Should physicians, and especially physicians’ groups, “stay in their own lane?” The NRA thinks so when it comes to gun control legislation. This issue flared recently when the American College of Medicine advocated a program of gun control legislation. The NRA’s beef with physicians goes back decades, when the Centers for Disease Control (CDC) reported that gun ownership had no protective value for citizens.
NRA nixes gun research The NRA soon put an end to the CDC’s gun research, as well as proposals for computerized gun registration and background checks, permanent firearm identifiers, computer chip control locks, and liability for owners of misused weapons. The NRA (along with even more aggressive gun lobbies) successfully deflected efforts to sustain limits or bans on military-type weapons, unregistered “gun show” sales, open-carry permits, silencers, armor-piercing bullets, outsize magazines, and devices capable of converting single-fire weapons to continuous-fire machine guns. As a physician with an abiding interest in social psychopathology, I attribute these efforts on behalf of arming our society not to a rational interest in individual self-defense (my favorite conservative, Bill Buckley, advocated a sawed-off shotgun in your closet), but rather to a collective delusional state, fostered by an internet echo chamber of conspiracy theories focused on governmental overreach or suppression of individuality. It is ironic that much feared authoritarian state at core of this delusion is one we (and other developed countries) have been lurching toward in recent times.
What should doctors do? But this article is not about guns, but rather about the social responsibilities of doctors. Are we asked by our schools or by our oaths and declarations to do anything more than provide individuals with competent, honest, confidential, prejudice-free, dutiful care? We are not, but should that declaration be enough? The case for a broader societal responsibility was made repeatedly by the Dean of the UCLA School of Medicine for its first 24 years, Sherman Mellinkoff (not “melon head” in German, as some fellow students impishly suggested). He gave several lectures to the student body every year in which he (as a paradigm of the classically educated physician) repeatedly elaborated on medicine’s responsibility to the “polis,” the supremely creative city-state of early Greek civilization and model for advanced modern societies.
Charity care “disappeared” It was possible in 1970 for physicians to commit a portion of their practice to treating non-paying patients. In fact, charity care had been considered an ethical requirement of physicians in private practice by the AMA and by local medical societies since their inception. But by 1970 local and federal programs were pre-empting this role for doctors, and less than a decade later charity care disappeared as the costs of medications and diagnostics swamped physician fees. So in what other arenas should doctors provide help and guidance for their polis?
Doctors have responsibility Are physicians leaving ‘their lane” in advocating for gun safety, air pollution control, cheaper medicines, access to clean water and quality nutrition for all, child care and early childhood education? While any citizen may stand up for these issues, should physicians feel additionally responsible to society for supporting action by charities, NGO’s, and governments on these issues that are so impactful on physical and mental health? And in turn, should their views be given special attention because of their background in science and day-to-day attention to individual health? My answer is “Hell yes!” The solemn declarations taken by new physicians in the future should be composed to confirm this. Dr. Richard Bertken drbertken [at] comcast.net