Cafe Hayek - Latest Comments in Why it's none of your business

Re: Why it's none of your business

Russ Roberts — Wed, 21 May 2008 10:58:28 -0000

Isaac Crawford and others,

I do not think this is a problem of the state though I think it is a related trend.

But, one of the reasons doctors don't treat me like a customer is because in general, most patients aren't the customer at least in the sense of being the one who pays the money. That is mainly due to the extensive government subsidies of education.

Re: Why it's none of your business

GumboFilé — Wed, 21 May 2008 09:43:52 -0000

Physicians are agents of the state. They are required to gather and report private information to the state.

Re: Why it's none of your business

Ben — Wed, 21 May 2008 09:31:39 -0000

You folks might want to look in to state law before jumping to conclusions. For example, the state of Washington grants autonomy (and privacy) to minors for medical decision making on a variety of issues (birth control, treatment of STD's, substance abuse, etc.)starting age 14 and up.

You may question the wisdom of such law, but don't disparage the doctor for trying to follow it.

Re: Why it's none of your business

Keith — Wed, 21 May 2008 05:57:14 -0000

Qoute from jmp: "In a few states hospital nurses in maternity need to ask the soon to be mom if she feels she and the baby will be safe at home, either due to abusive husbands, boyfriends, step-fathers, fathers, or whatever."

Funny, since statistically women are far more likely to abuse children than men.

Re: Why it's none of your business

Keith — Wed, 21 May 2008 05:54:48 -0000

Quote from Russell Roberts: "Raise your children as you see fit. Just don't presume to raise mine for me."

I think you've hit the crux of the problem. There are too many people who do presume to raise your, and everybody else's, children. They always seem to "know better". The whole "it takes a village" mob of academics, medicals, and "law enforcers" (religious and civic) can never seem to mind their own business.

Re: Why it's none of your business

cpurick — Wed, 21 May 2008 05:47:21 -0000

Sorry, I thought the doc was trying to do your son a service. As far as I see it, the burden is on you to work out with your son what he'll talk to others about.

I saw no evidence that the doc was going to give your son any instruction or advice that your son didn't ask for; he merely offered your boy an opportunity to ask it in private.

Unless you honestly think your 13-year-old doesn't have a private life that you don't know about -- sexual, or otherwise -- I think the doc was only offering him more service than he might seek in the presence of his parents.

Do you not think the doc is fully on your side??? Where did you get the adversarial position from? You sound pretty jaded, Russ.

If you don't think the doc is on your side, then get another one. Otherwise, you might trust your son with a man whom you'd allow to probe your prostate or stick a needle full of who-knows-what in your (or your son's) arm.

The doc, AFAIK, is not an agent of the state, and I didn't take it as if he's gathering any information "against you."

In this case, the doc's intentions are probably good enough that he'd be a little offended to see it put this way, even if he didn't say so.

What did the doc say when you talked to him about it?

Re: Why it's none of your business

Sam Grove — Wed, 21 May 2008 05:27:53 -0000

I want to know what you think of the writings of Judith Rich Harris, who points out why parents don't really have much direct affect on their kids outcomes anyway

Because they send their kids to government schools where they are socialized by other kids and teachers of a progressive bent.

Re: Why it's none of your business

sprague — Wed, 21 May 2008 04:32:30 -0000

I'm just one datapoint, so take it for what it's worth, but my wife sees no problem with this when the doctor asks to speak privately with our 10-year-old. Part of it is because we know the doctor well.

Russ, sometime I want to know what you think of the writings of Judith Rich Harris, who points out why parents don't really have much direct affect on their kids outcomes anyway (after accounting for genes of course).

Re: Why it's none of your business

save_the_rustbelt — Wed, 21 May 2008 04:26:32 -0000

Physicians are trained to take these actions these days, for a wide range of reasons.

Parents, however, still should maintain firm control of the situation.

Some of this comes from both real and (over) perceived problems of child abuse.

One really irritating school of thought is that the pediatrician should ask the kid if there are any firearms in the house. Not all docs buy that line of thinking though.

Having moved on to grandparent status, I now realize that we have created a society that heaps lots of stress on kids, and they all need some kind of safety valve. What that is I'm not really certain (school counselors are often the very worst - yuck).

Re: Why it's none of your business

vidyohs — Wed, 21 May 2008 03:50:23 -0000

Wow!

I am blown away by the wussie ignorance I see written above by some cafe visitors.

Russ you are one hundred percent correct in being concerned, and I for one thank you for blogging on the subject. You have not blown it out of context, and your suspicion that your son's doctor's activities are more than just a one time one doctor random incident is also one hundred percent correct. Reason magazine and Liberty both have reported on this trend in the medical profression.

I can't believe that I read some people above say that the doctor is not your employee.

Seeing the responses above makes me more afraid of the state than I already am. Look what they have done to my people.

A young couple I am friendly with had a child some three years ago here in a Houston Hospital. When it came time to check the mother and child out of the hospital included in the paperwork was an application for an SSN in the child's name. My friends refused to fill it out and the hospital told them that they would use security to prevent them from removing the child until the SSN form was filled out.

At that point my friends escaped the hospital without law confrontation by asserting that since the child had not been named yet and that wouldn't happen until the christening then the form couldn't be filled out. They escaped with their child and never went back.

And, you people out there think that the state isn't constricting around you like an Anaconda? Wake up. How many people were as educated to reality as my young friends and would just kneejerk fill out the form? Virtually all would because "the state" in the form of the official medical community is telling them they "have to".

No thought, no questions, no arguments, just do it, even though you have no clue as to its legality.

Bah, I get disgusted reading the words of statist ninnies. I am going to go make some money so I can pay my employee, the dentist, on Thursday.

Re: Why it's none of your business

richard — Wed, 21 May 2008 03:20:17 -0000

Let me add a note, because if I read back what I wrote, it sounds silly.

If the parent is responsible for protecting the child, who protects the child from the parent?

and

If the state is responsible for protecting the child, who protects the child from the state?

It still remains a difficult question.

Re: Why it's none of your business

richard — Wed, 21 May 2008 03:16:29 -0000

One of the things you expect the government to do is to protect the people who cannot protect themselves.

Children qualify for that.

i.e.: You would expect the state to protect children. They obviously cannot do this themselves.

This can be done through the parents, of coarse, but I don't think that this dismisses the state from making sure the child is protected.

Difficult question. I don't really have an answer.

Re: Why it's none of your business

babinich — Wed, 21 May 2008 01:57:09 -0000

Russ,

For what it's worth I am behind you one hundred percent.

As was mentioned before, the child was getting a check-up. This was not an urgent care event.

Simply put, this is an intrusion on parental boundaries.

Re: Why it's none of your business

Gil — Tue, 20 May 2008 22:54:26 -0000

Whoa!! When reading some of the posts here I almost forgot this was a Libertarian site! This is sure a far cry from Rothbard's belief that a parent is free to abandon children as the child has no positive rights that any other person can have towards the parent. But then didn't ten year olds, in the height of the Industrial Revolution, leave home and made their own way in the world or if men and women didn't have their first child by twenty then every one else presumed something was wrong with them?

Re: Why it's none of your business

Ray G — Tue, 20 May 2008 21:06:38 -0000

As for the pushing of early adulthood, that much I think Russ is perhaps thinking along the right lines, but he missed the real crux of the situation.

The village isn't trying to make adults out of our children (that would require the teaching of self-responsibility) the village is trying to insert itself where the parents naturally belong.

So children are told that abortion, sex, homosexuality and other such issues are not moral issues, but they are perfectly natural to everyday life, even adolescent life. Anyone who says otherwise is simply trying to "force" their morals on society, and so children are being raised - as much as possible - apart from the anachronistic ways of their parents, and more by the culture at large.

Re: Why it's none of your business

Chris — Tue, 20 May 2008 19:01:51 -0000

Student --

I think the idea that an adolescent should be able to get birth control (or an abortion) without a parent's permission is nuts. Those are moral issues into which it is wrong for some third party to intrude -- the ability to make up your own mind about such things comes at adulthood, or earlier _with_parental_consent_. Teenagers are simply too immature to make such choices for themselves, and a parent needs to be involved.

piperTom -- that can't really be the principle, can it? he-who-pays is often an insurance company, an employer or the government, even when the parent is present.

Re: Why it's none of your business

piperTom — Tue, 20 May 2008 18:19:39 -0000

Sir Russell is entirely correct and the doctor is, at best, a bonehead. The first thing the doctor must learn is that he-who-pays is the Customer. On top of that, any child living under the authority of his parent cannot make independent decisions. Got that, Doc?

After recognizing the above, the doctor may still have legitimate reasons to interview the patient in private. Here's the plan: explain this to the Parent! Pledge (and honor) to limit questions described to the parent. A VAST majority of parents will agree. For those who do not (unless there is evidence of a crime), that's the end of it.

Re: Why it's none of your business

shecky — Tue, 20 May 2008 18:00:47 -0000

I appreciate your explanation, Russ. But I still think you're out to lunch on this one. Do yourself a favor and find a new doctor you trust. You will be happier, and your doctor will be happier without a patient who believes his practice is sinister.

Re: Why it's none of your business

Ray G — Tue, 20 May 2008 17:27:28 -0000

I've been coming here to this blog for some time and I have never seen this amount of knee-jerk animosity to the professor.

He's a big boy and very intelligent so I'm not presuming to take up for him, but since I've not visited much in the last few months, I'm wondering what has changed.

Russ, did you come to someone's attention on the Left and now you're getting "seminar" posters?

This basic issue - parents' rights and an intrusive state - is a ready-made litmus test of ideology.

The classical liberal view as expressed already by Professor Roberts.

And then the textbook collectivist view that the community has a right to children that supersedes the parents'.

Re: Why it's none of your business

student — Tue, 20 May 2008 15:49:46 -0000

And it is not reasonable that you suggest that that person be someone other than the doctor. You must find him another private doctor, if you don't like this one. What if a girl wants birth control and the parent can't think of any doctor that the girl is allowed to talk with privately? Then the girl's out of luck. What if a boy wants to discuss any given bodily abnormality or physical dysfunction or mental health issue he was too embarassed to bring up with you, but he wants addressed? Since you have to choose for him a doctor he can speak to privately, I don't think it's unreasonable for the doctor to whom you actually brought your son presumes that he is the doctor you think your son can speak to privately. Getting 2 doctors, 1 for checkups, the other for father-approved medical concerns, is unusual.

Re: Why it's none of your business

Bret — Tue, 20 May 2008 15:46:28 -0000

Dr. T wrote: "...you are correct to be suspicious of a physician's motives for asking for a private conversation."

Hold on. The doctor did not ask for a private conversation. The doctor asked if the patient would like a private conversation. That's quite a bit different and not nearly so sinister.

Dr. T also wrote: "Most pediatricians and family practice physicians ... believe that they know more about what's good and bad for kids than parents do..."

I would hope that after umpteen years at medical school and practicing medicine that a doctor would know more about what's good and bad for my kid from a health perspecitive than I do. Otherwise why would I bring my child in for a checkup in the first place?

Dr. T also wrote: "They [the doctors] ask kids about their parents' habits (booze..."

Let's say that my wife and I were serious alcoholics or something and I brought my child to the checkup. First, as noted above (by Dr. T and myself), if I didn't want my child to have a private conversation with the doctor, I could put a stop to it and that'd be the end of the story.

But let's say I said okay to the private conversation. And let's say my child said something like, "Dr. Smith, my parents are drunk all the time and I'm terribly worried about them and the rest of my family and there's nobody else I can talk to about this. Is there anything I can do?"

The information is still confidential. The child might get some good advice. So what's wrong with that?

Re: Why it's none of your business

Constant — Tue, 20 May 2008 15:43:43 -0000

This article from the Boston Herald may be closely related to what's going on behind the scenes.

Excerpt from the article:

“The doctor wanted to know how much you and mom drink, and if I think it’s too much,” my daughter told us afterward, rolling her eyes in that exasperated 13-year-old way. “She asked if you two did drugs, or if there are drugs in the house.”

“What!” I yelped. “Who told her about my stasher, I mean, ‘It’s an outrage!’ ”

I turned to my wife. “You took her to the doctor. Why didn’t you say something?”

She couldn’t, she told me, because she knew nothing about it. All these questions were asked in private, without my wife’s knowledge or consent.

“The doctor wanted to know how we get along,” my daughter continued. Then she paused. “And if, well, Daddy, if you made me feel uncomfortable.”

Great. I send my daughter to the pediatrician to find out if she’s fit to play lacrosse, and the doctor spends her time trying to find out if her mom and I are drunk, drug-addicted sex criminals.

We’re not alone, either. Thanks to guidelines issued by the American Academy of Pediatrics and supported by the commonwealth, doctors across Massachusetts are interrogating our kids about mom and dad’s “bad” behavior.

We used to be proud parents. Now, thanks to the AAP, we’re “persons of interest.”

The paranoia over parents is so strong that the AAP encourages doctors to ignore “legal barriers and deference to parental involvement” and shake the children down for all the inside information they can get.

And that information doesn’t stay with the doctor, either.

Debbie is a mom from Uxbridge who was in the examination room when the pediatrician asked her 5-year-old, “Does Daddy own a gun?”

When the little girl said yes, the doctor began grilling her and her mom about the number and type of guns, how they are stored, etc.

If the incident had ended there, it would have merely been annoying.

But when a friend in law enforcement let Debbie know that her doctor had filed a report with the police about her family’s (entirely legal) gun ownership, she got mad.

Re: Why it's none of your business

student — Tue, 20 May 2008 15:38:20 -0000

I disagree. Your son's autonomy and privacy should not be denied, just because he is a minor. He should never be forced to speak about his medical issues with his parents. He has the right to know that he has access to a medical or mental health professional regarding any of his concerns. If you feel this doctor is a bad influence, fine, then maybe not with him. But you are obligated then to find a replacement, someone who is will respect his privacy while addressing personal concerns related to his health. If your son wants to talk privately about condoms with someone and not tell you, it's not your business, and you have to ensure that he has someone to do that with. If your son decides that he doesn't want to talk to a doctor in private, that's his prerogative and you both win. But you don't get to make that choice.

Re: Why it's none of your business

Joshua — Tue, 20 May 2008 15:35:25 -0000

"I can imagine lots of scenarios where I would want my children to have the opportunity to talk to people without me being there because my presence affects the outcome. But why would the doctor presume to have that conversation without my agreement?"

This seems to me a sensible way to look at it. Commenters have given a lot of good reasons why the doctor may want to talk to the child alone, and no doubt Roberts agrees with a lot of them. The point is that the doctor presumed to spring this on his wife unannounced. A better doctor might have pulled the wife aside, explained his rationale, given her a rough list of topics he was going to cover, asked her permission and, having gotten it, then asked for some guidelines on groundrules (i.e. how much of what the son says does he have to report back, etc.). If the AMA or whatever agency is encouraging these kinds of tactics, then they would be well-advised to hand out guidelines to doctors on the proper procedures for suggesting them, etc. Roberts isn't the only parent who isn't going to take kindly to this (and, for what it's worth, I am not a parent but am sure I would feel the same way as Roberts in the same situation).

Re: Why it's none of your business

Dr. T — Tue, 20 May 2008 15:07:45 -0000

Previous commenters were concerned about the child's rights or the doctor's rights in these situations. Since I am a licensed physician, I have the knowledge to respond.

This child was getting a check-up. He was not getting urgent or emergent care. Therefore, the parent or guardian has the right to specify exactly what will or will not be done. If the physician believes the restrictions are too onerous, he can negotiate or decline to do the exam. The child has no right to the most comprehensive physical possible, the child has no right to privacy (from parents) during the exam, and the physician has no right to perform only fully comprehensive exams.

Having dealt with overly intrusive or compulsive pediatricians with my own kids, I agree with Dr. Boudreaux's concerns.