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WSJ - Dr. to Patient: Do You Have a Gun?

Mike

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http://www.wsj.com/articles/doctor-to-patient-do-you-have-a-gun-1470957519

SNIP

"Doctor to Patient: Do You Have a Gun?

I cannot understand how my asking this question will help."

By
Jerald Winakur

Aug. 11, 2016 7:18 p.m. ET

Of all the hundreds of questions I have asked patients over the years, there was one I never asked: Are any firearms kept in or around your home?

The Health and Public Policy Committee of the American College of Physicians has recommended that this question be added to the litany of queries doctors ask our patients during routine visits. Do you smoke? Do you practice protected sex? Have you had your flu vaccination? Are any firearms kept in or around your home?


By
Jerald Winakur

Aug. 11, 2016 7:18 p.m. ET

Of all the hundreds of questions I have asked patients over the years, there was one I never asked: Are any firearms kept in or around your home?

The Health and Public Policy Committee of the American College of Physicians has recommended that this question be added to the litany of queries doctors ask our patients during routine visits. Do you smoke? Do you practice protected sex? Have you had your flu vaccination? Are any firearms kept in or around your home?

From a public-health standpoint, adding this question to the medical history must seem logical to policy gurus far removed from the trenches of primary care. According to the American Foundation for Suicide Prevention, 60% of the 30,000 Americans who take their own lives every year do so with a firearm. Ninety die every day from shootings—60 are suicide, 30 are murders.

Yet as horrified as I am by these losses, I cannot understand how my asking this question will help. If a patient’s answer is “Yes,” then what I am to say?

Of course, the platitudes: Guns can be a danger around the home, especially one with children. Make sure you use gunlocks or a special safe. Everyone knows this; it’s akin to telling patients that smoking is hazardous to one’s health. And now that my patient has admitted that he owns a firearm, this fact is duly recorded into the—secure, of course!—electronic medical record.

If my patient suffers from mental illness or substance abuse but is not, in my estimation, a danger to himself or others, then what? Report the patient to someone, some agency? Who might that be? Will my patient be harmed more than helped? What will it do to my ongoing relationship with my patient?

. . .

I have had patients who died from firearm suicide, and their deaths will haunt me the rest of my life. I can ask: Are any firearms kept in and around your home?

But then what do I do if they answer: Yes?

------

Dr. Winakur is a clinical professor at the University of Texas Health Science Center at San Antonio. His book, “Human Voices Wake Us,” is forthcoming from Kent State University Press.
 

since9

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I wish Dr. Winakur had continued his investigation into the statistics surrounding death by firearms. If he had, he may very well have uncovered the Harvard study that concluded it doesn't matter whether guns are in the home or not, that those who wish to commit suicide will find a way, regardless. He might have realized firearms deaths are so far down on the totem pole of various diseases and conditions that it doesn't show up on most lists at all.

Perhaps then he would have realized that asking such questions is seen as rather intrusive by most of the more than half of all Americans who revere our Constitution and its Second Amendment, and that if asked to the tiny minority who are predisposed to any sort of mental condition like he mentioned, might be enough to nudge them over the edge.

Far better to simply treat all patients as normal people, as gun-owners are precisely that: Normal people.
 

color of law

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Black's Law Dictionary 4th Edition.
NORMAL. According to, constituting, or not deviating from an established norm, rule, or principle; conformed to a type, standard or regular form; performing the proper functions; regular; natural.
I think these doctors should be inquiring as to what religion their patients practice, even if they have ever petitioned the government for redress of grievances and more importantly if they have ever peaceably assembled.
 

solus

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Cite!! There is a distinct difference between killing a patient and not being able to save the patient.

For your consideration: http://www.medscape.com/viewarticle/863788
http://www.medscape.com/viewarticle/864492

http://www.medscape.com/viewarticle/862832

http://www.medscape.com/viewarticle/866063 physicians want recant of BJM study

http://www.medscape.com/viewarticle/863436

of course physicians are up in arms...this study could and probably will cost them in the pocket book not to mention the health insurance industry loosing hundreds of millions of dollars. when they fill out the death certificate, of course there is no block that states...I SCREWED UP, or a block stating: MEDICATION ERROR ad nauseam

for the record, physicians are not doing what is described in this medscape article: Should a Doctor Decide When a Patient Has Had Enough Care? http://www.medscape.com/viewarticle/861608#vp_4
 

utbagpiper

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And really, to correct and clarify. We kill animals. We murder people.
Who is this "we" you speak of? I don't murder anyone.

When one person causes the death of another, the term is homicide, not murder. Murder implies intent and lack of justification.

Self-defense is not murder; it is justifiable homicide.

Accidental deaths, with no intention to harm and no neglect, might well be classified as unintentional manslaughter.

Deaths caused by neglect might be negligent manslaughter.

To the topic at hand, one might do well to consider the differences between doctors who happen to commit "murder", doctors who engage in medical malpractice leading to the preventable death of another, doctors who make an unintended medical mistake that causes the preventable death of another, and doctors who are unable to preserve or extend the life of a patient.

In addition to these cases are those who die (or are harmed) due to no particular mistake of anyone, but simply due to the nature of modern medical treatment. Hospitals are great places to contract a so-called "super bug" that is highly resistant to antibiotics. Most all medicines have side effects and the susceptibility to side effects varies from person to person and is often impossible to predict.

Doctors "murder" very few persons in this nation. Medical malpractice is more common, but certainly rather rare. Unintended medical mistakes and being unable to save a given patient? Well, there is a reason they call it "Practicing Medicine." Only one person in recorded history ever got it perfect.

Charles
 

davidmcbeth

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<snip>

Doctors "murder" very few persons in this nation. Medical malpractice is more common, but certainly rather rare. Unintended medical mistakes and being unable to save a given patient? Well, there is a reason they call it "Practicing Medicine." Only one person in recorded history ever got it perfect.

Charles
Like accidental discharges? Points taken.
 

color of law

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42 U.S. Code § 300gg–17 - Ensuring the quality of care
(c) Protection of Second Amendment gun rights
(1) Wellness and prevention programs
A wellness and health promotion activity implemented under subsection (a)(1)(D) may not require the disclosure or collection of any information relating to—
(A) the presence or storage of a lawfully-possessed firearm or ammunition in the residence or on the property of an individual; or
(B) the lawful use, possession, or storage of a firearm or ammunition by an individual.
(2) Limitation on data collection
None of the authorities provided to the Secretary under the Patient Protection and Affordable Care Act or an amendment made by that Act shall be construed to authorize or may be used for the collection of any information relating to—
(A) the lawful ownership or possession of a firearm or ammunition;
(B) the lawful use of a firearm or ammunition; or
(C) the lawful storage of a firearm or ammunition.
(3) Limitation on databases or data banks
None of the authorities provided to the Secretary under the Patient Protection and Affordable Care Act or an amendment made by that Act shall be construed to authorize or may be used to maintain records of individual ownership or possession of a firearm or ammunition.
(4) Limitation on determination of premium rates or eligibility for health insurance
A premium rate may not be increased, health insurance coverage may not be denied, and a discount, rebate, or reward offered for participation in a wellness program may not be reduced or withheld under any health benefit plan issued pursuant to or in accordance with the Patient Protection and Affordable Care Act or an amendment made by that Act on the basis of, or on reliance upon—
(A) the lawful ownership or possession of a firearm or ammunition; or
(B) the lawful use or storage of a firearm or ammunition.
(5) Limitation on data collection requirements for individuals
No individual shall be required to disclose any information under any data collection activity authorized under the Patient Protection and Affordable Care Act or an amendment made by that Act relating to—
(A) the lawful ownership or possession of a firearm or ammunition; or
(B) the lawful use, possession, or storage of a firearm or ammunition.
Now what was your question doctor?
 

solus

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Who is this "we" you speak of? I don't murder anyone.

When one person causes the death of another, the term is homicide, not murder. Murder implies intent and lack of justification.

Self-defense is not murder; it is justifiable homicide.


Accidental deaths, with no intention to harm and no neglect, might well be classified as unintentional manslaughter.

Deaths caused by neglect might be negligent manslaughter.

Only one person in recorded history ever got it perfect.

Charles
black's law dictionary:

murder: The crime committed where a person of sound mind and discretion (that is, of sufficient age to form and execute a criminal design and not legally “insane”) kills any human creature in being...
1st degree ~ the term that describes the killing of a person that has been planned and carried out with malice.
2nd degree ~ term that is given to a killing of a person that was not premeditated but came from a desire to inflict harm.
3rd degree ~ this is the term that describes a murder committed while a felony is committed

homicide: The killing of any human creature.

justifiable ~ the term that is given to killing a person out of necessity, because of his duties and without blame.

manslaughter: In criminal law. The unlawful killing of another without malice, either express or implied; which may be either voluntarily, upon a sudden heat, or involuntarily, but in the commission of some unlawful act 1 Hale, P. C. 400 ; 4 Bl. Comm. 191. Manslaughter is the unlawful killing of a human creature without malice, either ex- press or implied, and without any mixture of deliberation whatever; which may be vol- untary, upon a sudden heat of passion, or involuntary, in the commission of an unlawful act, or a lawful act without due caution and circumspection. Code Ga. 1S82.

involuntary ~ the term that is given to the unintentional killing of a person during the committing of an unlawful act.


voluntary ~ the term given to the killing of a person that is associated with a fit of anger seemingly for a good reason. It is intentional but not planned.


mate is it possible in the future to allow readers the opportunity where we at least have endure your epistle after you have used the appropriately defined terms as defined throughout the land?

so mate, could you provide further insight on which person got it right?
Elijah the prophet?
Elisha ?
Elisha's bones?
Jesus?
Jesus?
Peter?
Paul?

ipse
 
Last edited:

utbagpiper

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Like accidental discharges? Points taken.
Not much like that at all. There are very few "accidental discharges"; most are negligent discharges.

The operation of a gun is so simple that almost anyone can learn to do so safely and effectively. Guns a purely mechanical devices, with no free will an almost zero variation in operation across specimens of the same make and model.

You might contrast this with the vast hours required to obtain any specialty in medicine, the fact that patients are human beings with free will who are probably going to lie (or otherwise provide inaccurate information) about their behavior and symptoms, who will mix alcohol and their prescription drugs regardless of warnings to the contrary, and who are biological systems with potentially vast differences in metabolic rate, sensitivity to various stimuli, etc.

Very few members of society have the necessary combination of brainpower (memorize all 270 bones, 64 muscles, the symptoms of hundreds of different diseases, the primary and side effects and dosage information for dozens of commonly used drugs, etc, etc, etc), manual dexterity (from properly using an otoscope or removing an obstruction from an airway to basic sutures to operating on a live human heart), physical endurance, strong stomach (nobody wants his doctor puking when he sees the compound fracture), motivation/drive necessary to become a medical doctor. Most doctors were serious about education at least as early as high school where they learned good study habits and got good grades while many of their peers were out partying. Pre-med is no cake walk, medical school is rough with gross anatomy being a killer, internships and residency are mostly unimaginable for those who have not gone through it or had a close associate go through it. Almost anyone can safely handle a gun. Almost nobody can actually become a medical doctor.

It is one thing to be critical of the politics of the AMA or to dislike how insurance or other aspects of medical care function. (A lot of doctors would share your views there.)

It is quite another to be dismissive of the tremendous complexity that is the practice of modern medicine.

Charles
 

davidmcbeth

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The statistics I've both heard and read from several sources cite mistakes made by doctors, not all deaths while under the care of a doctor.
They don't mean to kill .... but I assume when they do that they still get paid for their work. What would that make those doctors?
 
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