Time to Shoot Down the NRA

The NRA reveres the Second Amendment (well, their version, at least). The First, not so much.

In the wake of daily reports of gun violence–the most recent of which include the massacres in Orlando and Dallas, and the murder of two bailiffs in a Michigan courtroom and none of which were prevented by a “good guy with a gun”–it may be appropriate to look at the extent to which the organization has stymied even reasonable legislative efforts to understand the dimensions of the problem.

Thanks to the NRA, Congress has steadfastly refused to fund research that might help us understand how we might tackle gun injuries and improve public safety. But the NRA isn’t active only at the federal level, and it isn’t just worried about research.

As I learned from Mort Tavel’s blog,

As a physician, I had always prided myself on being free to advise patients about all health issues, including risks that could endanger their personal well-being and that of their families and loved ones. This meant that I could inquire not only about immediate risks such as smoking and diet, but, among others, about whether a patient was using his/her seat belt when driving, or exposing family members to the toxic effects of secondary cigarette smoke in the home. I was also free to inquire whether a given patient had a firearm at home, because of the potential dangers involved. In that regard, evidence shows that the presence of a gun in a home increases by threefold the risk of death for all household members, especially by suicide, when compared with homes free of guns. Even worse, this risk rises to fivefold greater for children residing in homes possessing firearms. Thus these dangers are so great that it is incumbent on physicians to counsel patients about risks of home firearms and to recommend countermeasures, which include use of safety devices and meticulous storage of weapons, or better yet, total removal of guns from the household. This is so important that all major physicians’ organizations, including the AMA, have recommended that physicians discuss firearm safety with their patients.

So can such responsibilities be forbidden? Outrageously, Florida’s Firearm Owners’ Privacy Act was enacted in 2011 in response to concerns raised by some patients whose physicians asked them about gun ownership. The law prohibits physicians from intentionally entering information into a patient’s record about firearm ownership that “is not relevant to the patient’s medical care or safety, or the safety of others.” Thus physicians may not ask about firearm ownership unless they believe “in good faith” that “such information is relevant to the patient’s medical care or safety, or the safety of others.” Physicians who violate this law may be “disciplined” (whatever that means).

A physicians’ group sued Florida, on the very reasonable grounds that the law violates doctors’ First Amendment free speech rights. However, a 3-judge panel of the Florida Court of Appeals upheld the Act, on the dubious grounds “that physician counseling may be so persuasive as to deter patients from exercising their Second Amendment right to own guns.”

To say that such a decision is bizarre and totally inconsistent with First Amendment jurisprudence is an understatement.

Worse, last year, the Eleventh Circuit Court of Appeals upheld the decision.

This, the court acknowledges, is a restriction on doctors’ speech. But, the court concludes, when a professional (lawyer, doctor, financial planner, and the like) is directly advising a client — as opposed to, say, opining on law or medicine on a blog — that professional-client speech is more restrictable.

The Volokh Conspiracy is a legal blog maintained by Eugene Volokh, a conservative law professor who is a strong defender of both the First and Second Amendments. Volokh has serious concerns about the Eleventh Circuit’s reasoning.

This selective targeting of questions about guns — when other, likely quite common, questions about private matters aren’t restricted — suggests that this law isn’t really about protecting privacy as such. Rather, it’s about preventing doctors from spreading what many gun rights supporters see as unsound anti-gun propaganda.

The First Amendment forbids government suppression of speech based upon its content. This is a very troubling deviation from settled constitutional principles.

Missouri and Montana have laws similar to Florida’s; all supported by the NRA.

For far too long, elected officials at all levels–and evidently, a number of judges– have been in thrall to the NRA, an organization devoted to the bottom-line health of gun manufacturers, not fidelity to the Second Amendment or–quite clearly– any other part of the Constitution.

It needs to stop.

19 Comments

  1. I believe the Hippocratic Oath begins with, “First, do no harm.” I am 79 years old and every time I have a doctor appointment for a general checkup, one of the first questions I am asked is, “Do you smoke.” A cigarette is not a lethal weapon but can and does endanger lives…of the smoker and those around them. By the way; I stopped smoking 18 years ago, still miss it but have no intention of starting again. I am also asked about taking my medications, my exercise ability and my eating habits. All of which is personal information. I had a handgun and permit to carry years ago for self-protection. When I no longer needed that protection, I sold my handgun and have no intention of buying another. Not even with the “High Noon” and “Gunfight At The OK Corral” dangers that surround me everywhere, every day and night. Not even with the almost daily killing reports on the morning news.

    This denial regarding doctors questioning gun ownership remind me of Sarah Palin’s “death squad” analysis of a very helpful section of the original ACA bill. Her ability to force removal of this vital section of medical care managed to be believed by many elderly and ailing patients who need that section to discuss their wishes for their right to be kept alive by machines or with feeding tubes or “die with dignity” in certain drastic health situations. They were scared off by her nonsense and Congress removed that section of the bill satisfying a gun-toting, drinking, national embarrassment.

    The patients have the right to simply state they prefer not to answer the question regarding gun ownership…another protected freedom of speech.

    I have heard for years, “We cannot legislate common sense.” Evidently we do need to be allowed to do just that today; not legislating common sense gun control reform has caused thousands of death and they continue escalating. Watch your news; local and national.

  2. Thank you so much for this piece since it is spot on as usual.

    When I was a kid I was in the NRA’s Young Shooter’s Program, which was aimed at teaching teens marksmanship but, most importantly, firearms safety and with a very heavy emphasis on the latter. My training instructor was my Dad, an IPD homicide detective and crack marksman himself. I would get my “bulls eye” targets in the mail and be graded on my accuracy and my adherence to safety. I have great memories of going to rifle ranges with my Dad and honing my marksmanship skills. The materials on firearms safety that the NRA provided were great as I remember.

    I wonder if that program even exists today and even if it does it is so overshadowed by the NRA’s abject craziness at the top of the organization largely centered on their chief maniac, Wayne LaPierre. It’s high time that the hijacking of this once great organization at its highest levels comes to an end. It needs to return to its roots, something that most of its members want anyway, and LaPierre, and the others of his ilk, ride off into the sunset for the good of everyone.

  3. …but it’s OK in some places for a pharmacist to deny a patient access to medications the pharmacist doesn’t believe in even if the patient has a clear legal right to the drug. Piece by piece we’re losing the Constitution it seems.

  4. There is not a city in this land, one nation-state’s worth of properties, that has solved or can do intellectual chores talking about fighting humans with guns or drugs, poisons or platitudes — all legally dealt with by those of 21 years or more life experiences as individuals. Who respects Sunday School teachers or clerks at supermarkets, anyone at all who would be scaring people with talk about “fights” and “wars” instead of tasks to be done on agendas. Maybe some moral support for the few State delegates to DC would help them get that split Court at least with a full complement for reading letters and writing opinions about their nation-state as up-to-date with UN human rights and protection responsibilities for humans. We are the only humans at Earth, one habitat, and all the DNA that is vital, from all our ancestors within each of us. If there is a get on with it gene , folks, it is going to be an efficiency one for those 50 working years after graduations, marked with reunion reminders.

  5. It is beyond outrageous that the NRA has the power to dictate what doctors discuss with their patients. How on earth is this legal? But how do we turn it around? If Sandy Hook didn’t change things, I don’t know what will. It’s very depressing.

  6. It is also noteworthy that Republicans in Congress have prohibited the CDC from using federal funds for research into the effects of gun ownership since a 1993 study that showed the incidence of injury due to the presence of guns in a home. The NRA would rather the truth about guns never be told.

  7. I will have surgery this Friday. Three weeks ago at the preliminary exam I was asked, “do you feel safe in your home?” I’m 85, married 63 year to a lovely, non-violent person. I answered in the affirmative, puzzled at the reason for the question. Then the light came on. Abuse. The question may be required now, I don’t know. But no question or advice about firearms. Hmm

  8. It is required now Wayne. I was asked a similar question when I visited the ER a few years ago. Sad isn’t it?

  9. We have plenty of evidence that society can bring about revolutionary and even impossible changes when society focuses on a purpose.
    I have faith that one of you sharp people will start a movement leading to a constitutional amendment if not a convention. The NRA would have you believe that the Constitution is sacred; cannot be changed. Take up the challenge !!

  10. http://www.politifact.com/punditfact/statements/2015/aug/27/nicholas-kristof/more-americans-killed-guns-1968-all-wars-says-colu/

    “More Americans have died from guns in the United States since 1968 than on battlefields of all the wars in American history.”
    Deaths from warfare since 1776 > 1,396,733.
    Deaths caused by firearms in the USA since 1968 > TOTAL, 1968-2015 = 1,516,863.

    It is important note this figure 1,516,863 is not all homicides or murder.
    Homicides represent a minority of gun deaths, with suicides comprising the biggest share. In 2013, according to CDC data, 63 percent of gun-related deaths were from suicides, 33 percent were from homicides.
    ================================================================

    What is the answer or answers???? Are any politically feasible????

  11. The part of the equation that really rankles my soul is that the NRA is an advertising agency hired by the gun industry to sell killing machinery. Not a very high purpose but they have we the people and our government acting like trained monkeys. To me it’s another bizarre situation where we are so easily distracted by entertainment on pervasive media that we completely forget about what’s important and chase squirrels.

    I would have thought that the average us would have turned out much more capable but the evidence keeps coming back that we’re on the average rubes at the county fair ready for plucking.

    It’s very discouraging and points out how intractable are the problems that President Clinton II will inherit. She’s going to wish that she didn’t run so hard.

    What’s the future for a democracy of lemmings?

    If those statistics quoted above aren’t compelling enough to sound the alarm over the pitch of a carnival barker I don’t know what will.

  12. In Griswold v. Connecticut which was a predecessor to Roe v. Wade, lower courts ruled a Connecticut physician was in violation of a state law which banned not only contraception but a doctor’s right to advise patients on contraception. Ultimately the Supreme Court over-ruled the state statute and protected the right of privacy to acquire and give information on contraception.

    The right to acquire, give and receive information is foundational to this country’s formation and continuation. Free speech is part of what the 2nd amendment is supposed to protect.

  13. Thinking about the physicians who’d like to speak about firearms in their patients’ homes, especially pediatricians whose patients are children, I’d suggest that patients and/or parents of patients might be skittish about answering a ‘yes/no’ question while the doctor checks off a block on the patient’s medical history form which ultimately is entered into an electronic database.

    There’s more than one way to skin a cat. Most people are amenable to chatting with their physicians, simply an informal friendly conversation near the close of the examination. Rather than the doctor asking a closed-end/yes or no question while holding a checklist, why not use something to the effect of “Oh, by the way, I don’t know about you, but I’m really bothered about the number of our kiddos who have access to guns in their homes.” Opening a conversation rather than asking point blank questions works far better with most people. After the conversation is started, then listen to potential patient concerns, share thoughts and maybe a brochure about guns in the home. If the doctor truly wants to educate his patients about the danger of guns in the home, chatting is better than a cold clinical yes/no question recorded on a checklist soon to be entered into an electronic database.

  14. The law is unenforcable, no medical licensing board in the country would ‘discipline’ a doctor for promoting safety. And couldn’t any doctor claim the ‘good faith’ exemption?

    This is an obvious example of a badly conceived, badly written law designed to encourage government SLAPP suits. Malpractice insurance should cover these, but the insurance companies are notorious for throwing doctors under the bus when it suits them.

  15. Our Dr gets paid by Medicare to conduct a once per year “wellness” visit which covers many safety issues most of which are important to be researched and addressed are needed but quite unlikely for us. I think though that it’s a great idea to have the Dr try to influence where they might apply.

    What better example than guns in the house?

    People should be advised that there are all kinds of best practices to be followed in order to reduce the risk of guns. What’s the point in stressing bicycle safety for instance if there’s a loaded pistol in the night stand?

  16. Indiana may be about to lose Pence (Yea!) but not exactly in the way that Hoosiers thought (Horrors!). Another commenter said Pence should just lose his governorship in November and go home. Great idea for Hoosiers and the good ol’ USA.

  17. I have a right to eat pizza. My doctor tells me I shouldn’t eat pizza. I had no idea he was violating my rights!

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