Know What Ben? It’s Time For You To Shut Up.

Ben Carson isn’t the first physician to run for President and, in fact, isn’t the only doctor trying to get into the White House in 2016.  He may be the only board-certified doctor, because it’s not clear whether Rand Paul is certified or not.  Carson certainly is.  All the more reason that when he says something which violates the Hippocratic Oath we should ask whether he has the credentials even to claim that he’s a bone-fide physician, never mind credentials to be the next President of the United States.

Let me make one thing clear about the Hippocratic Oath.  It’s not mandatory either to subscribe to it or to follow it.  There are some medical schools that don’t, in fact, administer the oath to new graduates, there are also various versions of the oath floating around.  But the Hippocratic Oath is a reminder that medicine is a profession whose effective practice requires attention not just to science and learning, but to compassion and ethics as well.  After all, we vest the responsibility and often the authority for making life and death decisions within the medical profession.   So it’s heartening to know that this profession expects its members to think and behave according to certain basic and well-tested rules.

hippocratic                And rule number one is: Do No Harm.  Now these words aren’t, in fact, found in the text of the oath itself.  But ask any physician to tell you what it means to subscribe to the Hippocratic Oath and he or she will state either those exact words or words to that effect. Which brings us to the recent statements made by Ben Carson following the slaughter at Umpqua Community College that produced a sickening amount of harm.

The first statement was on Ben’s Facebook page, although he scrubbed it when the responses began pouring in.  Nevertheless, here’s the exact quote:  “I never saw a body with bullet holes that was more devastating than taking the right to arm ourselves away.”  In other words, if Carson was practicing in a locality that had very strict gun-control laws like, for example, Washington, D.C., he would claim that the inability of a D.C. resident to carry around a handgun was a greater medical risk than if that same individual was brought into the ER with a bullet lodged in his head. So much for Carson’s ability to stratify gun violence risk, adopt the proper medical response and thereby reduce harm.

Just to make sure that ol’ Ben keeps his bone fides alive with the pro-gun crowd, he then went on CBS and said that if he were facing a mass shooter, the first thing he would do is put up a fight.  He would also advise other people in the vicinity to do the same thing. Of course macho man Carson has absolutely no idea of the degree to which such behavior increases risk, and if you don’t believe me, just take a look at the active shooter guidelines issued by the Department of Homeland Security: Run, hide, if all else fails, fight.

Every time Carson opens his mouth about gun violence, he says something that increases risk.  If he wants to say something stupid, that’s fine.  But when he advises people to do something that increases risk, he’s not just being dumb, he’s violating the Hippocratic Oath.  The Coalition to Stop Gun Violence has posted a petition asking Carson to apologize to the survivors and victims’ families at Roseburg because of the comments he made on Facebook and ABC.  The petition says that Carson’s remarks are “offensive and beyond the pale.”

I think it’s now time for the medical community to tell their colleague Ben Carson that he should stop putting the initials ‘M.D’ after his name. Because no doctor who takes his work seriously would make statements like that. Ben doesn’t  just offend the Umpqua survivors, he offends the profession which he claims to represent.  Shut up Ben, just shut the f***up.

 

Should Physicians Advocate for More Gun Control? Of Course They Should

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A remarkable article on gun safety advocacy by physicians has recently been published in the Annals of Internal Medicine.  Written by three public health specialists, it calls for physicians and other health care professionals to be more aggressive in advocating measures to cut gun violence.  What’s remarkable about the article is not what it says, but the fact that it has been published at all.  Because despite the overwhelming evidence that the existence of several hundred million guns is coincident with the highest levels of gun violence of any advanced country, physicians of late have been reluctant to play the role of advocates in the gun violence debate.

The self-imposed constraint on gun safety advocacy goes back to the firestorm that was ignited by physicians who were one of many groups that called for stricter gun controls, if not some degree of outright abolition of guns, during the public debates that led up to the passage of the assault weapons ban and Brady laws in 1993-94.  In retaliation, the NRA launched a successful campaign to defund the CDC from sponsoring gun research, and continues its barrage of nonsensical claims about the inherent value of guns to protect us from crime and violence.  Worse, many of these so-called “studies” are the handiwork of individuals who use their alleged medical credentials to promote social and political agendas that go far beyond any rational discussion about guns or anything else.

One of the latest salvos is the handiwork of an Arizona internist, Jane Orient, who recently published a survey of gun control research in the Journal of American Physicians and Surgeons, an organization which can best be described as “libertarianism meets medicine.”  Now don’t get me wrong.  Physicians have as much right to organize and advocate for any political position as anyone else.  They also have the right to publicly criticize any and all government policies that affect their work as physicians.  But there is a difference between using your status as a medical professional to challenge medical procedures or policies, as opposed to promoting a political agenda based on unproven claims masquerading as medical research.

There is simply no valid proof to the continuous claims made by NRA-leaning researchers that a positive correlation exists between private ownership of guns and decreases in crime rates.  The best the pro-gun crowd can offer are studies that show a decline in gun violence coincident with an increase in concealed-carry licensing.  But what do they say when a jurisdiction like New York City sees a significant drop in violent crime while, at the same time, refusing to relax its stringent gun control laws at all?  The silence is deafening.  The truth is that Dr. Orient and her followers are opposed to gun control because they are opposed to all government regulations, not just as they might apply to guns, but as they apply to environment, financial activities and, of course, the practice of medicine itself.

On the other hand, when serious research on gun violence is done by serious medical and public health researchers, they need to put as much time and energy into publicizing the results as they spend in doing the research itself.  Sending a press release to the gun control lobby, like the Brady Campaign or The Coalition to Stop Gun Violence does nothing to mitigate the pro-gun advocacy work of Jane Orient and her like-minded friends.  But if the American Academy of Pediatrics decided it wanted to tell the world about a new study on school bullying, I guarantee they would send something to every PTA.  I’m really glad that a few voices are finally speaking up for the necessity of more physician advocacy about guns.  Like I said yesterday, I just want a fair fight, and for that to take place, the medical community has to get back into the fray.