mercredi 6 avril 2016

Doctors To Ask Patients About Guns, But Then What?

Doctors To Ask Patients About Guns, But Then What?

Guns line the walls of the firearms reference collection at the Washington Metropolitan Police Department in 2007. (Jacquelyn Martin/AP, File)

Guns line the walls of the firearms reference collection at the Washington Metropolitan Police Department in 2007. (Jacquelyn Martin/AP, File)

Every year, the Massachusetts Medical Society picks an important public health topic of the day and tries to figure out how to make a difference.

This year, it’s guns.

Dr. Georges Benjamin, director of the American Public Health Association, warned physicians to be ready for pushback.

“‘Cause you will be asked, ‘Why do doctors care about this?’ I’d love for you all to say: ‘It’s mine, because it hurts people or kills people, it’s a physician’s prerogative,’ ” he said.

According to the Centers for Disease Control, about 90 Americans are killed with guns every day.

Attorney General Maura Healey hopes to partner with the medical society to reduce gun deaths.

“Now’s the time for us to seize this and take it back and reframe this issue,” Healey said. “We can begin to treat gun violence as the public health crisis that it is.”

Healey and the medical society plan to craft uniform questions doctors would ask patients about guns. But, the answers may create new problems for doctors.

Their first step is urging more doctors to ask patients if there are guns in the home, if they’re locked and unloaded or if the patient feels threatened. (Many pediatricians already do this.)

Docs vs. Glocks

Healey slammed a Florida law — tied up in court and commonly referred to as Docs vs. Glocks — that limits when doctors can discuss guns with patients.

“Physicians ask patients about everything from use of seat belts to alcohol and drug use to vaccinations,” she said. “For God’s sake, you mean, physicians should be precluded from asking about the most lethal consumer product out there: a gun? That’s just wrong.”

Even if asking questions is the right thing to do, what happens if a patient’s answers raise concerns?

During the medical society’s forum on preventing gun violence, Dr. Chris Barsotti told the story of a patient brought to an emergency room after the patient’s dad called police.

“There’s a patient who had a high capacity weapon, and he had a fight with his dad,” he explained.

The patient’s medical record showed a history of risky behaviors.

“He’d been in fights. We also thought that maybe he abuses narcotics, because he’s been here a lot and had prescriptions filled in this state and that state,” he said.

But this was all confidential information. Barsotti could have ignored privacy rules and alerted police, but only if he thought the patient was an imminent risk to himself or others. Barsotti said he didn’t know how to decide: immediate danger, future danger, none at all?

“I have no guidelines,” he said. “I just know there’s this person who has a large gun that’s caused concern in the community, but I don’t know what I can do about it.”

Some doctors say Healey should press for legislation that would release doctors to disclose patient information more often in the spirit of public protection.

Gun rights advocates have a direct message for doctors who plan to take steps to remove their guns or even ask about them.

“Quite frankly, it’s none of your business.”

That was the response from Jim Wallace, director of the Gun Owner’s Action League of Massachusetts.

Wallace said his members may not tell doctors the truth, because they’d be worried about how information about guns might be used against them.

“People are already very cautious about discussing the Second Amendment and who they discuss it with, because it is so cherished by the American people,” Wallace said. “I think most people would agree that, the few minutes that I do get with a physician, I want to talk about what’s bothering me or what’s ailing me, I don’t want to have discussions about things that may or may not be in my house.”

Still, Massachusetts Medical Society President Dr. Dennis Dimitri said he sees room for compromise.

“Even those who want to have guns of their own, don’t want guns to be in the hands of people who are potentially dangerous. And on that particular issue, I think there’s a lot of agreement,” Dimitri said.

Wallace said he agrees and would meet with the medical society and Healey to discuss their plans.

It would help, he said, if more of the people making rules about firearms understood how they work, how they are used and what they mean to people who own guns.

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