amazed at the condescending mindset that posits that university or otherwise "higher" educated folks (like doctors) gain by their schooling an almost "philosopher king" status by which they deign to guide the unwashed masses even as to things that are wholly unrelated to their area of expertise and the framework of their license.

Until I hear of medical doctors stopping patients before any diagnosis or procedure and advising them that more people die each year at the hands of their physicins than die of firearms, I'll contine to question whether those folks are abusing their position of trust to further ideological agendas.

Have a nice day.

**What is *with* you people? Why do you have to protect
**yourselves from even encountering a different point of view
**from your own?

By the way, I don't think anyone is saying that M.D.'s can't have a contrary view on gun control, and write as many letters to the editor, give as many public speeches, or donate to as many groups as they want.

What WE are saying is that they don't get to abuse the sanctity of the physician-patient to advance a political agenda. Its really not that difficult. I don't mind anyone challenging a view different from my own. But its a little different when the person pontificating to me is in the middle of giving me an annual and wants to recite the bullet points from VPC propaganda whilst his gloved finger is up my rectum searching for prostate enlargement. Don't want to get this kind of pushback, stick to MEDICINE while you practice medicine.

What WE are saying is that they don't get to abuse the sanctity of the physician-patient to advance a political agenda.

Beware of The Argument From Sanctity, is one of my axioms.

Gonzo, it appears that some *doctors* may have a different view of that relationship than yours. So let's just declare their opinion illegal, okay?

No, my point is that the "Free Speech" concerns are a smokescreen conveniently erected in this case to facilitate social engineering by persons in a position of power and whose profession is being coopted by a politically motivated interest group. I point out that the champions of free speech here are silent when they seek to regulate a professional through his license for purposes of advancing a liberal issue. Anyone remember the license actions taken against pharmacists who did not want to dispense the "day after" pill? What about the recent much to do when Walmart indicated it did not wish to carry such medications in its pharmacies. Hey, the patients can go elsewhere right?

As Mr. David Kopel wrote elsewhere:

"People in pain, people fearing cancer, and people who are injured and weak are vulnerable. They all look to their doctor to do right — right for the patient, rather than for the insurance company, or for the doctor's view of social policy. Doctors have a fiduciary relationship with their patients. They are obligated to set aside personal agendas and put the patient first. Putting the patient first means that the doctor must respect boundaries in the relationship with the patient. So when the doctor makes a pass at a patient, or tries to sell her real estate, or lobbies patients against gun ownership, the doctor is committing an ethical-boundary violation. Patients notice when a doctor abuses their trust or takes advantage of their pain and fear."

And to the a couple posts up: Again, no one's saying that doctors who believe they are philosopher kinds should have their opinions made illegal.

But if they want to be licensed by the state, they should limit their "practice" to things to which that license applies.

An OBGYN, for example, must ask a lot of very invasive questions to a woman in her care: Whether she's sexually active; how often; how many partners; whether it hurts. Those questions all go, however, right to the practice of medicine, and the reason she is there.

But that OBGYN who tells the woman "You know, statistics teach us that its really bad for women to bring up children without a proper male role model, and by the way, my brother is a nice guy and he's available" engages in a boundary violation. At the behest of someone to whom the doctor owes no medical duties, that doctor is taking advantage of access to the patient to advance a personal agenda.

Just to show how hysterically politically correct physicians can become I will tell about my fellow physicians at the hospital where I work. Now I hate authoratarian personallities and laws. Arkansas has been bitten by the ban smoking laws. A recent law has banned smoking on all hospital owned property but there is an exception of psychiatric hospitals and the physician can write an order at any other type of hospital and let the patient go outside and smoke. But this was not good enough for my hypocrites (some who smoke,chew,get drunk, drive too fast, commmit adultry, date hospital staff etc) they even will not allow that. I asked them if there was a patient(and we have them like this) who was a diabetic who came in with ketoacidosis but after the initial crisis wanted to go smoke. This patient said she would leave immediately if not allowed to go outside and smoke. Would they just let the patient go knowing it could cause her death or at least she would show up again within 38 hours as sick as she was from the beginning. They all said it would be her fault if she died. Not one of them cared as not allowing smoking is more important. I still write the orders. My patients still get to go outside and smoke. I tell them to call the administrator at 0200 and complain to him. I haven't had him yet say a word to me. Some people are hollier than now.

How about an anti-gun doctor group coming to the conclusion that gun ownership is child endangerment , per se.
Since the State gives the docs a monopoly on the practice of medicine, I believe the State can regulate the practice of medicine, including banning intrusive questions based on a political/social agenda.
The State can require professional speach in the case of reporting suspected child abouse. It all comes from the power to regulate the practice of medicine.

Anderson--------I do not think you have a constitutional right to smoke. Plus I gave up asking parents if they smoke. I could care less as far as their children go. I do not buy into the 2nd hand smoke propaganda. I could ask all kinds of things as mentioned above. A single mother who lets a boyfriend live in is probably more dangerous to her children than her smoking ever would be. So is getting drunk with said boyfried and children in the home. So is parents smoking pot with and in front of their children. Or watching porn with their children. Do you really want me to be my patients moral policeman. Firearms in the home is very very far down the list. I see children that I can probably predict with 90% accurancy their life will involve an illegal act that gets them arrested just by seeing and knowing their parents. What am I to do????????????????? Call the police or the social service nannies because they are what I consider poor parents. We do not have enough money to even put a dent in that problem. Plus social services in my experience do very little. Sometimes they make things worse. Academic medicine is like everything else academinc it is far removed from the real world.

Maybe gun owners are "paranoid" because there are gun bans. Maybe because the USSC semms to keep quiet on a issue of great importance to millions. Maybe because they refuse to protect the 2nd amendment not only from Federal infringement but also they have never protected it aganist State infringement. Maybe we arn't paranoid. There are places in this country I can not live because my private property that I legally own would make me a felon. Maybe I am just paranoid. I don't think so. And the NRA is less vocal than the gay rights, and abortion activists no matter the screeds written by the NYT saying otherwise. When is the last time you saw a protest march of gun owners in DC. Or how about a gun rights parade. Think NYC would host that? I think we are a very low key and long suffering bunch of citizens who try to work through the democratic process since the USSC will not protect our rights or yours. So what if it is controversial when has the protection of rights not been.

Professor Volokh, the reporter wasn’t inaccurate, just had a slight bias; unfortunate when the actual impassive wording’s available. It’s far clearer in the text that medical professionals can’t make “Oral or written inquiry...” A small quibble to be sure.

The article also says that the bill “...blocks a common practice by medical professionals to inquire about gun ownership and safety when they go over a safety checklist with parents...”

It’s not common, when “common” means general, usual, ordinarily, or normal practice. It’s probably not rare either, but less than 10%. I’ve never met a doctor that asked those questions.

Virginia is a moderately pro-rights state concerning firearms. The General Assembly is 58-Rep, 40-Dem, 3-Ind; their vote for the bill was 88-Y 11-N. As several other comments made clear, doctors [overall, and especially in Virginia] likely own guns at a higher proportion than the general population.

The bill allows doctors full latitude to answer queries, review dangers, even lecture or harangue. It prohibits non-health questioning camouflaged as board-certified medicine. This is especially relevant to pediatrics, where the patient may not be able to distinguish relevance or privacy; especially unfortunate that field is the one most at fault.

Why does the pediatrician have to ask about the parents' gun ownership when just talking about gun safety in general will do the trick?

Almost 40 years ago, as a young father I twice dislocated--or at least hurt--the shoulder of my two-year-old daughter in physical play, first by pulling her by the arms and a few months later by swinging her by the arms. Both times a visit to the emergency room quickly took care of it, but I felt horribly guilty about causing pain to my precious little girl. The second time the doctor interviewed my daughter alone, presumably to make sure it was an accident and not deliberate abuse After the first incident, the doctor told me to be careful in play and not to yank her arms. I didn't but I did swing her, thinking that was okay since it did not involve a yank. I'd done it many times before without incident.

I wish some doctor had told me BEFORE THE FIRST OCCASION to be careful how I played with my duahgter, not to swing her or pull her by the arms and the like. Common sense to most of you perhaps, but it was not to me. And I suspect some young parents are as stupid as I was.

I'm all for doctors generally discussing child safety with parents. It need not be intrusive. If it is, move on to another doctor.

why not ask Virgina to pass a law that forbids them from recording any information about gun ownership?

Because there's no way to tell if the doctor's recording the information (unless he's dumb enough to do it in front of the parents). Banning recording instead of questioning would be unenforceable.

I think that State has very broad powers to regulate the practice of medicine, and the State has very broad powers to protect the privacy interests of patients. In terms of the First Amendment, barring intrusive political/social questions is, in my opinion, reasonable regulation of commerical speach.
Doctors are perfectly free to write letters to the the editors of peiodicals, post on the internet, and generally carry on in public about why private gun ownership is a bad thing.

Max,

If there was such a law, then there would have to be a mechanism to check on whether the law was being adhered to which would involve an Office of Medical Records Compliance (OOMRC) that would be able to come in and check your records, without warrant probably, at any time and copy or sequester those records. I think this would engender a lot more concern about privacy than some doctor asking if you had guns in the house. Would you want that?

I still think it is micromanagement to shelter patients from political speech (of course, it is my ox being gored.) The present Virginia law already has this provision: "16. Performing any act likely to deceive, defraud, or harm the public" which may cover this problem if a there was a complaint to the board. (They also have a provision concerning the performance of "criminal abortion".)

The law does not have a preamble that addresses a class of doctors: "These laws are being promulgated because AlQaida the American Academy of Pediatrics has held such thrall over many (as in the primitive counting system of 'One, two, many") doctors who uncritically accept the advice that guns are harmful to families. These treasonable acts must be stopped." Rather the rules, which seem fairly obvious to me since they address criminal acts, incompetence and gross abuse of position, are common sense ones which reflect the experience of medical boards across the country.

I suspect that there are some limits to the state's ability to regulate any profession. I think that all of the Bill of Rights would be involved in setting those limits along with the various state constitutions. I just wonder if it is worth the unintended consequences that might come out of such specific regulations such as the formation of an OOMRC (which exist in some forms in many states due to over-regulation, the mental health clinic laws in WI being one example.)

Well, actually that's the NEA, not the NEA.

But, completely off the point, that really wasn't a typo, was it!

Maybe these politicians are beholden to the 2nd amendment. THE ACLU theories and such cover many more topics and are not based necessarilty on the constitution but their current pet theory and agenda. The 2nd amendment is well just the 2nd amendment. No matter how hard some have tried to make the amenment mean something other than what is written (kinda like the ACLU does) very few buy it. Unfortunately the US citizens can read for the most part.

That's funny, Therut, since the 2nd amendment is written rather ambiguously to any dispassionate observer. The argument that it only applies to state militias was dominant in constitutional law circles until Professor Volokh and others started challenging it, and still could be described as the "clear majority" view.

Whereas, the First Amendment, taken literally, is quite less ambiguous.

Since physicians are "mandatory reporters" to "child protection" authorities, actively preventing them from discovering the presence of guns in a household may be necessary to keep people from having their kids kidnapped by the State.

Gordo

The argument that it only applies to state militias was dominant in constitutional law circles until Professor Volokh and others started challenging it, and still could be described as the "clear majority" view.

Actually, the dominant view, pretty much the only view, right up to around the turn of the last century (ie., 1900) was that the Second Amendment guaranteed an individual right. That fell by the wayside about a hundred years ago, and only since the 1980's has serious legal scholarship come to the fore to refute the mistaken idea that it doesn't protect an individual right.

Back to the subject at hand, however.

If you expect to get lectured by your pediatrician on guns in your home, tell her that it is none of her (most of the ones I've met were female, might explain a lot...) business how you store your firearms. If pressed, remind her that while firearms accidents cause the deaths of about 40 children under age 14 in the US every year, physician mistakes account for about 50 deaths in children under 14. Then point out that while there are between 40 and 50 million gun owners in the US, there are only 6 million doctors, so that logically the pediatrician herself is a far greater danger to your child than any firearms you may or may not own*. If she questions the source of your data, give her this website:

http://webapp.cdc.gov/sasweb/ncipc/mortrate.html

Which is the "National Institute for Injury Prevention and Control" WISQARS mortality database, part of the larger "Centers for Disease Control" (CDC).

That oughta take the wind out of her sails, and in addition might make her think before she gives advice about things she doesn't know about.


*Per year, that works out to roughly 1 accident death per million firearm owners, and about 8 deaths by medical mistake per million pediatricians.

Bill Twist, nice little bit of misogyny thrown in there too, by the way.

It's not your prereogative, or that of any other 2nd amendment absolutist for that matter, to pass a law forbidding her to do her job to protect the health of her patients.

Balderdash, you can't prove that her asking this question is absolutely necessary "to protect the health of her patients." And if it is, that certainly opens up practically endless possibilities for what she can ask you. I mean, if you think about it, what aspect of your life doesn't have a health aspect to it? Who you are, what you do, where you live, what you own... she could justly ask about all of that on grounds of "protecting your health".

Gordo:

Bill Twist, nice little bit of misogyny thrown in there too, by the way.

What misogyny? Merely observation, in that:

1. Most pediatricians I have met are women, and
2. Women are less likely, over all, to have a positive view of firearms.

Now, I'm not saying that *ALL* women have a bad view of firearms. However, a quick sanity check will reveal this:

How many nationally known anti-gun people are women? Quite a few, really. I can think of Diane Feinstein, Carolyn McCarthy, Hillary Clinton, Barbra Mikulski, Sarah Brady, Rosie O'Donnell, and quite a few others.

Now think of nationally known pro-gun women. Having trouble thinking of some? No suprise. I can only think of a couple myself, and they aren't as famous as the people I listed above.

So, no misogyny here, just an observation, and no more misogynistic than saying women tend to like wearing makeup.

As for this statement:

As for your comparison of the relative dangers of physicians vs. guns, you have quite frankly made a ludicrous argument. While physicianss may kill 50 kids a year, they save thousands, and make the health of millions better. Unless you are willing to argue that the unlocked arsenal cases of gun-happy parents has saved thousands of children's lives, just give it up.

One, we don't have a good idea of how many kids are saved by guns every year, although I would imagine that it is less than those saved by doctors.

However, I was comparing 'accidents' (ie., medical malpractice leading to a fatality) to 'accidents' (accidental firearms deaths). So the comparison is somewhat valid.

Actually, I was being generous in that I was using the total number of doctors, not the total number of pediatricians, which is far less. That would make the rate for the doctors soar.

If the AAP just recommended that you keep your guns secured, I wouldn't have a problem with that statement. It's common sense, really. Heck, I have a toddler at home and my guns are secured out of his reach. They don't stop there, however. From their website at http://www.aap.org/healthtopics/safety.cfm :

Advice to parents

The best way to keep your children safe from injury or death from guns is to NEVER have a gun in the home.

* Do not purchase a gun, especially a handgun.
* Remove all guns present in the home.
* Talk to your children about the dangers of guns, and tell them to stay away from guns.
* Find out if there are guns in the homes where your children play. If so, talk to the adults in the house about the dangers of guns to their families.

For those who know of the dangers of guns but still keep a gun in the home

* Always keep the gun unloaded and locked up.
* Lock and store the bullets in a separate place.
* Make sure to hide the keys to the locked boxes.

They don't give the same advice for pools. In fact, other than the common sense measures they say don't get one if you child is under six. They don't say this:

* Don't buy a pool, especially a kiddie pool.
* remove all pools presently at your house.
* Talk to your children about the dangers of pools, and tell
them to stay away from pools
* Find out if there are pools at the homes where your children play. If so, talk to the adults in the house about the dangers of pools to their families.

That, my friend, crosses the line from safety counseling to political advocacy. If as a pediatrician you do that you are crossing a line. And I, as a knowledgeable gun owner, will call you on it.

Having said all that, preventing them from saying it if they wish is also a blatant violation of the First Amendment. I like *ALL* of my rights, thank you very much.

Ohh quick point. Yes doctors are in positions of coercion over patients. Sure you can change individual doctors but that is like saying you can always change to a different employer. If every employer out there demands that women who want a job sleep with the boss they are coerced to sleep with the boss and the variety of employers makes no difference.

In our society doctors are more than mere providers of advice. They control access to medication. It is only with a doctor's good will that you are given the medication which you require and this is an extremely coercive situation.

Just an example from something you see around campus. If you admit to your doctor that you are a drug abuser he likely will not continue to prescribe your ADD medication. While not so severe there is a real worry that if you refuse to answer questions about gun ownership the doctor will assume you are irresponsible or unwilling to follow his directions and be less inclined to prescribe needed but dangerous medication.