Boatswain2PA Posted February 22, 2016 Share Posted February 22, 2016 cbrsmurf - do you ask about other things that can affect the child's health? Porch railings? Hot water tank temperature? ATV ownership? GFCI's? If not, why not? The answer, of course, is because you have not been asked to. You have been asked to ask about safety belts, car seats, drug use, smoking in the house, and guns in the house because they are not only potential health risks, but also because they are political issues.Politics is a part of our life, and especially our profession, you can't get away from that. The basic definition of PUBLIC HEALTH is that it involves the health of the PUBLIC, which, in latin, is POLIS...the first part of the word POLItics. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted February 22, 2016 Administrator Share Posted February 22, 2016 It is very hard to produce evidence-based data when the CDC and NIH are blocked from receiving any funding to research firearms as a public health issue. The gun lobby has consistently blocked all efforts to generate any evidence-based research. Yep, and rightly so, since guns aren't "just" a public health issue, but a multifaceted issue with pros and cons that makes the issue one that combines public health, economics, criminology, and other disciplines. A one-dimensional look at guns (of whatever perspective) is only ever propaganda, never about holistic review of the pros and cons. Link to comment Share on other sites More sharing options...
medic25 Posted February 22, 2016 Share Posted February 22, 2016 Yep, and rightly so, since guns aren't "just" a public health issue, but a multifaceted issue with pros and cons that makes the issue one that combines public health, economics, criminology, and other disciplines. A one-dimensional look at guns (of whatever perspective) is only ever propaganda, never about holistic review of the pros and cons. I'm sure the alcohol and automotive industries could make the same argument that they are "multifaceted issues", but we don't explicitly ban research into those issues. I could care less about the economics and politics; I'm just trying to look at this from a public health perspective. We've got over 33,000 deaths a year as a result of firearms, just about the same number of deaths from motor vehicle accidents. Where is the outcry over research into automotive safety? I've never heard people arguing that seat belts and DWI laws are driven by propaganda and politics. If more guns save lives, why is the NRA afraid of evidence-based, peer-reviewed research actually looking at the data? As a clinician I feel that I have a responsibility to support public health and evidence-based science; without doing the research first, I don't see how we can reasonably approach the health issues associated with firearms (good or bad). Link to comment Share on other sites More sharing options...
PAMEDIC Posted February 22, 2016 Share Posted February 22, 2016 cbrsmurf - do you ask about other things that can affect the child's health? Porch railings? Hot water tank temperature? ATV ownership? GFCI's? If not, why not? The answer, of course, is because you have not been asked to. You have been asked to ask about safety belts, car seats, drug use, smoking in the house, and guns in the house because they are not only potential health risks, but also because they are political issues.... There are around 20k non-crime-related gun deaths in the US a year. I can pretty much guarantee you that if 20k people a year were dying of porch railings, hot water tanks, ATV, and GFCIs, we would be asking about them as well. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 22, 2016 Share Posted February 22, 2016 How many of those are suicide? How many involve children?? Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 22, 2016 Share Posted February 22, 2016 Alas, we now have ICD10 where every metric is recorded about accidents and injuries and illness. Kind of like a perverted came of Clue - Col Mustard hit his head on the sink in the kitchen on a Tuesday......................... If enough people hit their heads on a sink in a Tuesday - sinks will be banned from use on a Tuesday. Or so goes the twisted analogy of data mining. I don't favor unregistered gun ownership and completely fail to understand those who insist that the Second Amendment written over 200 years ago is still applicable to our population of nearly 300 million. I do not begin to fathom why anyone would need to own 400 guns or automatic weapons that could shred a hunted animal making it worthless to eat. I do not understand the fascination nor the hubris of it being a "right". Not everyone is smart enough to own a gun or even use one. People don't take self responsibility. Countries in Europe have shown fewer gun related events because guns there aren't open to ownership, theft and misuse. So, I don't give a rat's butt about govt statistics. I ask because I care. I want to know that I at least discussed that guns without trigger locks or properly stored could become a nightmare. The 14 year old in Western Washington proved that by taking his uncle's gun to school and killing his cousins and friends. The 2 year old who went into Mom's purse inside a Walmart and managed to fire a loaded weapon through a zipped compartment killing her own mother. The 11 yr old who killed an 8 year old because she wouldn't let him see a new puppy...... The 11 yr old psychopath who had a hit list of kids at school and packed his mom's gun in his back pack and took it to school on the bus........................Seriously, do we have to have this endless discussion of adult carelessness leading to pediatric disaster?...... I implore my professional colleagues to put aside any thoughts of govt conspiracy and invasion of privacy and look at the kid in the exam room and really think about the potential consequences. Own your own guns and handle your own family - just remember that - as healthcare providers we have a moral and legal obligation to protect children - even from their own parents. Think about this family scenario - Mom and Dad are both on benzos and chronic hydrocodone with 4 kids in the house under the age of 15 and enough guns to arm a militia and enough ammo that the fire dept had to abandon their burning house because it was exploding.... These kids have impaired parents with a bunch of guns in the house and we think that is ok?....... I certainly don't Link to comment Share on other sites More sharing options...
PAMEDIC Posted February 22, 2016 Share Posted February 22, 2016 How many of those are suicide? How many involve children?? Like I said, they are non-crime-related. That would mean that they are all suicides and accidents. I couldn't tell you how many of the 20k a year are under 18. Maybe you could google that. But honestly, I don't understand the purpose of your question. I was taught that as a medical provider, we should seek to recognize and prevent suicides. Your comment sounds like you are saying that if it it suicide, it is no business of ours to ask or try to prevent. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 22, 2016 Share Posted February 22, 2016 My 42 yr old stepbrother, a long standing well diagnosed but rarely treated bipolar patient - owned over 50 guns and was, quite frankly, obsessed with them. He openly expressed paranoia about a lot and carried both a taser and 9mm EVERYWHERE. He was not a hunter. He killed himself with one of his massive arsenal on August 27, 2015. HOW did he get a background clearance? He had a known history of inappropriate behavior and suicide attempt in the past. He had a 2 yr old in the house when he killed himself. He was not a veteran. He did not have a criminal record. So, should his psychiatrist or PCP be required to report him as a threat to himself to some authority for background checks on weapons? I believe he should not have been able to purchase a gun - PERIOD. Would he still be alive - meh, probably not. He would have found a way to end his life - perhaps a bit less messy. BUT - his 2 yr old daughter was in a house with an unstable man with a small arsenal. Was he of sound mind to protect her from those weapons and an accidental discharge? Absolutely not Link to comment Share on other sites More sharing options...
cbrsmurf Posted February 23, 2016 Share Posted February 23, 2016 ...but gov't conspiracies cbrsmurf - do you ask about other things that can affect the child's health? Porch railings? Hot water tank temperature? ATV ownership? GFCI's? If not, why not? The answer, of course, is because you have not been asked to. You have been asked to ask about safety belts, car seats, drug use, smoking in the house, and guns in the house because they are not only potential health risks, but also because they are political issues.Politics is a part of our life, and especially our profession, you can't get away from that. The basic definition of PUBLIC HEALTH is that it involves the health of the PUBLIC, which, in latin, is POLIS...the first part of the word POLItics. How many kids do porch railings, hot water tanks, ATV's, and electrical outlets kill per year? (btw, I live in an area where a lot of kids are involved with motorsports, I will ask if they use a helmet). If you believe guns in a household aren't a significant health risk, then that is your clinical judgement. I disagree, which is why I ask, not because of my political views. Link to comment Share on other sites More sharing options...
SHU-CH Posted February 23, 2016 Share Posted February 23, 2016 I don't favor unregistered gun ownership and completely fail to understand those who insist that the Second Amendment written over 200 years ago is still applicable to our population of nearly 300 million. I do not begin to fathom why anyone would need to own 400 guns or automatic weapons that could shred a hunted animal making it worthless to eat. I do not understand the fascination nor the hubris of it being a "right". Just for reference, are there any other "rights" that you think have expired? Maybe there are a few things in the Bill of Rights I could live without. Link to comment Share on other sites More sharing options...
db_pavnp Posted February 23, 2016 Share Posted February 23, 2016 These varied responses are exactly why I posed the question. I'm not sure why but for some reason I'm surprised there aren't more on the "I do" or "I would" ask side of the fence. I think you need a good picture of the population that "posts" on the forum to understand why you aren't getting more, "I woulds". I mean, you probably recognize 90% of the usernames posting here and, realistically, you knew their stance before they posted in the thread. Lemme just say that if I lived in BFE and ATVs were killing kids, I would goddamn talk about ATVs. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 23, 2016 Share Posted February 23, 2016 The rights haven't expired. They haven't been looked at seriously in the context of the advancement of time, technology and logic. It is not logical to take something written over 200 years ago before the industrial revolution when our population was 1/15 of what it is now and expect it to apply in the same wording or intent. Do you honestly think the writers of the constitution had ANY CLUE as to the population being 300 million people with vehicles, weapons, the internet and automation? Seriously - these guys had muskets and couriers on horseback and information taking months and years to dissipate into the general population. Remember the Emancipation Proclamation taking TWO YEARS to get to some people on the same bloody continent and only a few states away....... So, what was written over 200 years ago can't be taken as literal interpretation when it doesn't even have context for our current conditions. In Judaism, the rabbinical scholars write the Talmud - and take 5000 year old laws and writings and consider how they affect society today and if they apply to our current level of technology and communication. They constantly make commentary on how to take the laws and apply them to current life. Medicine as an art and science takes things into consideration and adapts them over time. Science the same - the world is not flat and the earth is not the center of the universe. We have to adapt to what can apply rationally to our current situation. So, nothing expired - it just needs to be evaluated and clarified to our current population and technology. We have guns - a lot of them - and for what purpose - I can't figure out some days........................ Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 23, 2016 Share Posted February 23, 2016 Like I said, they are non-crime-related. That would mean that they are all suicides and accidents. I couldn't tell you how many of the 20k a year are under 18. Maybe you could google that. But honestly, I don't understand the purpose of your question. I was taught that as a medical provider, we should seek to recognize and prevent suicides. Your comment sounds like you are saying that if it it suicide, it is no business of ours to ask or try to prevent. Per the CDC FastStats There were 33K firearm related deaths in the US There are 21K firearm related SUICIDES in the US. How many of these will we prevent by asking parents if guns are in the house? My guess is virtually none. There were 13 suicides (all causes) per 100,000 in the US. Far less than many countries (France, Czech, Belgium, Iceland, Finland, Japan, etc) that have significant gun prohibitions. Apparently banning guns doesn't do much to prevent suicide. You are taking a HUGE (and incorrect) extrapolation by suggesting that my resistance to personally asking about firearms is equal to not trying to prevent suicide. I'm sure all of us have been affected by suicide. But show me some little bit of evidence that checking a box on the computer screen saying you asked about gun ownership = reducing suicide rates. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted February 23, 2016 Administrator Share Posted February 23, 2016 I'm sure the alcohol and automotive industries could make the same argument that they are "multifaceted issues", but we don't explicitly ban research into those issues. I could care less about the economics and politics; I'm just trying to look at this from a public health perspective. We've got over 33,000 deaths a year as a result of firearms, just about the same number of deaths from motor vehicle accidents. Where is the outcry over research into automotive safety? I've never heard people arguing that seat belts and DWI laws are driven by propaganda and politics. If more guns save lives, why is the NRA afraid of evidence-based, peer-reviewed research actually looking at the data? As a clinician I feel that I have a responsibility to support public health and evidence-based science; without doing the research first, I don't see how we can reasonably approach the health issues associated with firearms (good or bad). Again, this is a false dilemma. There is plenty of research on guns. Lott's "More Guns, Less Crime" is a good start. Likewise, there are plenty of "guns are bad" research too. Again: Polemical if they don't acknowledge and engage with the benefits AND harms. A poorly constructed study which has a political purpose can absolutely be peer reviewed... yet it doesn't mean it's correct and useful for public policy. In fact, I think that there's a lot of automotive research that is biased and probably draws wrong conclusions. How many people have died due to smaller, lighter (read: CAFE fuel efficient) cars? How many QALY's have been lost by imposition of speed limits? It's "common sense" that speed limits save lives... but they also cost lives, in small chunks, across a broad population. If we switch to pay-per-mile as opposed to a gas tax, how will that affect miles driven? Cars--with combined issues of travel time, fuel efficiency, and cost--are actually a pretty good analogy for the multifactoral dimensions firearms have. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 23, 2016 Share Posted February 23, 2016 ...but gov't conspiracies How many kids do porch railings, hot water tanks, ATV's, and electrical outlets kill per year? (btw, I live in an area where a lot of kids are involved with motorsports, I will ask if they use a helmet). If you believe guns in a household aren't a significant health risk, then that is your clinical judgement. I disagree, which is why I ask, not because of my political views. I don't know. How many kids are ACCIDENTALLY killed or seriously injured by firearms? I did quick search and couldn't find answer. My anecdotal experience is that ATV injuries/deaths outnumber accidental firearm injuries/deaths. Again, I'm not telling you that YOU shouldn't ask. I think you should practice medicine the best way you know how. And I don't think the government should tell you how to do it. The rights haven't expired. They haven't been looked at seriously in the context of the advancement of time, technology and logic. It is not logical to take something written over 200 years ago before the industrial revolution when our population was 1/15 of what it is now and expect it to apply in the same wording or intent. ....... We have guns - a lot of them - and for what purpose - I can't figure out some days........................ The constitution, and the bill of rights, are "seriously looked at" every year by the supreme court, which has held in "Heller v. D.C." that individual firearm ownership is a right. Just because you can't figure it out doesn't mean someone else hasn't. Link to comment Share on other sites More sharing options...
Guest Paula Posted February 23, 2016 Share Posted February 23, 2016 I just realized how horrible of a provider I am. I do not ask about pools, helmets, guns, if the kid ties their shoelaces, or eats candy for breakfast. Crap, I'll probably fail PANRE. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted February 23, 2016 Administrator Share Posted February 23, 2016 Crap, I'll probably fail PANRE. Don't worry, NCCPA will be happy to take your money again, regardless. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 23, 2016 Share Posted February 23, 2016 I just realized how horrible of a provider I am. I do not ask about pools, helmets, guns, if the kid ties their shoelaces, or eats candy for breakfast. The government thinks you are a TERRIBLE provider.....which means you are probably terrific!! Link to comment Share on other sites More sharing options...
cbrsmurf Posted February 23, 2016 Share Posted February 23, 2016 The gov't isn't forcing you to ask the firearms questions, although I do believe the aafp and aap recommend asking about gun safety for peds pts Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 24, 2016 Share Posted February 24, 2016 Never said the government was forcing us, but I'm sure one of the many government departments recommends it as well. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 24, 2016 Share Posted February 24, 2016 And, why, might I ask, is our government so completely evil? Do we not have running water, electricity, homes, schools, the ability to be PAs and many luxuries and freedoms not afforded in other places around the world? Yep, there are things that are a pain in the butt and things that are stupid - but - we are pretty dang lucky and blessed to have what we have. So, why the hatred? Link to comment Share on other sites More sharing options...
CAAdmission Posted February 24, 2016 Share Posted February 24, 2016 My parents and grandparents enjoyed more freedom than I do. Why was this given up? For what? Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 24, 2016 Share Posted February 24, 2016 Why are you reading "hatred" into anything I write? I love my nation, and I served it for 20 years in uniform. However I know that my government is as inefficient, and politically driven, as any organization on the planet (with the possible exception of the UN) Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 24, 2016 Share Posted February 24, 2016 My parents and grandparents enjoyed more freedom than I do. Why was this given up? For what? Sent from my iPhone using Tapatalk So we can all be SAFE from anything that might hurt us! And, once we found ourselves to be pretty safe, it was decided that we must be safe from things that hurt our FEELINGS!! Link to comment Share on other sites More sharing options...
turnedintoamartian Posted February 24, 2016 Share Posted February 24, 2016 In Florida I believe the government is forbidding you from asking about gun ownership. So there is the flipside out there as well. Link to comment Share on other sites More sharing options...
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