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back to article US doctors demand right to advise on gun ownership

Doctors in America are up in arms over the suggestion that they have no business advising their patients on gun ownership and safety. The incensed medics insist that it's their duty to tell Americans not to keep guns in the home, or if they do, to keep them unloaded and locked away. The debate on this issue was kicked off in …

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Suicide w/o Guns

Suicide is often a act of impulse. Using a gun makes it irreversible, versus some other methods from which the person can be saved. Think slit wrists, trip to the ER, lots of stitches.

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Idiotic article

Firstly, almost by definition I would suggest that in gunshot homicide it is the perpetrator rather than the victim who is normally considered the criminal.

Secondly, even leaving aside those 588 deaths attributed to accident, the 11406 intentional homicides and the 230 deaths of undetermined intent, the author's own linked source states there were also 31228 Incidents of injury by firearms. I would have thought it would be a noble intention to try to reduce any of this suffering, with prevention always being better than cure.

And finally. If I'd noticed this was Lewis Page before I started typing I wouldn't have bothered responding. At least it keeps him away from writing about climate change.

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RE: Idiotic article

Wow, it's like playing "spot the bandwagon humper"! Note the revealling trend - disbelief of simple statistics; preference for emotional decision-making rather than factual analysis; prediliction for supporting "I know what's best for you" ideas. I'm making a pretty safe bet when I guess you also want Gitmo closed, Assange knighted, and blame out current economic mess on "the bankers" rather than our politicians?

Doctors should be practicing medicine, not politics.

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Devil

Idiotic article for another reason

This article is missing the most important stat - how many are on Prozac (or generics). The stats I have seen used to show _MILLIONS_ across the USA. A doctor has all the moral, professional and medical right in the world to recommend putting the gun away to someone who needs happy pills to keep themselves from sucking on the barrel or shooting half of the neighborhood just because they do not like Mondays.

With all due respect any lawmaker who is interfering with this right needs to have their head examined.

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#Matt Bryant

"Doctors should be practicing medicine, not politics." or to put another way. 'Don't tell me how stupid I am just fix me up again and get me back out there'

Doctors should be trying to save lives not practising politics.

There. Fixed it for you.

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Anonymous Coward

Medical certificate

Where I live I often see signs offering medical certificates for various things, including driving and guns. Being over 40 I already need such a certificate when I have to renew my driving license. As for the gun certificate, not owning one, I have to assume it's some sort of psychological profile test which if were the case and migrated over to the US would probably disarm half the country in one go so I don't see it being a popular concept.

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Anonymous Coward

Little Lie.

"If I'd noticed this was Lewis Page before I started typing I wouldn't have bothered responding."

The article is laid out in the following way:

The first line is the headline, in large type.

The second line in the sub--head, in normal but bold type.

The third line is the writer's name, in normal but blue and bold type.

It would have taken real effort not to notice Lewis Page's name right at the very beginning of the article there, to the degree that your statement that you didn't notice it until you started to type a reply is a pretty obvious lie - because once you get to the reply page, you can no longer see the byline.

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Gimp

Derigueur

Just another attempt to push gun control by other means.

Like other lightning rod issues in the US special interests try to mix topics.

Like a Wall street banker crafting a CDO they take a issue that has little traction and try to wrap it into some other strong emotional issue. In this case it is mixing gun control with the power of physicians to advise. For other examples. look at abortion, that mixing women's rights and a medical procedure.

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Strangely not on household chemicals, cars, hot tubs etc

But is there a law that tells them they can't advise on household chemicals, cars, hot tubs etc like the one for guns? No? So what's your point?

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Boffin

Also...

... household chemicals have warnings printed on them, so do cars "Objects in the mirror are closer than they appear", plus you have to take a driving test but not a firearms test, hot tubs have warnings and thermostats...

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Errrm... Firearms are sold with warning labels, too. But similarly to hot tubs, cars, and household chemicals, the warnings go unheeded by the usual suspects.

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wrong

in many U.S. states you mast take a firearms safety course before buying a firearm there is in my state.

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IIRC

I am pretty sure that there are laws governing what a doctor can and can not say to a woman (or underage girl, for that matter) regarding abortion and alternatives. If so, then principle of government involvement in doctor-patient relationships is already established.

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Mushroom

I'll talk to them about firearms in the home, if they are willing to have a serious discussion about Medical Misadventures.

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Facepalm

Doctors should also advise people not to have a kitchen in their house, since the majority of injuries in the home occur there.

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Coat

If they want to advise me, they will be advised it is none of their business. If they persist, they will be transferring my records to my new GP.

How many people are harmed by knives in kitchen accidents each year? Oh noes, get rid of the knives!

Muppets.

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Lewis Page == paid troll

"it might be more cost-effective for them to focus on traditional doctor stuff like heart disease and cancer"

WTF Lewis? The doc's are those that put us back together and have to suffer the trauma themselves in more ways than you have empathy cells.

If the doc's are saying this they are doing it for a reason - reductions in gun injuries will reduce overall health costs, prevent less PTSD for the staff involved in treating these injuries and generally be good for the whole population.

I know I'm feeding the paid troll here, but in this article I believe you have really overstepped any authority you have for writing articles on the Reg.

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Of course

"If the doc's are saying this they are doing it for a reason"

Sure, they want to build a database just like Google and everyone else and then sell it to the highest bidder. Granted, they will mix it in some "report", undoubtedly one which will be presented to congress, that correlates anything of their choosing because they can say they "anonymized" their data and so peer review isn't possible and all the other agreeing doctors will nod and say that patient confidentiality must take precedence.

BTW, got a number for what the "cost" is as a fraction of the total? How about the relative PTSD impact on staff between bullets vs other sundry mutilations like bike on truck? Yeah, didn't think so. I'd make a heat-kitchen comment on that second point but it seems a little crass.

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Health care costs

Most recent I could find (1997, so I guess it's way higher now):

"This article estimates the costs of U.S. gunshot and cut/stab wound by intent. It also compares U.S. to Canadian gunshot experience. Incidence data are from published sources, the National Hospital Ambulatory Medical Care Survey (NHAMCS), and cause-coded emergency department discharge and hospital discharge data systems. Medical care payments and lost earnings per case come from National Crime Survey data, a literature review, and weighting of costs by diagnosis from Databook on Nonfatal Injury-Incidence. Costs, and Consequences by Miller et al. (The Urban Institute Press, Washington, DC. 1995) with the diagnosis distribution of penetrating injuries from the discharge data systems. Quality of life losses are estimated primarily from jury awards to penetrating injury victims. In 1992, gunshots killed 37,776 Americans; cut/stab wounds killed 4095. Another 134,000 gunshot survivors and 3,100,000 cut/stab wound survivors received medical treatment. Annually, gunshot wounds cost an estimated U.S. $126 billion. Cut/stab wounds cost another U.S. $51 billion. The gunshot and cut/stab totals include U.S. $40 billion and U.S. $13 billion respectively in medical, public services, and work-loss costs. Across medically treated cases, costs average U.S. $154,000 per gunshot survivor and U.S. $12,000 per cut/stab survivor. Gunshot wounds are more than three times as common in the U.S. than in Canada, which has strict handgun control. With the same quality of life loss per victim, gunshot costs per capita are an estimated U.S. $495 in the U.S. vs U.S. $180 in Canada. Per gun, however, the costs are higher in Canada, Gunshot wound rates rise linearly with gun ownership."

http://www.ncbi.nlm.nih.gov/pubmed/9183471

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PTD in care workers

Traumatic events may provoke fear and helplessness and people at these events may experience stress reactions. We assessed the prevalence and risk factors for PTSD in HCW at a hospital treating SARS patients. METHODS: A 91-item questionnaire was administered to HCW on high-risk (ICU, ER, SARS Unit) and select control units 6 weeks into the Toronto SARS outbreak. Seven dimensions representing possible risk factors for PTSD were created and calculated by taking the mean over all questions. Dimensions included perception of risk to self, perception of risk to others, confidence in infection control measures, confidence in information received, impact on personal life, impact on work-life and depressive affect. PTSD was measured by the Impact of Events Scale-Revised (IES-R) corresponding to criteria in the Diagnostic and Statistical Manual of Mental Disorders IV. Scores of >20, corresponding to the mean score measured for journalists in war zones, was used to indicate the presence of PTSD symptomatology. RESULTS: Results are available for 248 HCW (173 nurses, 6 physicians, 69 others). Mean IES-R was 19.1+15.8; mean IES-R was higher on high-risk vs control units (21.9+16.4 vs 13.8+13.2, p<0.001). Overall, 102/235 (43%) had a PTSD score >20. In univariate analysis, sex, age, and years of experience as a HCW were not associated with a score >20. In multivariate analysis, working on a high-risk unit (OR=2.1, p=0.04), working in ICU (OR=2.0, p=0.04), number of SARS patients attended (>1 vs 0) (OR=4.3, p=0.004), perception of risk to self (OR=3.8, p<0.001), impact on work-life (OR=3.4, p=0.02) and depressive affect (OR=4.7, p<0.001) were associated with PTSD. CONCLUSIONS: A substantial burden of acute PTSD with identifiable risk factors was present in HCW. This may affect HCW retention. Awareness of this problem and intervention may improve the health and well-being of HCW.

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102265447.html

There, it didn't take long to find that information; perhaps it would be a valid point to ask you to research something prior to flaming?

Heat? Kitchen?

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Anonymous Coward

tl;dr

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"Most recent I could find (1997, so I guess it's way higher now):"

Why guess when all it takes is a quick bit of addition. I assume the figure of 37,776 deaths is from all firearms causes so we can easily add the 2009 numbers for the same and come up with 30,913. I would say that isn't "way higher" but the exact opposite, in fact it's way lower, over 18% or nearly one in five.

"The gunshot and cut/stab totals include U.S. $40 billion and U.S. $13 billion respectively in medical, public services, and work-loss costs."

While not strictly an answer to my question, we can take a stab at it. According to Kaiser, healthcare costs are $2.3 trillion. Using the raw $40 billion without the 18% reduction and keeping in the related but not healthcare costs, such as work-loss, the cost of firearms related as a fraction of the total is 17/1000 or 1.7%. While I'm a bit surprised by the number, perhaps you can explain why a doctor would harp about gun ownership when cardiovascular disease, according to the CDC, "accounts for about $1 of every $6 spent on health care in this country." It isn't about dollars.

I have to admit you have me stymied on the PTSD part as I didn't see any mention of bullets, guns, firearms or anything related to the probability of developing PTSD based on exposure to differing stimuli. It could be because the didn't or couldn't separate such data as pretty much everything comes into the ER and ICU so it may be difficult determining which incident type caused what PTSD rate. On the whole I don't see how the link is relevant to the topic at hand.

"There, it didn't take long to find that information; perhaps it would be a valid point to ask you to research something prior to flaming?"

I'm sure it didn't take long. It never takes long to find any old thing that isn't really pertinent. It does show that studies are a great source of funding and building interesting looking databases may serve to siphon a bit of that funding in a particular direction. Oh, for the record, it wasn't a flame, it was a snark and I love to cook so the heat isn't a problem for me.

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Angel

The children, Lewis. Think of the children!

The American Journal of Preventive Medicine warned us in the article that "... guns ... are a major danger ... to American children." Anyone who disagrees with them clearly isn't thinking of the children.

Lewis Page is a bad man!

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Anonymous Coward

I'm sorry

What is the down side of a doctor advising someone to keep a safe house, including firearm safety.

Do people have a right to do stupid things that can impact others?

If a child is hurt / killed by a improperly stored firearm the owner is looking at child endangerment charges.

Saving a few lives is not worth 1 min of someones time?

Do the gun nuts think this will lead to losing their guns? I know, many think the constitution gives them the right to bear arms.

I agree - you can own any style of firearm that existing when the constitution was written. I think that means upto black powder / flint lock is ok.

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FAIL

RE: I'm sorry

The advice should be coming from someone qualified. Personally, I think any member of the public that wants a firearm should have to do a safety course before gaining their licence, but that course should be delivered by an authorised body with the actual knowledge of gun use and safety.

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No downside, except they are focusing on the wrong things

If they only have 10-15 minutes (or however long a consultation is) then why are they focusing on guns when there are bigger killers out there.

For example, the doctors would save far more lives by asking about what car you have and whether you service it regularly.

If it is a 30-second sound bite alongside other home safety hints then no harm in that. Something like: "Keep all your cleaning chemicals in a locked cupboard. If you have guns in the house then it is best to keep them unloaded and locked away."

#disclaimer: While I am pro-gun, I am not pro-gun in the American way. I live in NZ which, IMHO, has about the best gun-ownership/control laws. In NZ you are legally required to unload guns and lock them away when not in use. You won't get a gun license unless you have a satisfactory gun safe.

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upto black powder / flint lock is ok

I wonder how the 2nd Amendment will be interpreted by the Supremos when it comes to personal laser weaponry rather than chemically-propelled slugs...

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Technically the 2nd amendment should still apply seeing they will be sold as Laser guns ;)

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@Jean-Luc

Interesting question. If I had to guess, the BATFE would classify laser weaponry as a destructive device in the same way they would, say, a pipe bomb. That said, the 2nd Amendment doesn't say anything about differentiating "Arms" so in vein; firearms, guns, mines, bombs, lasers, missiles, rockets, ICBMs, nuclear subs, etc, are all "Arms" so... Shit, did you know you would bring up a whole other CWMD (Can of Worms of Mass Deliberation)?

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Anonymous Coward

Doctors are pretty qualified to advise on health issues. And really; if not the Doc, then who else is a parent going to sit with for five minutes and listen to as regards the health of their children? American society doesn't provide dedicated paid professionals to pop over and give parental advice (unless it's at the point that Welfare are knocking at the door, which of course is not common). Would school teachers be in a better place to ask these questions?

Truth is; we don't really know the context. Doctors are not likely to be spending 15 minutes discussing the issue. I imagine the actual situation is a bit closer to a checklist:

"Do you keep your bleach under the sink? You should move it out of reach. Do you smoke? Maybe you shouldn't around your child. Do you have loaded firearms in the house? Maybe you should unload them and store them safely. Is your medicine cupboard within reach? Maybe you should have a lockable one..."

See... what's wrong with that? Sensible advice to new parents, half of whom are of below average IQ and might genuinely not have thought about it. If thirty seconds of questions saves 500 deaths and thousands of injuries every year, what's the actual problem? How is that treading on anyone's rights or overstepping a boundary? Are firearms so sacrosanct that a professional - concerned for the welfare of children - cannot make enquiries about them?

I can't help think that there is no 'story' here, and it's simply more paranoid "oh noes, they want to take our guns YOU CAN HAVE THEM WHEN YOU TAKE THEM FROM MY COLD, DEAD HANDS!!!" style complaints from the gun lobby.

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"I agree - you can own any style of firearm that existing when the constitution was written. I think that means upto black powder / flint lock is ok."

I don't think you have any right to say that using a communication medium that didn't exist when the constitution was written. It's not speech or press if it is being delivered electronically, right?

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FAIL

Its not the question

It isn't just the doctor asking, it is him putting down the answers in your medical records. Which is a great under wraps way of registering firearm owners for whatever you want to use that list for. That information does not belong in that medium.

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Paris Hilton

Keeping things in perspective

Medical accidents: 2550 deaths? Doctors would do well to advise their patients to stay away from doctors.

Paris because 'The nurse will see you now' could take on a whole new meaning.

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Anonymous Coward

No

For a start, the stats only mention deaths, not injuries. For example, one of those idiots in the infamous "Do It" case wouldn't be included because they only permanently injured themselves when they failed to blow their brains out correctly.

Second, "want to be able to" does not equal "want to do it to the exclusion of all the other stuff". It's going to take them a few seconds in a first appointment to go through a checklist to make sure the dumbasses aren't putting their children or other people at risk.

You might bar it from being recorded, but barring them from asking is a ridiculous law and whoever's responsible for it is also a twat.

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FAIL

RE: No

"......to make sure the dumbasses aren't putting their children or other people at risk...." Wow, did it take long to develop that overbearing belief that you are so much smarter than everyone else and that you have the right to tell them what to do? I see many more kids being killed each year when driving their parents' cars because their parents didn't think to teach them some real driving skills.

I'm not exactly thick (I would qualify for MENSA with plenty of points to spare if I could be bothered), and I see no problem with sensible gun ownership. I actually know a rocket scientist (well, missile one) that shoots regularly. I even know a surgeon (sorry, not a brain surgeon, but a peadeatric one) that looks forward each year to the 12th of August.

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Megaphone

Gun owner here

I know doctors go into the field to help people and save lives, but there is this little thing called The Constitution that allows gun ownership and the privacy laws in the US, as tattered and rotting as they've become since 1932, means this is no more an area for doctorly advice than my selection of operating system.

And for the record, my guns are not kept at my house, except one, which is kept unloaded with the safety on in a place the kids can't get to. In fact, if I put it with the dirty dishes or their laundry baskets, they'd never get within ten feet of it.

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Now that you went there

The Constitution also grants the freedom of speech. Therefore this Florida law violates the rights of the doctors.

I'm also a gun owner, btw. I just don't see the problem with doctors advising people to keep them safely stored.

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Anonymous Coward

So you're unwilling to tell a doctor advising on safety in the home that you have firearms due to privacy issues, but are happy to announce it to the entire Internet?

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1) It's a matter of personal choice

2) I'm trying to explain, from the perspective of a responsible gun owner/former hunter and father, why I think doctors shouldn't advise this

3) At least you didn't ask about the plastique and the tiger pits

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So there should be a list of what not to talk about?

Guns may not be the number one risk to health in most people's homes, but the Doctors aren't saying they are going to only talk about guns. They want to be allowed to discuss anything that is relevant to the patients circumstances.

Seems the Reg is happy with lobby groups compiling a list of items that doctors shouldn't be allowed to talk to their patients about.

Start of with the gun lobby banning talk about risk.

Next the tobacco lobby making sure smoking isn't talked about,

Maybe include alcohol as that's nothing to do with doctors,

Then the pharmo industries can make sure no one mentions drugs that might have side effects.

Soon enough the doctors won't be able to discuss any risks.

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Facepalm

an obvious gun lover this author

First its pretty well shown that if suicide isn't as easy, it doesn't happen as often.*

So yes I think if people kept their guns unloaded and locked up they would be at least a little less likely to use them, certainly much more so if there are no guns in the house at all. Suicide is rarely from an overwhelming dedication to ending ones life, but is more often done in moments of weakness, when something simple like a gun appears to offer a quick escape from current pain.

More importantly if guns are 43 time more likely to kill loved one or friend family member than a criminal, then of the 11,406 gun homicide deaths, MANY (the large majority) must be from killing family members or friends in arguments, or mistaking them for a burglar. So excluding the criminals shooting people AND other criminals (again your article states that these two scenarios are the least likely) you are still looking at 10's of thousands of deaths a year, which could be prevented if people practiced proper gun ownership, and a bit of common sense. You twist this to make it seem like only criminals are killing criminals when the facts are that mostly guns MUCH more often used to kill family members or friends. You also seem to conveniently ignore this in your defense of guns.

Also you seem angry at Doctors for spending time on this as its unimportant, which ignores two key facts

One: even if its not number 1, its one of the larger preventable groups of deaths in the US each year, which makes it a worthwhile area to spend time on, and could get more results than other groupings, like driving which other than not drinking and driving, and getting good sleep, isn't very avoidable.

Two: You naively assume that they don't also spend time advising people on the other groupings as well. I believe doctors do advise people on storing chemicals properly, especially when small children or pets are around, and do advise people to not drive tired or drunk etc.

How can you even try to defend a law that restricts Doctors from discussing the facts at hand. Would you also support a ban on them not being able to suggest that people don't swim alone, or while intoxicated, just because its not the biggest killer? Or that a Doctor should be charged if he steps on the chemical companies toes and says their products should be kept safe away from children?

Doctors (usually) have the intelligence to discuss with their patients the things they MAY be at risk from, for some people its their own guns. To pass a law preventing such discussions is myopically stupid, and really indefensible.

God do you have a tiny dick or something? Why the crazy protection of Guns? The doctors aren't even telling people not to have guns, they just want to be free to tell their patients, when they think its appropriate...."uh hey don't be a dumb ass and keep loaded guns lying around the house"

*Can't remember the particular drug, but it was common in suicides in the 60's-70's they passed a law to make it where you could only buy a limited amount, to kill yourself you would have to visit more than one store....suicides using this drug type dropped significantly (and marginally overall, but other current social factors like vets returning from Vietnam make this kind of moot without better data that doesn't exist). Same result with structures that have locks, guard rails etc when they are not as easy to kill yourself with, they tend not to be used as often for it.

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FAIL

Drs Kellermann & Reay? Really?!

"More importantly if guns are 43 time[sic] more likely to kill loved one or friend family member than a criminal..."

Once again the NEJM, (June 1986?) of a 6 year study of 743 firearms death rears its head. Yes, about half of the deaths in the study pertained to a home where the firearm was kept. Yes, suicide is a terrible thing. Yes, 83.7% of those deaths were suicides. In simple terms, unless you are a bloodthirsty freak who would prefer to kill an intruder than deter an intruder, the study says that you are 37 times more likely to kill yourself on purpose than kill a criminal, who you probably only want to stop from committing a crime and not kill. Likewise you are over 4 times as likely to commit murder (and be a criminal) than kill a criminal, who you probably only want to stop and not kill. Finally, if we assume the firearms accident rate didn't drop by over 60% since 1986 you would be 1.3 times as likely to accidentally kill yourself as KILL someone you probably only want to stop from committing a crime. Bear in mind that killing a criminal is far less necessary as often wounding, incapacitating, and scaring the crap out of them is just as, if not more, effective than killing the little bugger.

Sometimes I can't tell, would they actually be more receptive to firearms if everyone killed criminals instead of letting the police and courts handle it? Somehow, I think not.

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Addendum

"if guns are 43 time more likely to kill loved one or friend family member than a criminal, then of the 11,406 gun homicide deaths, MANY (the large majority) must be from killing family members or friends in arguments, or mistaking them for a burglar."

Homicide != Suicide. The 1986 study, where the 43X number comes from, does not differentiate suicide from homicide. Worse yet, it self selects as someone has to be killed with a gun in order to be included in the study. The study doesn't count homes where nobody is killed, it doesn't count homes where people are killed with the other common weapons (hands, feet, knives, poison, etc), it doesn't count other accidental deaths, injuries or suicides. Imagine that, cherry picking only deaths and only those gun related and coming up with a number.

It's as if they said having pink bunny slippers in the house made it 43 times more likely for a loved one to be run over by a bus by only counting the folks run over by a bus while wearing pink bunny slippers. Should doctors advise people of this pink bunny slipper menace?

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Boffin

It's easier to remove guns, than stairs (falls) or hearts (cardiovascular disease).

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Anonymous Coward

Blah blah, cold dead hands, pointless posturing, empty machismo, blah.

The right to bear arms is there to overthrow unjust government.

You really think that if you rose up to overthrow any US government, waving a firearm and telling them to take it from your cold, dead hands that they wouldn't shoot you and every other 'enemy of the state'/'terrorist'/'unlawful combatant' who pulled the same stunt dead in a second?

Do you really think that if the US did ban private firearms tomorrow and you told them to 'try' to take your firearms away that you wouldn't either end up tossing them down and throwing up your hands in the face of a SWAT team, end up face down on the sidewalk, tasered and maced; or simply shot dead?

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Maybe they need cigarette package style warnings

Warning : lead poisoning can be harmfully to your health.

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Anonymous Coward

And?

So gun deaths is not the, or even a, leading cause of death among children. Got it. Time would be better spent discussioning stairs, pools. draino, et al. Understood.

Does that mean doctor's should not try to protect their ability to discuss gun deaths of children with their patients? You seem to be implying they shouldn't care about the ability to discuss this with their patients because it doesn't kill enough children. However, the number of deaths isn't the issue, it's protecting the ability to have the discussion.

So what's your point exactly?

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Boffin

Doctors or nannies??

I'm hardly Joe NRA, but if my doctor started lecturing me on the dangers of keeping guns in my home (vs. poorly grounded electrical outlets, household cleaners, rickety stairs or railings, wet or oily floors, leaky gas appliances, flammable materials stored near heat sources, etc.) I'd tell him to shove it.

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Anonymous Coward

How about if he lectured you about firearms AND poorly grounded electrical outlets, household cleaners, rickety stairs or railings, wet or oily floors, leaky gas appliances, flammable materials stored near heat sources, etc?

The article is massively partisan, and there is no reason to suppose that the above scenario is not the case.

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