While the Founding Fathers wanted to preserve the ability of the citizenry to defend themselves against tyranny, there are those who would like to undermine this ability by advancing the notion that gun control is a "public health issue" and that crime is a "disease." As a result, patients are increasingly being questioned by health care professionals about their gun ownership. In an excellent article entitled "Doctors to Ask Patients About Gun Ownership," Dr. Miguel A. Faria writes, "In what is described as an effort to curb handgun violence, a group called Doctors Against Handgun Injury, a spin off of the AMA and organized medicine, is calling for sweeping changes in the patient-doctor relationship that would allow physicians, including psychiatrists, to pry into their patients' gun ownership.
In the past, the medical community strenuously fought against any invasion of patient privacy by the government or other third-parties. For example, the American Psychiatric Association (APA) had, in the past and for obvious reasons, been a bulwark in the defense of patient privacy and medical record confidentiality.
Suddenly, events have taken a nefarious course.
The APA has regrettably joined Doctors Against Handgun Injury, the gun prohibitionist coalition.
This coalition --- which also includes the American Medical Association (AMA) and, not surprisingly, the strident (i.e., when it comes to gun control) American Academy of Pediatrics (AAP) and ten other medical organizations reportedly comprising 600,000 doctors --- has called for a variety of patient privacy-invading measures in the name of gun safety.
Don't be fooled by their innocuous-sounding name and publically stated objectives.
Through a revealing article published in the New York Observer on March 15, 2001, much information has come to light about the gun control campaign of Doctors Against Handgun Injury. They are promoting more stringent gun control measures, what they call "upstream intervention" --- that is, using regular checkups to ask patients about firearm ownership and gun storage in their homes.
Ostensibly, the report states: "To promote public safety, health professionals and health systems should ask about firearm ownership when taking a medical history or engaging in preventive counseling. Patients should be provided with information about the risks of having a firearm in the home, as well as methods to reduce the risk, should they continue to choose to keep them."
The AMA and organized medicine led by the new activist president Dr. Richard Corlin in his inauguration speech on June 20, 2001, dedicated the AMA to battling gun ownership as a public health epidemic. "[Gun violence] is a battle that we cannot not take on." Dr. Corlin said that he had decided to fight gun violence against all odds and despite the risks. "People have told me that this is a dangerous path to follow. That I am crazy to do it. That I am putting our organization in jeopardy. They say we'll lose members." Indeed, Dr. Corlin has put his own personal agenda and self-aggrandizement at the expense of all physicians and the AMA, the organization that claims to represent all of us.
Moreover, he said the AMA will attack gun violence the way it has attacked other public health concerns: "What we don't know about violence and guns is literally killing us," he exclaimed. He blamed "the gun lobby" for the loss of the $2.6 million in federal funding for gun [control] research which was stripped from the CDC budget in 1996 because of biased, politicized, result-oriented research conducted by the public health establishment.
Thus, Dr. Corlin called for increased public spending to allow the government to collect data on gun violence. In other words, he made calls to resurrect the specter of the shoddy research conducted by the NCIPC of the CDC. He parroted the litany: "Gunfire kills ten children a day in America," ignoring the fact that automobile accidents, swimming pools, matches, football and bicycle injuries kill far more children. Are we going to ban them too?
Dr. Corlin continued: "If this was a virus or a defective car seat or an undercooked hamburger that was killing our children, there would be a massive uproar within a week. Instead our capacity to feel a sense of national shame has been diminished by the pervasiveness and numbing effect of all this violence." And then he concluded, "Our goal is to cure an epidemic. If removing the scourge of gun violence isn't bettering the public health --- what is?"
Here Dr. Corlin propounds the erroneous notion that gun control is a public health issue and that crime is a disease, an epidemic --- rather than a major facet of criminology. He forgets that guns and bullets are inanimate objects not constrained by Koch's Postulates of Pathogenicity that prove that a microorganism is responsible for a particular disease.
Conveniently, Dr. Corlin also ignores the benefits of firearms in our society. For example, as many as 75 lives are protected by a gun for every one life lost to a gun; medical costs saved by guns in the hands of law-abiding citizens are fifteen times greater than costs incurred by criminal uses of firearms. Guns also prevent injuries to good people and protect billions of dollars of property every year.
And while Dr. Corlin preached the gospel of gun control, the AMA's spin off organization, Doctors Against Handgun Injury, called for physicians to spy on their patients. This is a regrettable and ill-conceived effort, and a violation of the Oath and tradition of Hippocrates.
This policy constitutes a breach in medical ethics, a boundary violation in reference to abuse of the patient-doctor relationship, and an egregious invasion of privacy.
A boundary violation takes place when a physician breaches the patient's trust and uses his authority to advance a political agenda.
As Dr. Timothy Wheeler explained in an article in the Medical Sentinel, "A patient who seeks medical or psychiatric treatment is often in a uniquely dependent, anxious, vulnerable, and exploitable state.
"In seeking help, patients assume positions of relative powerlessness in which they expose their dignity, and reveal intimacies of body or mind, or both. Thus, compromised, the patient relies heavily on the physician to act only in the patient's interest and not the physician's."
From time immemorial, patient privacy and confidentiality have been ethical concepts that, up until now, were fundamental to all physicians and to the patient-doctor relationship.
The Oath of Hippocrates, in fact, states: "Whatever, in connection with my professional practice or not in connection with it, I may see or hear in the lives of men, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men at all times, but should I trespass and violate this oath, may the reverse be my lot."
For psychiatrists, who of necessity should be able to obtain very personal and confidential information for their patients' mental health evaluation and treatment, trust is paramount.
Understandably, psychiatrists have claimed a patient-doctor privilege similar to the attorney-client privilege that lawyers legally enjoy and which is a notch above what physicians now possess in patient-doctor confidentiality. This new policy makes a mockery of that claim.
With good reason this push by organized medicine has been received by patients with great concern and trepidation.
With this new incursion into gun politics by the medical profession, it's easy to see why patients may be more reluctant and less candid than ever with their physicians, which may, in turn, be detrimental to their medical care.
With good reason, patients may now perceive that their doctors, in asking them about guns in their homes, are acting more as an arm of the government prying into their personal lives than as their advocates in health care.
It will be easy to discern that physicians involved in this intrusion of privacy are placing the so-called good of society and the public relations goals of their professional organizations above their ethical obligation to their patients as required by the Oath of Hippocrates.
A Historic Precedent
In the momentous article "Medical Science Under Dictator-ship," Dr. Leo Alexander, the chief U.S. medical consultant at the Nuremberg War Crimes Trials, examined "the process by which the German medical profession became a willing and unquestioning collaborator with the Nazis." He noted the early changes in medical attitudes that predisposed German physicians to first collect data on their patients to conduct what today we call "cost-effective analysis," and then to use the latter information as a vehicle to commit medical genocide under the auspices of the totalitarianism of National Socialism.
Dr. Alexander warns us that "from small beginnings" the values of an entire society may be subverted, leading to the horrors of a police state.
The "small beginnings" in Nazi Germany that Dr. Alexander referred to first led the physicians to collect data from their patients and then violate their patients' privacy and medical record confidentiality by supplying the information to the state." (Full article with citations here).
I'm not a paranoid individual. But I do maintain a healthy distrust of government. You should too. For as Lord Acton said so eloquently, "Power corrupts. Absolute power corrupts absolutely."
Related reading: Americans discerning a chilling loss of rights.
Related reading: America in twilight.
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