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As Terror Strikes Orlando, AMA Tackles Violence

— Is it a public health issue?

Last Updated June 13, 2016
Ƶ MedicalToday

This article is a collaboration between Ƶ and:

CHICAGO -- Against news reports about nightclub, doctors meeting here urged the American Medical Association (AMA) to study health outcomes of violent encounters between police and civilians.

In the same session, doctors sought solutions for violence in the nation's hospitals.

For more than 45 minutes, AMA delegates debated two proposals: one asked the AMA to fund a study of the health effects of verbal or physical violence between police and unarmed civilians, especially nonwhite civilians; and the other sought to restrict guns and Tasers from hospitals, especially from the emergency department and psychiatric unit.

The debate came during testimony before a reference committee charged with review of public health issues. That committee will present a report to the AMA House of Delegates and the recommendations in that report -- if approved by the full house -- will become AMA policy.

Speaking to the need for the AMA to study the current tensions between law enforcement and unarmed civilians, American Academy of Family Physicians delegate of Fitchburg, Wis., said the family physicians "are on the front lines in our communities and we see this mistrust and animosity every day ... every day we see people in our practices who are afraid they will be attacked.

"You need look no further than where the mayor ... has not been able to find a way [to contain violence] to know that the effects of this can really be life changing for all," Bisgrove added.

More than a dozen delegates supporting various states and specialty societies urged the AMA reference committee to endorse the need for a study, but one physician opposed the idea. The AMA, he said, was regularly criticized for failing to achieve goals such as a reducing red tape for practicing physicians -- goals clearly within the AMA wheelhouse -- so "how can we study something at which we have no expertise ... I think it is very presumptive to propose this." He added that he was speaking "only for myself."

American Academy of Pediatricians delegate , of Fort Worth, Texas, countered that argument: "As a pediatric emergency physician, I say this is a public health issue. To say we are not experts in injuries is baseless ... this is the social determinant of health."

Emergency physician , of Los Angeles agreed. "We know public health. We know trauma," said Eiting, an alternate delegate from California.

And , a former AMA president, also agreed. Asked by Ƶ if there was a public health need for such a study, he said "absolutely ... but it must be studied both ways: the effect on police and civilians."

The same committee also heard testimony regarding a resolution by the minority affairs section urging the AMA to "advocate that hospitals and other healthcare delivery settings restrict guns and Tasers on their premises, particularly in emergency departments and psychiatric units where patients suffering from mental illness are present."

, an orthopedic surgery resident in New York City who wrote the resolution and spoke on behalf of the minority affairs section, testified that his brother, who is mentally ill, voluntarily presented at a hospital in Houston last August seeking attention. After he was admitted and became disoriented, "the nurse called for security ... the officers entered room, Tased him, and shot him in the chest, inside his hospital room" even though he was naked and had no weapon on him, Pean said. "They handcuffed him as he was unconscious and threw a drape over his body ... a code was called."

Pean's brother, who was the subject of an , survived and now goes on speaking tours to raise awareness of the issue. "We don't want for this resolution to limit or hinder the ability of personnel to respond to these kinds of incidents, but we have to keep in mind what policies in place currently do when it comes to limiting access to the most vulnerable patients -- patients like my brother," said Pean.

Most delegates seemed to agree with the resolution. "I work in a federal prison so I am considered law enforcement officer; we do not have any weapons," said of Rochester, Minn., a delegate from the minority affairs section. "Somehow we are able to work and function in environment with dangerous people [even though] they clearly outnumber the staff."

Some delegates did speak in favor of more enhanced security. , an American Academy of Pediatrics delegate from Fort Worth, Texas, described an incident in which a father who was upset with the hospital's treatment of his 4-day-old baby said he would "go to the car to get my gun to take care of this problem."

"I live in Texas -- you know he had a gun in his car," said Garretson, speaking for herself; she added that security did not allow him back onto the premises. She urged the committee to change the word "restrict" to "limit." "Tell me I can't have anything to protect our staff and ourselves, and I'm in trouble," she said.