Doctors "Should Do No Harm" but How About Carrying a Gun?

Is there any profession which is so dedicated to non-violence and "to do no harm" to others and particularly to those they serve? I am thinking about a priest or reverend or rabbi or others supporting their God.  I am also thinking about a physician. I found an interesting website (Brainblogger) and article regarding doctors and their access to guns either within or outside their office. There are also present a number of visitor comments and it seems that the majority find acceptance with regard to doctors having guns for self-protection and protection of their offices.  

But, what about the professional ethics of carrying a gun with the intent to shoot and most likely kill someone as a response to a threat to ones own life? Should doctors have some higher duty "to do no harm" if such harm could be prevented by not having a gun readily available?  ..Maurice.

p.s. On the other hand.  Here is another view of doctors and guns which has been seen on various websites but I don't vouch for all the statistics presented. However, I guess there are different ways of looking at the doctors and guns issue.

Doctors
(A) The number of physicians in the U.S. is 700,000.

(B) Accidental deaths caused by Physicians per year are 120,000..
(C) Accidental deaths per physician is 0.171 (17%).
Statistics courtesy of U.S. Dept of Health and Human Services.

Now think about this:
Guns
(A) The number of gun owners in the U.S. is 80,000,000. (Yes, that's 80 million !)
(B) The number of accidental gun deaths per year, all age groups, is 1,500.
(C) The number of accidental deaths per gun owner is .0000188 (.00188%)
Statistics courtesy of the F.B.I.
So, statistically, doctors are approximately 9,000 times more dangerous than gun owners.
Remember, 'Guns don't kill people, doctors do.'
FACT: NOT EVERYONE HAS A GUN, BUT ALMOST EVERYONE HAS AT LEAST ONE DOCTOR.
Please alert your friends to this alarming threat. We must ban doctors before this gets completely out of hand!!!!!

P.S. - Out of concern for the public at large, I have withheld the statistics on lawyers for fear the shock would cause people to panic and seek medical attention.

What is the Difference Between What is "Good" and What is "Bad"?

Perhaps, since what is a "good" for one person may be a "bad" for another, perhaps the question why should society bother to distinguish the "good" from the "bad" in the first place? Is it essential for society to define the differences in order to set standards acceptable to society with regard to individual behavior to prevent chaos: a conflict between persons who find one behavior to be acceptable and the other persons who find it unacceptable? And yet, one might wonder whether society, perhaps through political decisions and laws, are setting too many standards, too many decisions as to what is good and what is bad, perhaps more than what is really needed.  Actually, I shouldn't be blaming society in general since each individual in society may live their life with their own stereotypes of other's behavior or their own life experiences or possibilities as either good or bad. And these stereotypes may not be based on facts but more on feelings or moral beliefs.  What do you think? ..Maurice.

What's On Your Mind?: Medicine and Ethics

In the past 8 years, I have covered many, many topics regarding bioethics, ethics in general and ethics specifically as related to medical education and medical practice and I have many, many visitors who have contributed to the threads I have developed.  But, still, there may be a host of topics which I have not considered and which has troubled some visitor.  On this thread, I would like to hear about those topics which could be further developed or started as new. Google's Knol, a site where I was attempting to answer the ethics concerns of visitors there over the last few years is now being dismantled by Google. So, let's hear from you here if you have an idea or question. ..Maurice.

Gender Inequality and the Case of Contraception

Equality between genders.  Is that what our western culture should attempt to attain?  Would this be the most fair and just way for our civilization to move forward in the 21st century? There are attempts at beginning equality in employment, with women catching up to men in terms of responsibility and salary.  In medicine, my field, medical school student gender proportions are running close to 50-50.  In nursing, men have a long way to catch up.  In the management of home life along with care of the children, men are said to be more participatory these days than in the past allowing women to leave the house.

But also these days, women have been the political and philosophic or religious targets regarding issues of their potential for conception of new members of the family and the sustaining of pregnancy to delivery.  Currently, these issues have arisen with perhaps more civil and uncivil agitation than in the past with regard to contraception and abortion.  In the United States, these issues deal with the declared rights of women for control over their own bodies before and after pregnancy.  State laws are being written to suppress any such considered rights with requirements that can lead to severe penalties  applied to the women and their physicians if the requirements are not followed.   The goal of some creating such laws applied to women is to prevent contraception and diminish the opportunity for abortion.  Some laws are designed to subject women to severe legal penalty for various behaviors and acts during pregnancy which may harm a fetus.  It may require a woman's medical record to be scrutinized by government to assure that a woman is following  the rules.

And yet, in this area of potential restrictions regarding pregnancy as applied to women there appears to be no interest in gender equality.  Men have so far been immune from these laws which appear to favor conception and deny contraception for women or deny a pregnant woman control over her body. Specifically,  a husband who has a vasectomy for contraception purposes has so far not been under the watchful eye of the politicians  or their activists.  (There currently however is one exception in which a law proposed in Missouri by women lawmakers would make vasectomy for contraception purposes illegal.  It may not be formally debated or signed into law perhaps because of resistance by the male lawmakers.) And definitely men still have control over what happens to their bodies.

I wonder how my blog visitors feel about gender (either gender) inequality in general and the current gender inequality with regard to conception.  Write and let me know. ..Maurice.   

Patient Modesty: Volume 48

Yes, I do want to continue this thread despite its many year length. Why? Because the issues which have been presented here by my visitors over the years have not been resolved or even significantly beginning to be resolved and I do think that the issues presented regarding patient physical modesty and medical caregiver gender selection, even if only an issue for a small population of patients is still meritorious and need mitigation and resolution.  Every patient, even from a small population, should be treated humanely and given all the support they need during their interaction with the medical system.  If we, as professionals speak about "medical care" to ourselves, to patients and others, I do think that we should "care".  ..Maurice.

Graphic: "Helping Hands" from a Google resource site

NOTICE: AS OF TODAY MAY 30, 2012 "PATIENT MODESTY: VOLUME 48" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 49

Cyberchondria: "Doc, I Know My Diagnosis, Tell Me if I am Right"

With the widespread access to the Internet and all the "medical information" sites throughout, it is not surprising that "cyberchondria" (patient worries about diagnoses that they obtained by researching the Internet) is becoming a common experience for physicians to encounter.  Read the article in Amednews.com (American Medical Association News) about cyberchondria and return and let's talk about it.  What are the "goods" and what are the  "bads" aspects of this Internet educational opportunity?  ..Maurice.

A Doctor's Decision: Whether or Not to "Call the Cops"

A most interesting scenario was posted on Medpedia by Scott M. Dyck which I am, in part, reproducing here but you might want to go there to review the responses there but also feel free to make your comments here. If you were the doctor in this case, what would you do? ..Maurice.

You are a general practitioner and a mother comes into your office with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood, and improve circulation and healing. When you touch the boy's back with your stethoscope, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother. 

Doctor vs Computer: Can a Computer Make a Better Diagnosis?

I found this visitor question on a discussion forum:" i was debating this with some doctors who say that it would be impossible to program a computer to make diagnoses as well as they can. i find this pretty ridiculous. whatever thought process/string of questions they would use to analyze the situation are the same that the computer would be programmed to use. the compute:r would then analyze all available information, ask questions, analyze the answers and assign probabilities. in fact, it seems like this would be way simpler than some of the things computers have already been programmed for. what do u think?"


So what do I think? 

My opinion, as a doctor, is that  what is input into a computer for calculation is the most important  part of the process of making a diagnosis and deciding on a treatment program to benefit the patient.   No amount of computer power or access to data storage will substitute for the physician's input of the history and the physical findings of the patient.  A computer posing questions to a patient and the patient responding will never substitute for a direct doctor-patient communication.  There are many subtleties, nuances  of a history which can never be accessed by a computer, such as body language and verbal expressions  and there is no way for a computer to perform a complete and worthy physical examination.  A robot used in surgery still requires a doctor behind it and no robot will attain the skills to inspect, auscultate, palpate and percuss and then interpret  the findings.  To me, how complete and understood is the input of data both from a patient telling a history and the doctor performing a physical is the basis for the diagnosis.   Poor input will always lead to poor output.  And, finally, it will always take a doctor to analyze the results of the computer to confirm its diagnosis.  I would agree that the doctor with knowledge and with experience and then working together with the computer can be most productive of  the correct diagnosis.

So.. what do you think?

..Maurice.

Patient Modesty: Volume 47

We continue here the discussion regarding how the concerns about healthcare provider gender selection by patients and ways for the patient to be more comfortable with those who attend them can be brought to the attention of all those who provide service and maintain the status quo in the healthcare system.  ..Maurice.


ADDENDUM (1-16-2012)  On this date, PT, a long-time writer to this thread on Patient Modesty, wrote the following comment which includes a potentially valuable suggestion for a method for those who want to change the current medical system regarding patient modesty and caregiver gender selection.  This is what he wrote:
Alan said

" Rosa parks was a single woman who started
a movement with a single act of resistance,Malcolm X
took another path and my style is more like Rosa parks
than Malcolm."


My style is more like Genghis Khan until I
realized that the pen is mightier than the sword. My idea
to solve this issue is a 40 step process, meaning I have
put together 40 different avenues of approach over a
period of about 10 months.

Here is the first avenue, visit www.change.org
to start a petition. Now I suggest you start perhaps at a
hospital or clinic that you in the past had concerns with.
Others around the world will join the petition
and to be effective use multiple facilities in each city. Keep
in mind this is a medium to bring our concerns forward. The
first of many mediums we will use as I suggested in volume
46 of Dr. B's blog.


PT 


NOTICE: AS OF TODAY FEBRUARY 20, 2012 "PATIENT MODESTY: VOLUME 47" WILL BE CLOSED FOR FURTHER COMMENTS. YOU CAN CONTINUE POSTING COMMENTS ON VOLUME 48

Graphic: From Google image resource modified by me with Picasa3.