Florida MD restrictions overturned.

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If so, so what? Isn't that the (1A) right of the AMA?
Absolutely. That is why I opened with "Ignoring for a moment the potential 1A issues... "

My point was in response to the many people here whose doctors are not anti. I was just pointing out that as a profession, it isn't necessarily so.

No question the AMA can advocate a political position. I think it's an ignorant, but they have the right to be.
 
Doctors and guns do not mix. Doctors have no business asking about guns in the home because it is none of their business.
Back in Sept of 2010, Tom Gresham on his radio show GunTalk, interviewed Doctor Tim Wheeler, of Doctors for Responsible Gun Ownership, about the subject of Doctors asking about gun ownership. It can be a very serious "Boundary violation". This is a violation of medical ethics, which trump Doctors 1st Amendments rights.
I strongly urge people who are interested in this subject to listen to Tom Gresham's podcast on the subject, the first part of segment C of his September 26, 2010 broadcast. Link below.

guntalk.libsyn.com/2010/09

For some interesting reading, if you have the time, type "Medical boundary violation gun questions by doctors" into Google search. Hear are links to three that I thought important.
http://www.claremont.org/projects/projectid.39/project_detail.asp
http://www.haciendapub.com/wheeler1.html
http://www.haciendapub.com/article14.html

It is not just about 1st Amendment, It is about medical ethics.

Supposedly inviolate medical records seem to get put into the public record all the time, if the politics are right, especially in Florida.
In my opinion, the Law was good, because it discouraged medical boundary violations. In other words, it protected both patients and doctors.

Doctors have 1st Amendment Free Speech rights, but not at the expense of their patients.
 
Boundary violation? No.

It can be a very serious "Boundary violation".
The use of the term "boundary violation" by Wheeler is disingenuous. Boundary violation has a very specific meaning in the doctor-patient relationship (mostly in psychiatry, but it spills over), and this ain't it. Wheeler's idiosyncratic redefinition of "boundary violation" misappropriates the term and hurts his argument. (Except among those who like jargon-esque slogans: "Yeah, boundary violation! That's it! That's the ticket!")

As to the notion that doctors shouldn't ask about guns? Well there are folks that disagree with you. Those folks seem to be on the level of (for example) the American Academy of Pediatrics, the AMA, the American College of Emergency Physicians and the University of Michigan Medical School.

These are PRECISELY the types of bodies that influence and decide what the professional standards are, so that any claim (by Wheeler or anyone else) that gun inquiries are inconsistent with "professional boundaries" is patently untrue. Similarly, saying that docs have no business in "preventive medicine" or "injury prevention"--especially for kids--is simply refusing to see where medical reality is today, and where it's going to stay.

And whether docs should or shouldn't ask a question or give "advice" on injury prevention is, importantly, besides the point. The point is, if they do, that's 1A-protected speech.
 
Your Doc doesn't work for the government?
Of course he does.

Think about how much power your doc has over you.
He doesn't think your eyesight is good enough for you to drive, Bang your D/L is gone.
Heard of the Baker Act?
Your kid has too many bruises than he thinks he should, Hi this is the CPS officer.

AFS

You're just restating "he has a duty he takes seriously to safeguard your well-being and the well-being of others" in a paranoid, demonstrably false way as "he works for the government."

I would try to get a blind person off the road, and I would call CPS in a minute if I had reason to suspect someone was abusing his kids. My duty to the driver, his fellow drivers, the kids, and the lawful order of our nation would compel me to do this, not employment by the government.

Since when do you have to work for the government to do the right thing?
 
Boundaries? How far?

What happens when, in the face of growing patient claims of over-reaching, infringements upon privacy, and discriminatory practice, not to mention the ramifications of that information in a criminal context (criminal safe-storage laws), doctors are wholly unresponsive to such concerns and believe their 'boundaries', i.e., medical relevance and medically-relevant inquiry, remain unlimited?

Nothing, apparently .... That is, nothing, until the legislature acts to define some 'boundaries' for them, on behalf of the People. Hence, the Florida legislation.

"And whether docs should or shouldn't ask a question or give "advice" on injury prevention is, importantly, besides the point. The point is, if they do, that's 1A-protected speech."

That's a superficial, and plainly conclusory, view of 1st Amendment law. There's ample Constitutional authority for legislatures to regulate speech in the so-called professions, particularly where there is a professional purporting to advise, and act on behalf of his client. This includes forcing a professional to speak (e.g., disclaimers regarding private/privileged information), as well as restricting the professional's speech, in that special relationship.

That people here continue to argue 1A law as though Florida seeks to prevent two regular folks from having this discussion on the sidewalk (public forum, political speech, prior restraint), is laughable.
 
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This is solely about politics in the AMA. There is a part of the AMA that ius very liberal and very anti-gun.

Personally, I think if doctors want to dispense forearms advice as part of their medical practice, I think they should be required by state law to become competent in that area first. Perhaps as evidenced by becoming a certified firearms instructor.

I think this is something that is almost certainly going to come back and bite all doctors in the backside.

This isn't about doctors giving "firearms advice" without being competent on firearms, it's about paranoia that doctors will somehow betray the fact that their patients own firearms to the Government of Paranoid Delusions, which will then take them away.

And for this paranoid fantasy, they propose that doctors should be deprived of their first amendment rights.
 
art likes that answer

and so do I, The Nazis in Illinois ,liberty and justice for all......even Nazis :cuss:....before I saw the history of skokie Nazi rallies lawsuits, I had no idea why Illinois was so anti gun it all makes sense now....Nazis want your gun rights....In my 1895 Montgomery wards catalogue there's a small note besides the colt new army 1892 model..to buy It states that :any resident of Illinois shall send in a affidavit with 2 witnesses,Illinois residents only"..looks like Nazis have been in Illinois a long time..
 
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That's a superficial, and plainly conclusory, view of 1st Amendment law.
I'm not sure...but I think that's fancy-speak for that's your opinion, and I think you're wrong.

I think I'm right.
There's ample Constitutional authority for legislatures to regulate speech in the so-called professions
Talk about superficial. Show us the authority to legislate which opinions a professional is "allowed" to hold and voice; or limiting his ability to ask for information from his cllient, in order to advise him better.
as though Florida seeks to prevent two regular folks from having this discussion on the sidewalk (public forum, political speech, prior restraint), is laughable.
Well, we sort of agree here (although I hesitate, for purposes of politeness, to ever categorize another's position as laughable. Of course, politeness need not be everyone's concern.)

How I agree is that I think a doctor-patient conversation is deserving of far more protection than two regular folks from having this discussion on a sidewalk. Besides the lack of expectation of privacy on a sidewalk, there is the protected status of doctor-patient conversations; similar to lawyer-client, priest-penitent and husband-wife (oops; I guess it's spouse-spouse these days) conversations.

Please specify the governmental regs that should be active in these conversations, and how they should be enforced--and how any of that would be similar to doctors asking about or talking about firearms with their patients.

I can certainly understand legislators (or some lawyers) wanting to extend their power into controlling the protected speech between doctor and patient. I suspect they'd want to control everything.

What is harder for me to understand why those who say they believe in 1A would agree.
 
What happens when, in the face of growing patient claims of over-reaching, infringements upon privacy, and discriminatory practice, not to mention the ramifications of that information in a criminal context (felony safe-storage laws), doctors are wholly unresponsive to such concerns
Sue them for malpractice. Sue them all.

There is a famous 1974 Washington malpractice case, Helling v. Carey. It was decided that the doctor had acted within the standard of care of his profession, but the entire profession was negligent in having adopted the wrong standard of care (after the "Learned Hand calculus" used in the T.J. Hooper case).

So sue them. Don't pass laws dictating what they may or may not say about guns/injury prevention.

And if the suits don't prevail? Well, one answer might be that there really isn't a problem, despite the whining. (Oops, impolite) despite the complaints.

;):D
 
LoosedHorse, here's an excerpt from someone who has done his homework (;)):

http://volokh.com/posts/1085773062.shtml

Many professional-client relationships — lawyer-client, psychotherapist-patient, accountant-client, even often doctor-patient — mostly consist of speech. Sometimes, of course, they involve physical conduct (surgery) or the submission of statements to the government (a lawyer arguing in court). But often they consist solely of two people talking with each other, one asking questions and the other giving advice.

And yet this communication is often subject to speech restrictions and speech compulsions that would generally be forbidden in other contexts. For instance:

Many professionals may not advise clients without a government license — something that would be a prior restraint if applied to speech by people other than professionals.

The government may impose liability on professionals for negligent advice, not just for negligently false statements of fact, but also for negligent predictions, which would otherwise be generally seen as constitutionally protected opinions.

The government may bar professionals from revealing client confidences. This isn't just an implied contract term (which might be defensible under Cohen v. Cowles Media Co.), because under some such rules the obligation can't be disclaimed even if the professional expressly states to the client that he doesn't promise confidentiality.

Some professionals, including lawyers and psychotherapists, are barred from having sexual relations with their clients — and it is the professionals' communicating with the clients that triggers the prohibition. Laws that constrain the sexual choices of authors of advice books, or of movie stars who project an image of trustworthiness, would violate the First Amendment (as well as perhaps the sexual autonomy right recognized by Lawrence v. Texas); such laws involve a burden placed on people because of their speech. Yet similar burdens are imposed on some professionals because of their speech.

A requirement that doctors give patients certain state-provided information before getting the patient's consent to an abortion was upheld in Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992) (plurality), with just the following discussion:

All that is left of petitioners' argument is an asserted First Amendment right of a physician not to provide information about the risks of abortion, and childbirth, in a manner mandated by the State. To be sure, the physician's First Amendment rights not to speak are implicated, see Wooley v. Maynard, but only as part of the practice of medicine, subject to reasonable licensing and regulation by the State. We see no constitutional infirmity in the requirement thatthe physician provide the information mandated by the State here.

Speech restrictions (and speech compulsions) are constitutional exercises of legislative authority. If you'll notice, all of these examples are implicated where there is a measure of unequal power inherent in the 'communicative' relationship.

As I said earlier, this will go the distance. It's got the gas, despite the fact that Judge Cooke ruled that the ACLU/Brady VPC are in, as parties, and the NRA is out.

I'd like to know, in the meantime, from the doctors here, how far do you all think the 'medically relevant universe' (i.e., that exclusive one in which you decide all of the 'harms' as well as the best way to achieve them) will extend, when the highly abstracted objectives sought to be accomplished compromise, on very real levels, the very people you are obligated to protect?

Has Loosedhorse forgotten who 'the-:cuss:-complainers' (or, rather, the complainants) would be in this case? :neener:
 
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Just thinking about the value of a little 'civil disobedience'...

... it isn't really civil disobedience, but in that same spirit.


What if the entire gun community in Florida simply answered "No" to that question from their doctors?

Just say No. No further discussion.

The medical community in Florida would quickly realize that asking the question is meaningless.
If everyone answers in the negative (gun owner or non-gun owner alike)
then asking becomes a waste of time. They quit asking.

Any merit to this bit of old-fashioned grass roots activism? All gun owners, Just Say No.
 
... it isn't really civil disobedience, but in that same spirit.


What if the entire gun community in Florida simply answered "No" to that question from their doctors?

Just say No. No further discussion.

The medical community in Florida would quickly realize that asking the question is meaningless.
If everyone answers in the negative (gun owner or non-gun owner alike)
then asking becomes a waste of time. They quit asking.

Any merit to this bit of old-fashioned grass roots activism? All gun owners, Just Say No.

Not even civil disobedience. You're under no compulsion to answer your doctor's questions, or to tell him the truth to begin with.

Civil disobedience requires that you at the very least be disobeying something, no?
 
Many professionals may not advise clients without a government license
Doctors have licenses.
The government may impose liability on professionals for negligent advice
They are already in place, in the form of malpractice liability.
The government may bar professionals from revealing client confidences.
Already in place, already covered. In fact this is not usually considered a limitation on physician speech, but a limitation on goverment inquiry into protected physician-patient speech, allowing the physician to refuse to answer the government's questions about the patient. So yes, this is a fine example--of exactly the opposite of the intrusive FL law.
Some professionals, including lawyers and psychotherapists, are barred from having sexual relations with their clients
Ah yes: "boundary violation," the definition Wheeler seems unaware of. Already covered.
To be sure, the physician's First Amendment rights not to speak are implicated, see Wooley v. Maynard, but only as part of the practice of medicine
Absolutely: just as I said, if we want to make it so that physicians are ONLY allowed to say what the government specifies that they may say, then this law is the way to go. Obamacare at its finest: one approved answer for all medical questions.

Wow, for a guy who you imply "didn't do his homework," I seem to have hit all the issues that Volokh did--and in a post, not some amicus curiae brief!
that exclusive one in which you decide all of the 'harms' as well as the best way to achieve them
What a perverse and dishonest thing to say. I don't decide anything.

Doctors (in aggregate) decide what the prevailing "standard of care" is, until a malpractice court decides differently. Doctors do not attempt to achieve harms. Sometimes they do achieve them, and AS STATED, when that happens, the ready, available, and established avenue of redress is the malpractice courts...

Unless you're perhaps implying that a criminal conspiracy is in place. Fine. Prove it. Laws against crimial conspriracy already exist; so no new laws are required--especially those new laws that violate 1A.

Yes, I know: that's my opinion, and you think I'm wrong. Mr. Fancy-speak! :neener:;):D
 
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More on Planned Parenthood of Southeastern Pa. v. Casey. The "speech" at issue there was informed consent. Informed consent has been part of the ethical framework of medicine since the aftermath of the WWII Nazi medical experiments (sorry for the Godwin, there, but it's true), and was established as a medicolegal requirement by Salgo v. Leland Stanford Jr. University Board of Trustees (1957). So the informed consent portion of the Pennsylvania Abortion Control Act represented a "restriction" on speech that had been firmly entrenched as part of good, ethical, legal medical practice for 25 years before the PA law.

In contrast, the FL law is inimical to the best practice of medicine, as defined by virtually all (perhaps literally all) major medical institutions and associations.
 
LoosedHorse: You’re ‘hitting of the issues’ with ‘already in place, already covered’-comments are unresponsive to the fact that these practice areas were mentioned to demonstrate that governments already may regulate professional speech. Volokh thus introduces us to the possibility that the type of speech implicated in the Florida litigation (professional speech) will be fair game for the SCOTUS to decide whether or not to permit Florida to regulate. (Prior to this time, didn’t look like you were going to address it, with all the yammering about 1A ‘truisms’.)

Then …. you parse Volokh, who actually was excerpting a SCOTUS case?:

To be sure, the physician's First Amendment rights not to speak are implicated, see Wooley v. Maynard, but only as part of the practice of medicine

An honest person would’ve quoted the passage as a ‘reasonable whole’, giving it quite a different meaning:

To be sure, the physician's First Amendment rights not to speak are implicated, see Wooley v. Maynard, but only as part of the practice of medicine, subject to reasonable licensing and regulation by the State. We see no constitutional infirmity in the requirement that the physician provide the information mandated by the State here.

And you’re calling me dishonest? (And perverse …. Really?) You’re in top form, however, truncating quotes for use in what you believe to be your best, and wittiest, repartee. Truncating quotes from SCOTUS cases. “Bullet-point-quoting?” Nice method of helping folks comprehend issues of import on this forum. :rolleyes: It doesn’t confuse me, but it does makes you appear dodgy, intellectually speaking, when viewing the whole of your posts, here in this thread, and in similar threads on the subject.
 
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I tried to get through all the various arguments about this topic.. but probably skipped a few.... Being a straight forward type, I wouldn't waste one moment of time about this since it's simply solved by telling the good doctor to use his hat as a toilet, if he/she didn't accept "None of your business" as a response to that type of well meaning intrusion into my life...

As far as doctors in general are concerned.... it's helpful to remember that most have a sufficiently "interesting" background history that more than a few had serious problems ever getting a security clearance years ago when we actually did background investigations before granting one level or other of clearance as they came into the armed forces (both the officer types and the medic level types). Nowadays I'm sure we just don't look anymore, but that's another topic entirely.
 
An honest person would’ve quoted the passage as a ‘reasonable whole’, giving it quite a different meaning
You are loony, or have a personal grudge against me.

You object to the quote being truncated, but all quotes that don't encompass the entire decision are truncated. You say MY "truncated" quote changes the meaning, but it doesn't AT ALL: in your quote or mine, the Court says that it considers the state allowed to control speech that is within medical practice. Perhaps you should have asked for clarification if you were confused, before presuming--insupportably--that I meant anything else?

However, as I went on to say--shall I type slower so you get it this time, without accusing me of dishonesty and dodgy-ness?--

  • Those who support the state power to limit physician speech should be very comfortable with no-choice, no-opinion-except-state-approved-opinion Obamacare
  • The state presumably would be expected to use such power to further good medical care (as it redundantly did in Casey, affirming a "limitation" that had been imposed on docs by themselves and by the malpractice courts 35 years before); but the FL law seeks to thwart and prevent best medical practices, as defined by general acclamation of a very diverse profession.
And you’re calling me dishonest? (And perverse …. Really?)
You said that I decide harms and a best way to achieve them; and you attributed some exlcusive "medically relevant universe" to me. None of that is the case. Then, there are your subsequent words that I dealt with in this post. If you look up the definitions of "dishonest" and "perverse," I think you will find in them sufficient reason to consider those terms accurate; as I do.
 
I think it is reasonable for the pediatrician to say, "here's a brochure about making your home safe for kids. It includes making sure guns are locked up, second story windows have childproof screens/locks,
pools have a childproof gate, etc. " Also if a patient is severely depressed, then they need some questions asked then and there. Within the next 2-5 years virtually all physicians who are still participating in Medicare will have an electronic medical record. It is not too hard to imagine that these type questions could easily be part of the database just like smoking, alcohol use, etc. would be.
 
More about the truncated quote.

The Court made clear that ONLY speech related to the practice of medicine may be regulated. So to the extent you argue that "gun speech" by doctors may be regulated, it would seem you must admit that such speech is within the practice of medicine.

Even though many have argued that such speech has nothing to do with medical practice. So, decide: it is medically relevant, and may be regulated, or it isn't, and cannot be regulated.

To the extent that a doc decides to harangue his patient in general about "the dangers of firearms"--without specific reference to that patient's individual case and details--I believe that would still be outside the reach of licensing regulation: 1A-protected speech.

No? Fine. I'm here to learn.

Edited to add: pretty typical example of government-mandated medical speech:
under a law passed in 2005, doctors are required to read a script meant to discourage women from proceeding with the abortion: "The abortion will terminate the life of a whole, separate, unique, living human being." Until recently, doctors also had to tell a woman seeking an abortion that she had "an existing relationship with that unborn human being" that was protected under the Constitution and state law and that abortion poses a "known medical risk" and "increased risk of suicide ideation and suicide." In August 2009, a US District Court Judge threw out those portions of the script, finding them "untruthful and misleading." The state has appealed the decision.
Hmmm. All (so far) examples of the state mandating a certain speech, but that mandate fails if the speech is untruthful or misleading. Nothing so far saying that a physician may not inquire into a subject that would ONLY be vulnerable to state regulation IF it is medically relevant.

Okee-dokee.
 
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“You said that I decide harms and a best way to achieve them”

First, I meant doctors decide which are the harms, and the way to address them (i.e., achieve prevention of such harms). Nice way to ride a collateral mis-statement into the sunset. That out of the way, let’s get to some of the rest ....

LoosedHorse states:
Those who support the state power to limit physician speech should be very comfortable with no-choice, no-opinion-except-state-approved-opinion Obamacare

I have no love for Obamacare, and that kind of extrapolation, i.e., “if you restrict one type of question, you, therefore, must want to control all of the dialogue between physician and patient", is ridiculous.

LoosedHorse also states:
The Court made clear that ONLY speech related to the practice of medicine may be regulated. So to the extent you argue that "gun speech" by doctors may be regulated, it would seem you must admit that such speech is within the practice of medicine.

Even thought many have argued that such speech has nothing to do with medical practice. So, decide: it is medically relevant, and may be regulated, or it isn't, and cannot be regulated.

Nice try offering a false dichotomy. The docs haven’t been too persuasive in convincing anyone that such inquiries are medically-relevant (except, of course, a portion of their own and the Veterans’ Administration). Enough doctors, nonetheless, have decided ‘within [their] practice of medicine’ to insist upon inquiring, recording, and disseminating that information, on a bald assertion of 1A freedom, without regard for the ramifications for their patients (there are many, particularly in light of Obamacare). Patients will see no relief, because the medical associations (even if not even 50% of the doctors) insist upon it as well. Hence, the Florida legislation.

Then LoosedHorse states:
The state presumably would be expected to use such power to further good medical care (as it redundantly did in Casey, affirming a "limitation" that had been imposed on docs by themselves and by the malpractice courts 35 years before); but the FL law seeks to thwart and prevent best medical practices, as defined by general acclamation of a very diverse profession.

I remember this argument, Loosedhorse. Don’t you? July 2009, thr.us, Veterans Admin. Docs and Firearms Inquiries, ring a bell? Granted, it was in the context of a Veterans’ Administration physician, asking about firearms for suicidology studies (suicide-prevention being one of the specifically-asserted medically-relevant objectives). The substance of the statement, and its inaccuracy, is the same. Here’s what you said:

Loosedhorse in post #80:
“That's very different from saying that if you feel a question is inappropriate, it is therefore definitively a medically inappropriate question for all physicians, everywhere--especially when the bulk of professional opinion agrees that it is appropriate.”
(emphasis mine.)

And then I responded:
Do you have a citation for any of the above posts? My reading suggests otherwise. See Kaplan, Dr. M.S., J Epidemial Community Health 2007: 619-624.

The link is here:

http://chppm-www.apgea.army.mil/dhpw...anetal2007.pdf

Despite the conceding the fact that it is still a hotly debated issue in the suicidologist and medical communities (whether to conclude that the existence of firearms in a veteran’s home is a significant factor contributing to veteran suicide), the physician-author laments that only %50 of physicians inquire about veteran ownership of firearms and further concludes, conflicting data and contention notwithstanding, that physicians must, nonetheless, endeavor to collect firearms data on veterans.
Kaplan, Dr. M.S., J Epidemial Community Health 2007, at 622-623.

This is the kind of physician people are more likely to deal with nowadays. Even in the face of a 50/50 split on the usefulness of a particular course of inquiry, a contentious policy is still promoted.

So, does the bulk of professional opinion really agree? Then why was the good Dr. Kaplan pleading with doctors to continue their inquiries, unabated, ‘the conflicting data and contention’ notwithstanding?

So, I provided you with a link, two years ago, to a doctor who lamented, in a scholarly medical publication, that not enough doctors were engaging in firearms-inquiry, and you sit, here in 2011, insisting that the “bulk of professional opinion agrees that it’s appropriate”?

Spiral keeps circle honest.
 
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You guys have made this so personal I'm having trouble following your arguments. In my experience, Docs have no special corner on common sense. A good example of this is a poster a while back who cited the fact that his daughter adapted an anti gun attitude due to the gun related injuries she came across in an inner city hospital. I also find the people who immerse themselves in a field of study, as Docs tend to do by necessity, tend to be limited on other areas of worldly intelligence. Things like knowing how to properly inflate their tires are skills that elude them. I make my own decisions regarding personal defense. I don't want someone who grew up in a university preaching to me about what they learned in their books. I also have deep suspicions about their undue influence on youth. Let them run their mouths about health related matters. Not what they think are health related matters. If firearms/defense training and theory become a major part of their degree plans, then things might be different. Currently, it is not.
 
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