Florida’s gag order on pediatricians blocked

This past spring, I wasn’t sure if I was looking through a fun house mirror when I read that Florida pediatricians were going to face criminal charges for bringing up the topic of gun safety in the office with patients. I couldn’t believe what I was reading.

The irony of the whole charade was the reasoning of those who brought about the bill. “Direct questions about firearm ownership when it has nothing to do with medical care is simply pushing a political agenda, which doesn’t belong in exam rooms,”  representative Jason Brodeur, one of the bill’s proponents,  recently said.

There is nothing so hard to stomach, to me, as reckless political spin. Regardless of your political leanings (and I hung a picture of George H.W. Bush on my bedroom door in eight grade), it was this outrageous NRA sponsored bill that injected politics into the exam room.

For years, pediatricians have asked questions about everything from sex and risky behavior to guns, smoking, and the social fabric of the home. Questions that may seem a bit too personal in other circumstances roll right off my tongue in the exam room. It doesn’t leave the room and it is not my job to judge. It is my job to offer counsel. If a teenager has made a mistake and engaged in drug use, we can talk about this. If a parent is smoking around a new baby, we can talk about this. If a child is riding a bike, we can talk about safety and helmets. And if there is a gun in the house, we can talk about the right and the wrong way to keep this stored, safely out of the hands of children.

This is not politics. I am the last person you will find pitching a ‘leftist agenda’ on people. This is about preventing accidents. It has absolutely nothing to do with my political stance on gun control.  While one person may be a very conscientious gun owner and may resent a pediatrician ‘nosing in,’ the next family may not be so careful and that friendly talk may prompt dad to go home and make some changes in how things are stored. It isn’t up to me to sort out who is who. It is my job to offer counsel at every opportunity.

Children are killed by guns on a daily basis. This is not up for debate. If a few people are offended but one parent thinks to lock a gun up and it prevents an accidental shooting, I can live with that.  But really, there is no reason to be offended. The only folks who get offended are the folks who want to be offended, who have their own political agenda. Most conscientious gun owners have no problem reviewing gun safety, because it is a serious subject and one that should be emphasized in front of children. It is a chance to teach, not to be outraged.

Luckily, sanity and the U.S. Constitution seem to be winning out over an Orwellian form of government intrusion into the doctor patient relationship. U.S. District Judge Marcia Cooke has just blocked enforcement of the new law, arguing that it impinges on the right to free speech. I was starting to wonder what was going on down there. Today I breathed a little sigh of relief.

Am I taking this too seriously? After all, I’m not actually anti-gun and I know plenty of folks who own a firearm.

I really don’t think so. I think what horrified me was the idea that there could be laws limiting what topics I am allowed to bring up in a confidential office visit, that criminal charges could be filed against me for discussing a safety issue. This particular topic doesn’t come up all that often in truth. How is this law any different from a tobacco lobby demanding a criminal gag order on doctors who bring up the topic of smoking?

It isn’t different at all. Gun ownership and tobacco use are both perfectly legal. Both can sometimes lead to death. Not everyone who smokes will develop lung cancer or heart disease.  Not every infant of a mother who smokes during pregnancy will die of SIDS. This doesn’t mean I can be gagged and my discussion of these risk factors in a doctor patient interview made criminal. The idea that I could not bring up smoking, could not ask about smoking, as a physician would be enough to make me quietly pack up and renounce my citizenship. The principle is exactly the same.

In America you have the right to be offended, if you want to waste your time being offended, by questions asked by a health care provider. Thankfully, I still have the right to ask those questions without worry of some McCarthy era inquisition coming down on me. Thank you Judge Cooke for reassuring me that I still live in America.

Matthew Toohey is a pediatrician who blogs at The Pediatrician Next Door.

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  • Anonymous

    This post is a little disingenuous. While I agree that trying to forbid a physician from asking essentially any question is wrong on both a medical and a first amendment basis you fail to note that the origination of this law was because a pediatrician in Ocala fired a patient when the patient’s mother declined to answer the question. While the pediatrician in question claimed that this indicated a lack of trust and therefore they could not have a good doctor-patient relationship I find it hard to believe that were a parent to decline to answer a question on another subject that this physician would respond the same way. Again, this law was a poor response but it was not nearly as simple as an unprovoked NRA attack on physicians.

    • Anonymous

      Patients can fire doctors for no reason, doctors can fire patients for no reason. Even if wrong, the Ocala doc was acting within his rights, and there was no need for a legal response to his actions. Nothing in the original post is disingenuous.

  • http://twitter.com/Dr_Toohey Matthew Toohey MD

    I fully expected to be accused of hyperbole but ‘disingenuous’ is a strong term to level and I take issue with it.
    My aim was not to deceive the reader but to express a genuine, visceral response to this issue. The original case is interesting: doctor fires patient who refuses to talk about guns. As southerndoc points out, this is perfectly within the doctor’s rights. The doctor had a sense the relationship was breaking down and advised the patient to seek care elsewhere. It happens all the time. Again, interesting but not really important.

    What is important is what happened afterward. Lawmakers showed a staggering lack of understanding of the basic constitutional rights of citizens, disrespect for the fabric of the doctor patient relationship, and a complete disregard for the slippery slope opened up by their bill. If the point wasn’t clear in my post, substitute cigarette or ‘tootsie roll’  or anything you want for gun, I don’t really care. I saw a government intrusion into preventative medicine bolstered by a national lobby with a political agenda of its own and was very disturbed. As scary as it is to me that sub-optimal people can rise to power and create legislation like this, it is reassuring that our system of checks and balances is still intact.

  • http://twitter.com/AustrianSchool_ Austrian School

    @bladedoc:disqus So what?  Physicians are not clerks at Anne Taylor Loft that patients (consumers) snap and we jump.  The doctor-patient relationship has two parties, both have to be willing.  If the doc is not willing that’s the end of it.  
    If the comment  “I am not willing to be your doctor” or “I am not willing to be your patient”  does not suffice, then we are dealing with serfdom, compulsion, slavery or whatever you want to call it.

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