Stop those prying doctors!

 

Florida residents have their saviors in the Florida legislature to thank for shielding them from the insidious “prying into personal lives” that doctors have shamelessly been inflicting upon patients.

Apparently, doctors have been asking their patients questions about whether they own guns, and – prepare yourself for a shock – if the patient answers in the affirmative, some doctors have actually been counseling patients on how to store the guns safely and protect any other people in the home, particularly children, from accidental harm.

Fortunately, some attentive citizens were alerted to this disgusting practice and enlisted the NRA in helping them to get the Florida legislature to pass, and the Florida governor to sign on June 2nd, HB 155, which prohibits physicians from making written or oral inquiries regarding firearms ownership or recording such information in a patient’s chart (unless the doc believes “that this information is relevant to the patient’s medical care or safety, or the safety of others”).

It is a great relief to see that the physician-patient relationship — too long the purview of a suspiciously-dressed clique of highly-trained, dedicated professionals and their trusting patients, too long full of “prying into personal lives” as exemplified by questions like, “How do you feel?” “Does that hurt?”  “What do you use for contraception?” and “Did anybody in your family ever have cancer?” — is at last being exposed and regulated by those people we all trust way more than we do our doctors, the elected representatives in our legislatures.  My only regret is that some of the original provisions of the bill, such as the stipulation that a violation would amount to a third-degree felony punishable by up to five years in prison and a fine as high as $5 million, did not make it into the final legislation.

Encouraged by the NRA’s success, other bodies are stepping up to protect the unsuspecting public from some of the horrifying practices that routinely take place behind the closed doors of the consulting room.  The Tobacco Growers Coalition is promoting legislation to ban doctors from making inquiries about smoking, the GFFFA (Greasy Fried Fast Food Alliance) is working to make it illegal for doctors to counsel their patients about healthy diets, the NARL is drafting laws to ensure that doctors don’t counsel pregnant patients against abortion, and the Colombian drug cartels are looking for ways to prevent doctors from advising patients against using their special brand of products.

Sound too ridiculous to be true?  OK, I made that last paragraph up.  But read this.

Lest anyone misunderstand, this post is not about gun ownership, nor do I have anything against the NRA.  This post is about unwarranted encroachment upon the sanctity of the central economy of the medical profession, the physician-patient relationship;  and about what sort of Rubicon has been crossed when the paranoid intrusion and constraint represented by this bill is placed upon the good will and judgment of a doctor — and enshrined in the law of the land.

Thanks, GAVI!

In a world full of inequities in health care including a child mortality rate in some developing countries that continues to be alarming, it is good to recognize those who are making a difference.  The Global Alliance for Vaccines and Immunisation (GAVI) recently announced that they had entered into agreements with several vaccine manufacturers to obtain vaccines for developing countries at reduced costs.

GAVI is an international organization that attempts to unite donor nations, private donors, developing nations, international organizations, and immunization suppliers to meet the goal of saving children’s lives and protecting people’s health through better access to immunizations.  In the ten years from 2000 to 2010 more than 288 million children were immunized with GAVI-funded vaccines, and an estimated 5 million deaths prevented.

Organizations like GAVI deserve our thanks and support for making a positive impact on the lives of children around the world.

Treatment of HIV-infected Individuals to Prevent Transmission

The interim results of the HPTN 052 study released last week indicate that treating HIV-infected individuals dramatically reduces the likelihood that they will transmit the virus to their sexual partners.  This study of HIV-positive patients whose heterosexual partners were HIV-negative and whose disease was at a stage at which treatment would be considered optional showed a dramatic decrease in transmission to their sexual partners for those treated immediately and was stopped early due to the results.

This study raises some interesting ethical questions.

Are HIV-positive persons who have an unaffected partner now obligated to undergo treatment even if there is not evidence that the benefit of the treatment outweighs the adverse effects for the individual?

If treatment of infected persons is an effective means of preventing the spread of HIV, how aggressive should those responsible for public health be in seeking to identify and treat those with HIV?

What should be done in countries with a high level of HIV that already cannot afford antiretroviral treatment for the more severely affected?  If treatment of all infected people would dramatically reduce the incidence of new cases in those countries where do we get the resources to provide that treatment?