"Really, I probably live in a world of 140 codes.” AAFP President Robert Wergin, M.D.…
Am I A Government Agent? by Pat Conrad MD
Based on the recent news, those of my cynical bent would be excused, and perhaps thrilled, to quickly attack Pres. Obama’s targeting of firearm possession by making all physicians “extenders” of his aims. So gleeful I would be to notch another “told ya!” regarding an autocratic power swipe, but…how does one take something that has already been freely given?
The administration’s initiative, per the AMNews, “encourages doctors to talk to patients about gun safety and warn law enforcement about threats of violence…Obama clarified that the Affordable Care Act does not prohibit doctors from discussing gun safety.” In due fairness, this seems less a new intrusion, than a free speech issue, since organized medicine has long since ceded their moral authority to their government masters. In 2001, then-AMA prez Richard Corlin said, “We as physicians and as the American Medical Association have an ethical and a moral responsibility to do what it is we can to stop this epidemic.” Dutifully, current AMA baron Jeremy A. Lazarus, MD, “said the clarification from the president on the issue “reinforces the importance of unfettered medical discussions about relevant health and safety risks.”” The heroes over at the AAFP have repeatedly published a policy since 1987 that specifically recognizes violence as a major public health concern; and since 1998 have pushed legislation that requires use of trigger locks and that requires storing firearms locked away and unloaded.
Pres. Obama is not taking anything that was already not, sadly, given. Herein, the larger question:
Public officials with ever-increasing zeal are finding new ways to get into affairs once thought private. New York’s Mayor Bloomberg, based only on the eternal statute of good intentions, sees trans-fats, salt, smoking, and Big Gulps as fair topics of inflicted compassion. Here in Florida, the do-gooders got rid of indoor smoking in private establishments (depriving me forever of the ability to enjoy a good cigar after a great steak dinner in my favorite Irish pub). Anytime a public official wants to enact a public good, he trots out a photo-op stage full of the white-coated and stern-faced who support the prevailing politics. Can doctors properly be public advocates? Certainly, but to what extent? We all supported hand washing even before the latest moronic MOC module, and none of us want our towns devastated by the next zombie virus, so public health is a good thing. But does it have any limits? Should doctors support public efforts to ban video games, in an effort to curb childhood obesity and pre-pubescent pre-frontal programmed affinity for violence? If a study correlates that later closing hours for bars correlate with casual sex known to be proximally causal to unwanted pregnancy and STD’s, should doctors advocate earlier closing times? What about those of us who like killing video zombies and having wee hours drunken trysts, and the business owners who sell us the means?
Or should physicians deal with these and myriad threats to health and happiness in a private, individualized way that both respects the integrity of the counselor and the autonomy of the individual patient? Put more bluntly, should doctors revisit the ancient art of minding their own damn business?
Physicians should be free to ask about anything and everything in the privacy of the exam room, based not on political pressures but on their own rational judgment. Patients should have the reassurance to expect their physicians to be operating in their interest and not as government agents. And if they don’t like the questions, they can walk.