If the argument is simply that you don't want to answer the doctor's questions about guns, and suspect that your doctor isn't really knowledgeable enough about guns, I have no quarrel with that. But I understood the argument to be that such questions should be prohibited by law, or by rules coercively enforced by professional licensing agencies, much as was suggested (and, in a weaker form, implemented) in the Florida statute. That is what I have been criticizing.
Eugene ________________________________ From: [email protected] [[email protected]] On Behalf Of Phil Lee [[email protected]] Sent: Saturday, January 19, 2013 11:09 AM To: [email protected] Subject: Re: Doctors asking patients about guns I'm thinking that you must not have understood the point I made about professional boundaries and ethical restrictions on them. To start your comment '“Boundary violation” assumes the conclusion that it’s proper for the government to set . . .' is completely off the mark. No one is talking about the law or government. We're talking about ethics and rules of conduct established for professional conduct. Your point 'there is no requirement of a license before offering people advice about guns' is true, but I may or may not buy that advice and would approach those I judge to be knowledgeable about guns if I choose to pay. Doctors I pay for their medical expertise and they are trained and licensed to treat medical conditions. The protection we have against medical malpractice starts with the doctor's appreciation of his limits. So, your family doctor may refer you to a specialist for treatment just because he realizes an illness needs someone with better knowledge than he has. A doctor advising outside of his training to a patient seeking treatment is negligent and, if the advice is outside of medicine, the doctor is practicing unprofessionally. The Hippocratic Oath contains a requirement of Primum non nocere as one more significant rule of medical ethics. The treatment offered by a doctor that is outside of his expertise violates this oath and that is not obviated by the fact that everyone is willing to offer an opinion on this subject. A doctor is not less limited in the exercise of speech by his professional standing, but more so. And the limits don't stem from government, but from ethical constraints of his profession. I would never be so churlish to tell a doctor to mind his own business if he were to ask me about guns, but I would ask questions about his training and certification on the subject, I would ask him how guns relate to the treatment my visit is for, and I would ask how his advice will be tailored to my circumstances. Finally, I would remind him that unless he were more knowledgeable than I was, his advice might cause me harm. Then, I would see what he had to say. Phil ________________________________ From: "Volokh, Eugene" <[email protected]> To: "[email protected]" <[email protected]> Sent: Saturday, January 19, 2013 12:47 AM Subject: RE: Doctors asking patients about guns “Boundary violation” assumes the conclusion that it’s proper for the government to set “boundaries” on this particular kind of speech. I don’t think that’s right. To be sure, professional licensing laws do limit the ability to offer particular kinds of advice, whether legal or medical, not on a “boundary violation” theory but simply on the theory that – to prevent serious legal or medical difficulties caused by bad advice – some advice should be left to professionals. But that is an exception to the general rule of free speech, and not the rule. And fortunately, for perfectly good reasons, there is no requirement of a license before offering people advice about guns; you don’t need to be a professional gun advisor to tell people what kinds of guns they should or shouldn’t buy, and how they should or shouldn’t store them. While neither a doctor nor a gun store owner nor a baseball player may give legal advice unless he’s also a lawyer, everyone is free to give everyone advice about guns. So I see no sufficient reason why a doctor (or an accountant or a lawyer) can’t give such advice. And in the absence of such a sufficiently strong reason, a restriction on speech that offers such advice – or asks about gun possession – seems to me to violate the First Amendment, which has no “boundary violation” exception. Eugene On Fri, Jan 18, 2013 at 8:34 PM, Phil Lee <[email protected]<mailto:[email protected]>> wrote: It seems you disagree with the professional boundaries set for medical professionals. Let me try to explain. Suppose an accountant started advising his clients on legal matters. In addition to a boundary violation the legal profession might view the matter darkly. You might understand that many professions have ethical codes that are intended to guide professional advice and set boundaries that are not ill-defined as much as broad. If you read my reference, you might see the boundaries for doctors are clear enough. As a lawyer, you clearly will understand that it is better to avoid a lawsuit for malpractice in the first place than try to defend one for professional misconduct. If I go to the doctor with the flu, whether I own guns or how they are stored isn't relevant to my treatment (nor is whether I use seat belts). But the doctor isn't "barred" from asking about my guns (or seat belt use) by a professional boundary. What he shouldn't be doing is advising outside of his professional expertise which is medicine (and offering advice where he lacks training). Phil ________________________________ From: "Volokh, Eugene" <[email protected]<mailto:[email protected]>> To: firearmsregprof <[email protected]<mailto:[email protected]>> Sent: Friday, January 18, 2013 7:22 PM Subject: RE: Doctors asking patients about guns I’m skeptical of talk of “boundary violation[s],” which is rather ill-defined term. It seems to me that if doctors want to ask patients about things that they think are relevant to the patient’s health, they should be entirely free to do so. To be sure, if they give the patient advice that is unreasonable and harmful to the patient, they could be liable for malpractice and for professional discipline. But I see no basis why doctors, lawyers, accountants, or anyone else should be barred from asking their patients questions. Eugene From: [email protected]<mailto:[email protected]> [mailto:[email protected]<mailto:[email protected]>] On Behalf Of Phil Lee Sent: Friday, January 18, 2013 4:13 PM To: firearmsregprof Subject: Doctors asking patients about guns 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: www.ethics.va.gov/docs/necrpts/NEC_Report_20030701_Ethical_Boundaries_Pt-Clinician_Relationship.pdf<http://www.ethics.va.gov/docs/necrpts/NEC_Report_20030701_Ethical_Boundaries_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 [email protected]<mailto:[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. _______________________________________________ To post, send message to [email protected]<mailto:[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. _______________________________________________ To post, send message to [email protected]<mailto:[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. _______________________________________________ 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.
