My plumber offered to perform my vasectomy because "pipes are pipes."
Professional boundaries (weak as they be for litigation purposes) exist to grant some level of assurance about quality of service. As JK and others note, investigating areas outsides of one's expertise leads to a conflict between a trusted provider and their ability to provide. This issue was hot a while back in Florida (I even got air time on Thom Hartmann's Big Picture program). The issue there was that doctors were being coached on asking the question and _recording_ the answers. Though I did not hear Obama call for the latter, it begs the question about the usefulness of the former. Joyce Foundation (IIRC) had once funded a drive to get doctors to instruct patients on the danger of firearms (part of their broader effort to leverage the trust people have in doctors, and hence their generous funding of medical schools to perform criminology). Again, not proof of intent, but since Obama was on Joyce's BOD for eight years, it gives reason to speculation. Phrased differently, "What possible good is Obama attempting to achieve by suggesting doctors interrogate their patients on anything aside from medical issues?" <http://www.guysmith.org> Guy Smith Author, <http://www.amazon.com/gp/product/0983240701/ref=as_li_qf_sp_asin_il_tl?ie=U TF8&camp=1789&creative=9325&creativeASIN=0983240701&linkCode=as2&tag=frethim ed-20> Shooting The Bull and <http://www.gunfacts.info/> Gun Facts > -----Original Message----- > From: [email protected] [mailto:firearmsregprof- > [email protected]] On Behalf Of j k > Sent: Friday, January 18, 2013 4:33 PM > To: Phil Lee > Cc: firearmsregprof > Subject: Re: Doctors asking patients about guns > > It is not horribly unfair. Certification bodies in medicine try to rate > hosipitals/physicians etc by a bunch of quality measures and see how much > the doctors etc are complying with these... > > > Perhaps arbitrary, but, in the umbrella of lifestyle coaching for safety, certain > large hospitals in LA ask every patient "do you use seatbelts" and then coach > them to wear seatbelts if they do not. It is an easy metric by which one can > see "improvement" of doctoring. > > > In a country where 1/2 the people have guns, asking "Do you own firearms" is > okish if it is a lead in to "and do you store them properly." > > Also for many diseases, the disease or treatment might mean that counseling > for "and have you considered a custodian for your firearms during this time" > is reasonable. There are many age related illnesses for which this is very > important. > > > On the other hand, generically leading into "and have you thought about > getting rid of them for safety" is not great. Nor is a arbitrary invasion into > privacy. > > > Honestly, I have a hard time gauging the intent of the President's point other > than: > -physician learns of a possible risk > -physician trys now to make an assessment of the mental health of the > patient This seems the intended purpose and it also seems a bit of a witch > hunt. > > > > > On Fri, Jan 18, 2013 at 4:12 PM, Phil Lee < <mailto:[email protected]> [email protected]> > wrote: > > President Obama suggested the other day as part of his "gun safety" > > initiative that it was appropriate for physicians to ask about their > > patients' guns. > > > > Doctors who advise outside of their area of expertise have committed a > > professional boundary violation. > > > > The link: > > > <http://www.ethics.va.gov/docs/necrpts/NEC_Report_20030701_Ethical_Boundarie s_> www.ethics.va.gov/docs/necrpts/NEC_Report_20030701_Ethical_Boundaries <http://www.ethics.va.gov/docs/necrpts/NEC_Report_20030701_Ethical_Boundarie s_> > _ > > Pt-Clinician_Relationship.pdf , "Ethical Boundaries in the > > Patient-Clinician Relationship," National Center for Ethics in Health > > Care, July 2003, defines "for physicians: Professionalism is the basis > > of medicine's contract with society. It demands placing the interests > > of patients above those of the physician, setting and maintaining > > standards of competence and integrity, and providing expert advice to > > society on matters of health." > > > > So, if a physician asks about guns in the home of a patient, it may be > > argued that question has little to do with the patient's health unless > > he observes a condition such as mental disturbance that justifies such > > a question for a particular patient. Even if there were a circumstance > > with a patient justifying the question, doctors advising on guns may > > be questioned about their training ("standards of competence") to do > > so. It is rare that a physician has been medically certified to advise > > about gun safety and rarer still that a physician studies the perils a > > patient may face (i.e. crime in his neighborhood). Unless a physician > > undertakes a study leading to his certification and unless he studied > > the patients unique circumstances, in advising he would not have limited > himself as a professional should do. > > According to the linked document "A boundary violation occurs when a > > health care professional's behavior goes beyond appropriate professional > limits." > > > > Phil > > > > _______________________________________________ > > To post, send message to <mailto:[email protected]> [email protected] To subscribe, > > unsubscribe, change options, or get password, see > > <http://lists.ucla.edu/cgi-bin/mailman/listinfo/firearmsregprof> http://lists.ucla.edu/cgi-bin/mailman/listinfo/firearmsregprof > > > > Please note that messages sent to this large list cannot be viewed as > > private. Anyone can subscribe to the list and read messages that are > > posted; people can read the Web archives; and list members can > > (rightly or > > wrongly) forward the messages to others. > _______________________________________________ > To post, send message to <mailto:[email protected]> [email protected] To subscribe, > unsubscribe, change options, or get password, see <http://lists.ucla.edu/cgi-bin/mailman/listinfo/firearmsregprof> http://lists.ucla.edu/cgi- <http://lists.ucla.edu/cgi-bin/mailman/listinfo/firearmsregprof> > bin/mailman/listinfo/firearmsregprof > > Please note that messages sent to this large list cannot be viewed as private. > Anyone can subscribe to the list and read messages that are posted; people > can read the Web archives; and list members can (rightly or wrongly) forward > the messages to others.
_______________________________________________ To post, send message to [email protected] To subscribe, unsubscribe, change options, or get password, see http://lists.ucla.edu/cgi-bin/mailman/listinfo/firearmsregprof Please note that messages sent to this large list cannot be viewed as private. Anyone can subscribe to the list and read messages that are posted; people can read the Web archives; and list members can (rightly or wrongly) forward the messages to others.
