Doctors come together to address gun violence as public health issue
June 20, 2018
Coalition of public health agencies, including UW Medicine's Harborview Injury Prevention & Research Center, issue statement to the media.
Leaders of 10 public health agencies and professional group announced plans to do more to prevent gun-related injuries and deaths, including asking patients whether they own guns and screening them for risk of using a gun in suicide.
"As healthcare providers, we recognize firearm-related injury and death as a public health epidemic," they said.
Their statement was released at a press conference covered by KNKX and KIRO radio.
In Washington, 682 people died of gunshot wounds in 2016. Suicides accounted for three-quarters of all gun deaths in the state
The coalition called for more local and statewide research that could help identify those at risk of gun violence and evaluate the effectiveness of policies designed to prevent it. And the coalition recommended that medical professionals respect the beliefs of lawful gun owners.
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Your Washington Doctor May Soon Ask If You Own A Gun
Washington doctors say they plan to do more to prevent gun-related injuries and deaths, including asking patients whether they own guns and screening them for risk of using a gun in suicide.
Leaders of 10 public health agencies and professional groups, including the Washington State Medical Association and the Washington State Nurses Association, announced the effort in a statement Tuesday.
"As healthcare providers, we recognize firearm-related injury and death as a public health epidemic," the statement said.
Dr. Jeff Duchin, health officer for Seattle and King County's public health agency, said the coalition plans to release guidelines to doctors on how to screen patients for risk of gun-related death and talk to them about it.
"The mass shootings, the increase in suicides has re-energized a lot of the community, the public health community and the medical community, to say, 'We need to do better,'" Duchin said.
In Washington, 682 people died of gunshot wounds in 2016. Suicides
account for three-quarters of all gun deaths in the state.
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Boundary Violation
Boundary Violation: Gun Politics in the Doctor’s Office
Imagine this scenario: you visit your doctor for back pain. Your doctor asks if you have firearms in your home. Then he announces that your family would be better off (especially your children) if you had no guns at all in your house. You leave the doctor’s office feeling uneasy, wondering what guns have to do with your backache. Does your doctor care about your family’s safety?
Or instead, did he use your trust and his authority to advance a political agenda?
American families may soon find themselves in this scenario. Social activists are taking their war on gun ownership to a new battleground: the doctor’s office.(1)
The American Medical Association (AMA)(2),
American Academy of Pediatrics (AAP)(3), and
American College of Physicians (ACP)(4) are urging doctors to probe their patients about guns in their homes. They profess concern for patient safety. But their ulterior motive is a political prejudice against guns and gun owners.
And that places their interventions into the area of unethical physician conduct called boundary violations.
Doctor-patient sex is the most well-known and sensational example of a boundary violation. More recent literature recognizes a wide variety of non-sexual violations.(5) These cover such issues as finances, confidentiality, and gratification of the doctor’s needs. Although boundary violations were first addressed in the psychiatry literature, it has become clear that they also occur in general medical practice.(6)
Boundaries in the doctor-patient relationship derive naturally from the relationship’s fiduciary nature. In general, “treatment boundaries can be defined as the set of rules that establishes the professional relationship as separate from other relationships and protects the patient from harm. 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 weaknesses, compromise their dignity, and reveal intimacies of body or mind, or both.”(7)
Thus compromised, the patient relies heavily on the physician to act only in the patient’s interest and not the physician’s.
A doctor must put the patient’s needs before his own. But a physician reverses the priorities when because of passionate political beliefs he tries to influence his patient against guns. This physician puts his own need to “do something” about the perceived evil of guns before the needs of his patient. He crosses the line from healer to political activist.
Such doctor-on-patient political activism is recognized in Epstein and Simon’s Exploitation Index(8) as a boundary violation.
Just as some physician sexual transgressors may insist their sex relations with a patient are therapeutic, the activist doctor may protest that he only seeks to prevent “gun violence.” However, the conduct of the medical activists strongly indicates that their interest in patients’ guns is political, not therapeutic.
The AAP, ACP, and AMA are members of the Handgun Epidemic Lowering Plan (HELP) Network, based in Chicago. HELP is an exclusive advocacy group dedicated to banning guns. Physicians who disagree with HELP’s anti-gun agenda are barred from attending HELP’s conferences, a policy unthinkable in any scientific organization. HELP’s founder and leader Dr. Katherine Christoffel has compared guns to viruses that must be eradicated.(9) The group’s militant advocacy has no place for differing viewpoints on firearms, and apparently neither do the medical organizations which have signed on as HELP members.
