Written by:  Suzanne Berman MD

Having lived in the South for much of my life, I have a healthy respect for states’ rights.  Local governments are more sensitive to their constituents’ issues, as well as better judges of how to manage them, than a well-meaning but massively out-of-touch federal government, whose legislative mandates might make perfect sense in one community but pose a significant burden to another.

Diversity also promotes some healthy competition.  Two states, struggling with the same issue, come up with different approaches to the same problem.  Take the Massachusetts model  and the Utah model for health insurance exchanges.   Health economists and politicians argue their relative merits but seem to forget the good news: we need not choose one over the other.  Because we have Massachusetts and we have Utah, we can have two different designs, executed simultaneously, each serving their citizens as they see fit.   Lois McMaster Bujold’s  heroine  Cordelia Vorkosigan describes this continuous parallel experimentation phenomenon as fifty-one sociopolitical culture dishes.

I’m thus reluctant to sneer at a regulation which I might perceive as poorly thought through, if not downright goofy, as long as it’s in another state, and that state’s citizenry is willing to give it a whirl.  I’m willing to grant you a modicum of grace without smirking as long as you don’t laugh too loud as we in Tennessee try to work through our own legislative kinks.

With that said, when a bill or regulation proposed in another state’s legislature is so ill-reasoned, it blasts right past stupid into scary.  Every newly-opened legislative season has its own particular crop of two-standard-deviations-beyond-the-mean-of-crazy.

Ah, yes, speaking of open season…  A proposed Florida law would make it a felony  for pediatricians to discuss gun access with families.

First of all, a felony?  Five years in jail or $5 million for following a national standard of pediatric preventive care?

Interestingly, this started as a pediatrician exercising his right to terminate the physician/patient relationship when his patient steadfastly refused to communicate with him about guns.  Since this bill would make it illegal to discharge such a patient from one’s practice, a physician would lose his say in whom he treats.

Not only could doctors not ask about guns, they would be forbidden to put any notation in a chart or tell anyone else.  If a child came to my emergency room with a bullet wound, I would not be permitted to ask how it happened, or let law enforcement know my findings.   I’m curious to know if the bill’s sponsor thinks physicians are just waiting to release tabulated data on gun owners to Big Brother. But I’m even more curious to know how this felony could be prosecuted, since my medical records are protected as confidential.

I’m feeling a lot of hostility oozing out the edges of this bill.  And I don’t get it.  I practice in a rural, gun-dense area; we discuss this right along with car safety seats, swimming pools, and medication safety.  Even dads who come in wearing NRA LIFE MEMBER caps see it as an opportunity to train their kids to respect the power of firearms.

I get the bit about how this is a Second Amendment issue.  However, were this law passed, Florida would trample the Eighth, Thirteenth, and Fourth Amendments.  And that, of course, that would violate the first section of the Fourteenth Amendment and work against the Tenth, which allows us to our sociopolitical culture dishes to flourish.

Dr. Berman  is a practicing pediatrician in rural Tennessee.  She enjoys finding applications of science fiction quotations to medical practice.