House bill sets limits

SC clash between gun rights, pediatricians’ free speech

jmonk@thestate.comMarch 17, 2013 

Doctor's day

Bill in SC House would prohibit doctors from talking to their patients about gun safety.

CLAUDE DAGENAIS — Claude Dagenais / Two Humans

Survey at the bottom of the story

Some 57 House lawmakers have signed on to a bill that would make it illegal for doctors to discuss gun safety with their patients.

The bill has stunned some doctors, especially pediatricians, who say they do talk with patients about safety steps to be taken when there’s a gun in the household, to make sure a child isn’t accidentally shot. Besides, they say, they are guaranteed free speech under the First Amendment, just as gun owners have gun rights under the Second Amendment.

“They (gun rights supporters) are trying to get Big Government to come in and dictate what we can and cannot say, while at the same time, they are trying to tell Big Government to stay out of their right to own guns,” said Dr. Deborah Greenhouse, a Columbia pediatrician who is president of the S.C. Chapter of the American Academy of Pediatrics.

In the past 10 years, Greenhouse said, two children who were patients of her pediatric group’s practice were killed in home gun accidents that might have been prevented if more safety procedures had been in place. Since then, she said, she has made it a point to ask patients if guns are in the home and, if the answer is yes, to review a safety checklist.

“No one has ever taken offense, and numerous people have thanked me,” she said. “Many families aren’t aware of all the safety procedures I discuss. And you wouldn’t believe how many children know where their parents’ guns are.”

That’s exactly the kind of doctor-patient conversation that a bill by Rep. Joshua Putnam, R-Anderson, would outlaw in South Carolina.

“We don’t want citizens to feel like they are going to be intruded upon whenever they go to a physician,” Putnam said in an interview last week.

Under Putnam’s bill, except in relevant emergency situations, doctors would not be able to ask patients if they have guns. Since many gun safety discussions originate with that question, the bill could stop doctors from initiating conversations about safety.

The reason for the bill, Putnam said, is that he’s trying to protect doctors from any future federal law that might force them to ask patients about gun ownership.

“What we are kind of scared of is where this will go down the road,” Putnam said.

The bill contains no penalty. “We don’t want to charge them with a felony or anything like that,” Putnam said.

Some powerful lawmakers like the bill. House Judiciary Committee chairman Rep. Greg Delleney, R-Chester, said, “I don’t think it’s a doctor’s business to be asking about guns as part of medical treatment. People go to a doctor’s office to be treated. That’s not part of the treatment.”

Delleney said he’s not trying to limit doctors’ freedom of speech, since a doctor can always talk about gun safety after office hours. “If doctors want to call them up or go visit them at home as a friend, I don’t have a problem with that,” Delleney said.

Delleney also said he’s worried that doctors will keep a record of which patients own guns. “It’s going to wind up recorded somewhere that they have guns, and it’s their right to have guns,” he said.

Putnam’s bill doesn’t refer at all to medical records. But Delleney, who in his job as a lawyer sees medical records, says, “That’s what would happen.”

The bill underscores a clash of values: Many doctors see gun injuries as a health hazard that can be prevented.

“Educating patients about safety issues is called ‘anticipatory guidance – preventing accidents, whether it’s a car or gun or do not smoke in the house with a child – it’s at the heart of what we do,” said Dr. James Durant, a Sumter pediatrician who in 2005 helped lead a crusade that led to the Legislature’s passing a mandatory seat belt law.

Officials now credit that law with saving hundreds of lives a year across South Carolina.

Reservations

Some lawmakers have reservations about the bill. Rep. Chip Huggins, R-Lexington, originally signed on as a co-sponsor but later removed his name.

“I heard from several physicians in my district. Most were pediatric folks, and they had concerns about safety,” Huggins said.

In the past three months, three children in South Carolina have been shot and killed in their homes in the kinds of accidents that Greenhouse said she is trying to warn parents about. According to authorities:

• Tmorej Smith, 3, was shot and killed Feb. 1 in his Greenville apartment while he and his sister played with a loaded handgun.

• Easton Brueger, 8, was shot and killed by his father Dec. 30 in his Bennettsville home while his father was cleaning a rifle.

• Sincere Smith, 2, was shot and killed in his Horry County home after he grabbed a loaded handgun sitting on a table.

Richland County Sheriff Leon Lott called Putnam’s bill “asinine.”

“Instead of preventing people from talking about gun safety, we should be encouraging more people to speak out,” Lott said.

About 10 years ago, Lott said, one of his deputies’ children was killed in a home gun accident. A neighbor’s child came into the house, found the deputy’s gun, which contained one bullet, and accidentally shot the deputy’s child.

No one keeps precise statistics on the number of S.C. children killed and injured each year in home gun accidents. What statistics are kept on children are lumped together with firearm injuries and deaths that are caused by crime or are suicides or accidents.

Bill’s chances

The S.C. Medical Association has not taken a position on Putnam’s bill.

But Rep. Todd Atwater, R-Lexington, who is executive director of the S.C. Medical Association, said he doesn’t favor any bill that would prevent or require a doctor to discuss certain issues with a patient. He is not a co-sponsor.

Last week, Putnam said he is working on an amendment that will give doctors more freedom to talk about gun safety as well as protect them from any future federal mandates that order them to discuss gun safety. “Both sides will be pleased with this legislation,” he predicted.

Although the bill has been assigned to Delleney’s Judiciary Committee, it has not yet been assigned to a subcommittee. Typically, amendments and hearings on a bill are held at the subcommittee level.

Greenhouse said she knows she’ll be criticized for wanting to talk gun safety with patients. Indeed, a recent letter to the editor of The State newspaper said, “Talks about gun safety belong to dads, not pediatricians.”

But other doctors don’t want government dictating what they tell patients.

Dr. Allison Harvey, an emergency room physician at Palmetto Health Richland hospital, said she’s a gun owner and a “strong supporter” of gun rights. However, “I don’t think anybody should tell a physician what they should or should not tell a patient in the privacy of their own office,” she said.

In the 18 years she’s been an emergency physician, Harvey said, she has treated six to 10 children with gunshot wounds, half from hunting accidents and half from loaded guns being left out in homes.

“Every single one of them could have been prevented,” said Harvey, a former president of the South Carolina College of Emergency Physicians.

Durant said, “It’s better to prevent an accident than have to treat one.”

What do you think?

Reach Monk at (803) 771-8344.

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