Abuse of data

Via a comment by Paul Koning we have this commentary in the Wall Street Journal:

Doctor to Patient: Do You Have a Gun?

I cannot understand how my asking this question will help.

From a public-health standpoint, adding this question to the medical history must seem logical to policy gurus far removed from the trenches of primary care. According to the American Foundation for Suicide Prevention, 60% of the 30,000 Americans who take their own lives every year do so with a firearm. Ninety die every day from shootings—60 are suicide, 30 are murders.

Yet as horrified as I am by these losses, I cannot understand how my asking this question will help. If a patient’s answer is “Yes,” then what I am to say?

Of course, the platitudes: Guns can be a danger around the home, especially one with children. Make sure you use gunlocks or a special safe. Everyone knows this; it’s akin to telling patients that smoking is hazardous to one’s health. And now that my patient has admitted that he owns a firearm, this fact is duly recorded into the—secure, of course!—electronic medical record.

If my patient suffers from mental illness or substance abuse but is not, in my estimation, a danger to himself or others, then what? Report the patient to someone, some agency? Who might that be? Will my patient be harmed more than helped? What will it do to my ongoing relationship with my patient?

The obvious take-away from the article is that the suggestion that doctors ask patients if they own guns was not well thought out.

As Paul points out in his comment the data is required to go into an electronic records system which is susceptible to hacking (ask the DNC if you doubt me).

Another plausible point, as Paul pointed out in his email to me, is it is a “push for doctors asking about guns to be an attempt to spread hoplophobic disinformation”.

And as Paul hinted in his email one can extrapolate even further to see how these electronic records could be use to build databases of gun owners. Sure, the records are supposed to be private from government snooping except under certain conditions:

The federal Health Insurance Portability and Accountability Act (HIPAA) states that protected health information may be disclosed if it “is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and . . . is to a person or persons reasonably able to prevent or lessen the threat including the target of the threat.”

But we have laws in existence, right now, which require medical personal report people with, or had, mental health issues to the government so they can be prevented from purchasing guns. How much of a stretch is it to imagine a one or two line amendment to HIPAA which requires the reporting of self reporting gun owners?

And what does the government care about following original intent of the law? Census data has been abused by the governments throughout history:

The Civil War
Along with the benefits of census information for war planning, the census can be used for methods of destruction as a war tactic. General Sherman used census data to locate targets during the famed Civil War March though Georgia.
World War II and Japanese Internment
A specific example of the privacy risks of the US census can also be found in the 1940s. During World War II, Japanese-American citizens were rounded up and sent to internment camps. The Census Bureau might not have necessarily given out individual Japanese-American names or numbers, but the Bureau did work with US War Department to offer aggregated data about certain localities. Although there is still a lack of consensus concerning specific conclusions, the Census Bureau has issued a formal apology and now reports that the Bureau did not protect Japanese-Americans.
[It has been admitted the census bureau did give detailed info to the Secret Service.—Joe]
It has been recorded that even before the Japanese attack on Pearl Harbor, President Franklin Delano Roosevelt ordered the Census Bureau to collect information on “American-born and foreign-born Japanese” from the Census data lists. Information was gathered from the 1930 and 1940 censuses on all Japanese-Americans and then given to the FBI and top military officials. These sources point directly to the census information as one of the reasons that led to the internment of almost 110,000 Japanese-Americans on the West Coast, two-thirds of whom were U.S. citizens.
United Kingdom
A recent example of abuse from abroad can be found in the United Kingdom. It recently has reached the public view that compulsory transfers were considered in Northern Ireland in 1972. A UK government top-secret memo has surfaced describing a plan to relocate Irish Catholics. The plan was written with census data. Although never implemented, the use of census data for non-statistical purposes has caused great concern in Europe.
Germany
Germany has a contrasting history in census reporting. The most extreme example of census abuse is Hitler’s use of the census to track minorities for extermination during the NAZI regime.

Germany not only used the census data (and gun registration data) of their own country but that of countries which they conquered for evil purposes. My general rule is that if the data exists then it will be abused by a government. Carefully consider the type and persistence of data you disclose to anyone.

12 thoughts on “Abuse of data

  1. I’ve been asked that question a couple of times by doctors.

    I always ask them to define a medical ethics Boundary violation first. Then I ask if they are certified and trained in firearms safety. Then I ask them if this office makes a habit of having untrained and uncertified individuals giving advice.

    • My PCP is a lady from Bangla Desh. I figure if she ever asks that (hasn’t yet) I might take it as an opportunity (from one immigrant to another) to explain the benefits of the right to be armed vs. the disarmed victimhood practiced in much of the rest of the world. Given the known record of terrorism in her old country, I figure that might resonate.

  2. I once asked my doctor if she every asks about guns. She said that comes from a gun family and would never ask about guns unless she felt it was pertinent to her diagnosis such as extreme depression.

  3. Well, the doc isn’t supposed to say anything. He is to be a dutiful servant of the police state and enter these data into the system. Try hard doc, not to think about the death and destruction that follows some years down the road. Of course, there is that oath thingy you took, something about doing no harm.

    So this guy has 20 years of education and can’t pull this string in his mind to see how it unravels. Doctor? Pffft.

    Who kept the lists for hitler/mao/stalin. That’s who NEEDS the data. It’s the same evil.

    Bad language alert:
    The correct answer is; “do you swallow one while taking it up the ass from another? Yes doc, the question is that offensive, more so, if one knows history.

    • Die Geschichte der Juden in Deutschland, for one such history.
      Others exist, too.

      There’s a saying among hackers that data wants to be free, but free for what purpose is never said.

  4. Of course it’s an awkward question. It’s just as awkward as asking a patient if they have sex toys in their home.

    Those policy wonks “far removed from the trenches of primary care” could care less about the well-being of your patients, doc. It’s all about combining discrete data elements into information about those people, the ones who may threaten the progressive march to “Utopia.” (They use “Utopia” because their useful idiots can’t spell “totalitarianism.”)

    If this was about the “gun violence” of suicide, we might expect the physician to first ask about the patient’s attitudes, whether life is interesting to them or painful, or perhaps if they feel depressed, lost or constantly angry. Only if they get positive responses might asking about firearms be appropriate.

    Even here in the loopy liberal-land of California I’ve yet to have any doctor ask me this question. If so, I’m certainly going to ask how it pertains to the current medical condition I’m there about.

  5. “The obvious take-away from the article is that the suggestion that doctors ask patients if they own guns was not well thought out.”

    Wrong. The purpose of including the question was extensively thought out by the AMA. The primary purpose is to demonize legal gun ownership among not only the AMA member doctors but also among their patient population, to as large an extent as possible. Their secondary purpose is to establish using electronic medical records a legal registry of US gun owners for future use against gun rights. There are no other purposes.

    Are people asked about ownership of 5 gallon buckets? No, yet those Home Depot buckets kill more kids under 5 years old than guns every year, in horrible drowning accidents. Asking about gun ownership has no real safety component, improves no health issue, and is nothing but political activism against guns.

    The leftists who control the AMA now are seeking to remove firearms from the populace through long-term demonization of ownership of legal firearms as a safety hazard, a public health issue, and a danger to self and others. In this they are ignoring larger dangers to their patient population. Their only purpose in asking about guns is to further public fear of guns, and to create an electronic database of gun ownership for government use.

    • Agreed, except that I thought it was the CDC (a government agency not authorized by the Constitution) that concocted this thing, not the AMA.

  6. If anybody has been hurt as a result of medical malpractice on this issue, I’d like to see them sue and be made whole, plus a generous punitive award. A crime victim, for example, who unwisely got rid of his/her gun based on medical advice. Especially if there was any coercion or extortion involved – a perceived threat to withhold medical care, or not file paperwork properly for insurance/payment.

    If the medical malpractice insurance is afraid of letting doctors ask stupid questions, then doctors won’t ask stupid questions.

  7. There exists a plethora of commentary about this kind of intrusive inquiry by primary health providers. The general consensus is that this kind of ‘health care’ questioning has bad consequenses.
    Physicions are warned, in professional journals, that this is not a question which is productive. Usually, health-care providers are not cognizant of the complexities, and the question is typically asked by “professionals” who have a political agenda.

    The best response to such a question, if you find yourself to be the subject of such an agenda-driven inquisition, is to remind your doctor that your firearms ownership was not the purpose of the visit. If the physician persists, you should notify your local physician website (and I don’t know how to do this, because even the recommended remedies are without substance) and also the AMA.

    Suggestion:
    http://search0.ama-assn.org/main/jsp/templates/primaryJSP/fullview.jsp?keyword=my+doctor+asks+me+about+guns&FilterList=&advancedSearch=&sort=&pagination=

    a start

  8. So far, I’ve had exactly one medical professional ask about my shooting habits, and since she was an audiologist, and since her very next question was about my hearing protection habits, it was kind of relevant.

  9. I wanted my lead level tested because of all the indoor shooting and reloading I do. My doctor wanted to know why the lead tests and so I explained and she agreed.

    My optometrists have asked about my hobbies as well as my job. They want to know if my vision correction is working. I told them about the challenges of my aging eyes and shooting iron sighted guns. They all offered things and I tried them without much success. A few years ago my optometrist suggested multi-focal length contact lenses. They are almost magical and I can see the sights and the target almost as well as I could when I was 30 years younger.

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