Doctors and Guns Redux

[Loosedhorse]

I don't think the 1st Amendment was intended to -- or should -- restrict a doctor's freedom to discuss any topic with a patient.

Difficult statement to parse. No one has claimed that the 1st Amendment was intended to do that; just the opposite, the 11th Circuit has held it protects that freedom.

...is committing a boundary violation by presuming to enter into a field about which he or she is not knowledgeable.

That is not the definition of a "boundary violation." Please see post #73.

By contrast, accidental deaths due to firearms came in at 600.

And accidental injuries by firearm use number at 16,000 or more; and suicides and homicides by firearm use are well over 35,000. And...so what?

Again, please read the 11th Circuit's opinion. The court states that firearms safety discussions are well within the purview of medical care-givers. As it happens, the doctors have the same opinion. Your opinion that the court and the docs are wrong about that is, well, your opinion.

The fourth and fifth amendments both restrict what anyone can ask you to divulge about personal matters and expect a response.

No.

They do limit the government's powers of inquiry: what its agents can ask you, under what circumstances they can ask you, and whether it can impose penalties on you for refusal to respond as a means of compelling your reply.

They do not limit what your doctor can ask you, just as they don't limit what you can ask him or her.

they don't get to know whether I shoot guns or fire my howitzer in my recreational hours.

They do if they ask, as they are allowed to, and if you answer, as you are allowed to. Otherwise, correct: they don't get to know.

 

[ShootistPRS]

Our rights whether enumerated in the bill of rights or not are personal rights that are outside the control of the government. We retain those rights without governmental enumeration and they can only be restricted when they might conflict with the rights of others. You are not free to practice your religion in another's religious house (church) without the permission of the owner. You cannot carry a gun into the house of another without permission. You cannot freely travel across the land belonging to another without permission. You can't yell "FIRE" in a way or at a time that will needlessly endanger others. You can't use your free speech to incite illegal action in others.

As long as my rights are not infringed you are free to exercise yours. We had the rights before we had the government and we will have them long after the government is gone. The constitution does not provide our rights it tells government that they have to protect them.

 

[Frank Ettin]

Our rights whether enumerated in the bill of rights or not are personal rights that are outside the control of the government .....

We're discussing what the law actually is and how things actually work in the real world. Your personal, philosophical views are irrelevant. Our focus revolves around how courts see things, and at the core of this discussion are a specific, recent actions by the Massachusetts Attorney General and a recent decision of the Eleventh Circuit.

Please stick to an evidenced based discussion of the topic at hand.

 

[Aguila Blanca]

That is not the definition of a "boundary violation." Please see post #73.

I saw your post #73, and I looked at the link. That's only one definition, from one specific institution, but IMHO it still fits.

Boundary Violation
When one does not distinguish between his or her own personal and emotional needs from those presented by the patient. It refers to over-stepping boundaries that jeopardize and compromise the therapeutic relationship.

For example: If I go to my doctor (as I recently did) to follow up on a surgical procedure performed last year (gallbladder removal), I have no personal or emotional need to discuss firearms in my home. I'm there to see if I'm recovered from the operation. But the doctor's standard intake form included a number of questions unrelated to the purpose of my visit, including a couple about firearms.

Despite the fact that I wasn't there to talk about anything other than my gallbladder (or lack thereof), the doctor nonetheless asked a number of questions relating to other things that might or might not be going on in my life. Things that don't affect my health, except perhaps in some extremely tenuous and undemonstrable way.

By the definition YOU provided, that's a boundary violation.

 

[Loosedhorse]

That's only one definition, from one specific institution

It is a representative definition. I invite you to look at others from other medical ethics sources.

but IMHO it still fits.

Really?

At first, your definition of a boundary violation was shown here:

...committing a boundary violation by presuming to enter into a field about which he or she is not knowledgeable.

A boundary violation thus, according to you (without reference to any source), was when a doctor discusses with a patient "a field about which he or she is not knowledgeable."

Now, you are claiming that a doctor discussing gun safety is not part of the doctor-patient relationship, even though doctors and the 11th Circuit say it is; but instead that discussion is the doctor using the patient for "his or her own personal and emotional needs."

Seems we're still missing your evidence that your definition of "boundary violation" has any validity beyond your unsupported opinion; and that a doctor discussing gun safety--or just having a gun question on a standard form--is using the patient for "his or her own personal and emotional needs."

 

[Chris_B]

I just want to mention that the subject of extracurricular activities is a natural one in many cases not related to firearms.

If you injure your knee, the MD may well ask if you play sports. During my hospital stay this month, they discovered a hole in my heart. Sports came up. Yes, I want to play roller hockey again, stroke be damned. I can already run half speed and juggle. Anyway, it's an example of recreational activities that are surely applicable to medicine.

 

[Aguila Blanca]

Seems we're still missing your evidence that your definition of "boundary violation" has any validity beyond your unsupported opinion; and that a doctor discussing gun safety--or just having a gun question on a standard form--is using the patient for "his or her own personal and emotional needs."

I never claimed that my definition of a boundary violation was anything other than mine, or that my opinion that [most] doctors talking to patients about guns is a boundary violation was anything other than my opinion. That said, I am far from the only person who does think it's a boundary violation.

You are, of course, at liberty to disagree.

And you are taking liberties with the very definition you referred me to. There's more to it than just the doctor's personal needs and emotions. I quoted the definition to which you referred us above, but here it is again -- ALL of it:

Boundary Violation
When one does not distinguish between his or her own personal and emotional needs from those presented by the patient. It refers to over-stepping boundaries that jeopardize and compromise the therapeutic relationship.

"Those", in the context and grammatical structure of that sentence, refers to the personal and emotional needs of the patient, Do you disagree that if a doctor asking about the patient's ownership of guns makes the patient uncomfortable, or (as we have seen in previous discussions here) causes the patient to dissemble rather than provide straightforward, candid responses to questions. it "jeopardizes and compromises the therapeutic relationship"?

Since you're new around these parts, some suggested reading:

https://thefiringline.com/forums/showthread.php?t=34795&highlight=doctors+ama+boundary+violation

https://thefiringline.com/forums/showthread.php?t=60924&highlight=doctors+ama+boundary+violation

https://thefiringline.com/forums/showthread.php?t=210580&highlight=doctors+ama+boundary+violation

https://thefiringline.com/forums/showthread.php?t=446212&highlight=doctors+ama+boundary+violation

https://thefiringline.com/forums/showthread.php?t=497636&highlight=doctors+ama+boundary+violation

 

[jdc1244]

What right of free speech is involved in a doctor asking a patient about guns? That is a very private issue.

Government has the authority to place limits and restrictions on speech.

First Amendment case law places limits and restrictions on how government seeks to regulate speech, where some limits and restrictions comport with that case law – and are valid and Constitutional – and some do not, such as government seeking to regulate the speech of doctors discussing guns in the home with their patients.

In addition of being in violation of the First Amendment, the Florida measure is also invalid because it is predicated on the fallacy that doctors discussing guns in the home with their patients might have a ‘chilling effect’ on gun ownership, and the fallacy that doctors addressing the issue of guns in the home might ‘foment’ further ‘gun control,’ when in fact nothing could be further from the truth.

There is no such thing as being too conspiratorial when it comes to the issue of gun rights. Constant vigilance is required.

Nonsense.

Second Amendment ‘advocates’ engaging in hyperbolic conspiracy theories, unfounded demagoguery, and propagating ridiculous lies serve only to undermine the rights enshrined in the Second Amendment.

 

[44 AMP]

Government has the authority to place limits and restrictions on speech.

In public.

There is no such thing as being too conspiratorial when it comes to the issue of gun rights. Constant vigilance is required.

Nonsense.

Second Amendment ‘advocates’ engaging in hyperbolic conspiracy theories, unfounded demagoguery, and propagating ridiculous lies serve only to undermine the rights enshrined in the Second Amendment.

While I agree that running about yelling that "the sky is falling" when it isn't does not do our side any good, being vigilant against threats to the RKBA is not nonsense.

Perhaps you don't remember "if I could have gotten 51 votes, Mr & Mrs America, turn them ALL in!"

The threat IS real. It's virulence ebbs and flows, but it doesn't end, or ever go completely away.

 

[Loosedhorse]

Do you disagree that...

I disagree with the premise of your question.

You claim that the doctor, by asking a gun question, "causes the patient to dissemble". No. The patient is not a child, and the doctor does not control the patient's action.

If the patient CHOOSES to lie ("dissemble"), that's on him: he is his own agent and must take responsibility for his own decisions and actions. So, if there is any harm to the doctor-patient relationship, that has come from the lying patient--from HIS decision.

The patient has options. Tell the truth. Refuse to answer. Object to the question (very strongly, if he wants). Find another doctor.

Oh, and in case you're wondering: the patient choosing to lie is not a "boundary violation"; neither is the doctor's question.

Since you're new around these parts...

But not new to this topic. I am aware of Dr. Wheeler's opinion on "boundary violations"; he is wrong, as any medical ethicist or medical educator (or even the 11th Circuit) can tell you.

I like his other writing, however. For example, his chronicling of the malfeasance and bias at the CDC and at some medical journals (like the NEJM) is great; it well documents why the CDC should (my opinion) never be trusted with funding "gun violence studies" again.