Remember the Thrilla in Manila?  We’ve got Docs Versus Glocks and Round 3 has just come to an end.  The epic battle began in 2011 when the Florida legislature passed a law prohibiting physicians from inquiring about ownership of firearms unless the question was “relevant to the patient’s medical care or safety or the safety of others.” [All quotes from the decision posted on the 11^th Circuit website.]  That was Round 1.  The law was then challenged in Federal District Court and overthrown by Judge Marcia Cooke who issued a permanent injunction because it violated physicians’ 1^st Amendment free speech by curbing the ability of the doctor to freely inquire into situations that might impact a patient’s health. That was Round 2. The State of Florida then appealed to the 11^th Circuit which declared the law constitutional last week. Interestingly, the Circuit Court did not order Judge Cooke’s injunction to be lifted, which means that as of the end of Round 3, it’s something of a tie.

I’m no constitutional lawyer, or any other kind of lawyer for that matter, but I have been following this case very closely because it’s part and parcel of the NRA’s attempt to push physicians out of the discussion about guns, a campaign they have been effectively waging since 1996.  That year Congress removed funding for gun research from the CDC budget, a prohibition that was later spread to other federal research agencies and remains in effect to this day.  And even though a meeting of the Institute of Medicine following Sandy Hook identified areas of gun research that should be pursued, there’s scant (which means ‘no’) chance that such funding will appear.

                The ‘official’ reason that the NRA is against research into gun violence is that the research is being carried out by public health and medical scholars who use such research to advance an anti-gun agenda.  And if by ‘anti-gun’ the NRA means any form of gun control, they happen to be right.  The basic public health research on guns shows again and again that the presence of a gun heightens the possibility of homicides, assaults and suicides, findings that the NRA says are contradicted by the research of people like Gary Kleck and John Lott whose research allegedly proves that more guns equals less crime.  But no matter how you shake or bake the data, it’s simply impossible to deny the intuitive judgement of the novelist Walter Mosley that “if you carry a gun, it’s bound to go off sooner or later.” And if the bullet from that gun hits another person, there’s only one group of professionals whose response we really trust.

. The 11^th Circuit majority found the Florida law constitutional because they believe that the professional-client communication doesn’t necessarily warrant 1^st Amendment guarantees.   The law, according to the majority, only prohibits physicians from “inquiring about a private matter irrelevant to medical care.”  But what the majority avoided in its decision was spelling out who has the authority and obligation to decide the issue of relevancy, which, according to the dissenting judge in this case, is the responsibility of doctors themselves.  The dissent noted that gun violence is considered a public health issue by virtually every medical society, and physicians are performing their “chosen role” by informing their patients about risks that come with the ownership of guns.

I was in the audience at Madison Square Garden  when Ali won the Thrilla in Manila because he just outlasted Smokin’ Joe.  I think that Docs Versus Glocks will end the same way because no matter how hard the NRA keeps hammering, we value the competence and  expertise of physicians and we ultimately expect them to decide what’s best for our health.  The majority in the 11^th Circuit recognized that “the patient must place his or her trust in the physician’s guidance,” which means listening to what the doctor says even if even it’s something we don’t want to hear.  And by the way, there’s no patient in America who ever has to do what the doctor says.