Kentucky’s largest medical association has made gun safety and advocacy for tighter gun restrictions a top policy priority ahead of its annual meeting this weekend.

Louisville doctors have proposed nine policy resolutions related to firearm safety to be considered for adoption at the Kentucky Medical Association’s August 25-27 annual meeting — more than any other subject. Kentucky has the “14th-highest rate of gun deaths,” one resolution reads, and as such, KMA should champion legislation to ban assault weapons, high-capacity magazines, and the passage of “red flag laws, to disarm persons who pose risks of gun violence to self or others,” another reads.

The state medical association, by definition, is an advocacy organization to promote the well-being of patients, doctors and the community at large, said KMA Executive Vice President Patrick Padgett. Though KMA policy is not enforceable, it represents the consensus of a membership organization that represents thousands of doctors statewide, he said. KMA members also regularly conduct grassroots advocacy with lawmakers to provide expert opinions on health-related bills.

The medical association has a chance to make changes to its own policy once a year. In late August, hundreds of physicians convene for the association’s annual meeting to deliberate new proposals and discuss modifications to the current policy handbook. Any KMA member can propose a policy change. Once submitted, those proposals enter a maze of scrutiny and deliberation. On Sunday, a group of more than 100 doctors in KMA’s House of Delegates will gather to discuss and vote on which resolutions to officially endorse. Those deliberations are closed to the public.

ADVERTISEMENT Advertisement

Gun safety, the need for tighter restrictions, and whether the KMA should adopt policy opposing the GOP supermajority General Assembly’s track record on firearm legislation, are likely to be the topic most discussed this year.

One proposal asks the state create an Office of Gun Safety to “reduce firearm-related deaths,”; a second calls for tighter gun laws to reduce Kentucky’s higher-than average rate of “intimate female partner homicides” — 69% in Kentucky compared with 56% nationally; and a third champions the need for doctors to screen their adult and child patients for the presence of guns in their households.

Three proposals call on Kentucky lawmakers to adopt “red flag laws,” or extreme risk protection orders, to temporarily bar people who are deemed by a court as a risk to themselves or others from possessing guns. Gov. Andy Beshear, a Democrat, has called for the Legislature to pass laws to this end multiples times since he became governor — as far back as 2019 after two mass shootings in El Paso, Texas, and Dayton, Ohio, left dozens of people dead, and again this year, after a gunman in downtown Louisville killed five people.

In a state that has historically championed the proliferation of and freedom to possess firearms, laws that place restrictions on a person’s ability to have a gun, even if temporary, are not popular with the political party in power. Beshear’s predecessor, Republican Gov. Matt Bevin, said in 2019 that red flag laws are an “erosion of our constitutional rights” and instead signed a conceal carry bill into law, which codified that no separate permit or training is needed for legal firearm owners to conceal carry a gun. In 2020, a bipartisan bill to enact a red flag law in Kentucky failed to get traction. Earlier this year, legislators enacted a law making Kentucky a “Second Amendment Sanctuary” state.

Two of the KMA’s proposals related to gun safety include barbed criticisms of Kentucky’s GOP supermajority, which, as one resolution notes, “has denied protection of our school children, citizens and police officers by ignoring control measures for assault rifles and killing enhancements by avoiding enactment of effective background checks and ‘red flag’ laws.”

That resolution also calls for lawmakers to ban semi-automatic weapons and “killing enforcement features,” including high-capacity magazines and bump stocks.

Another calls for Kentucky to repeal its Second Amendment Sanctuary law and scolds lawmakers for not budging on “commonsense gun violence control laws to protect their citizens.”

The Kentucky state legislature “has not only failed to do so, but it has passed a law prohibiting local community government from enacting gun violence control laws to protect their local citizens.” This law, as well as the state’s Sanctuary law, “substantially weakens protection of our school children, citizens and police officers from mass shootings and gun violence,” the proposal reads.

Policy proposals to restore abortion access

At the 2022 annual KMA meeting, two months after the U.S. Supreme Court overturned federal abortion protections and Kentucky’s trigger law banning the medical procedure except to save a pregnant person’s life became law, abortion-related policies were the dominating issue.

Though abortion is the evidence-based standard of care — a reality at odds with Kentucky’s law banning nearly all abortions — doctors at last year’s meeting could not reach consensus to take a bold stance in opposition to state laws restricting it. That outcome — five, total, resolutions were proposed but most weren’t adopted — wasn’t because abortion isn’t considered health care (all major U.S. medical associations agree it is). But for fear among some member physicians that adopting policy at odds with the political majority would alienate the body responsible for passing laws in Kentucky, the Herald-Leader reported at the time.

This year, there are three abortion-related policy proposals. The first, from Lexington doctors, seeks to amend KMA’s official policy to make clear the association “supports comprehensive health care for women, including the opportunity to choose a medical or surgical abortion,” and to codify that “KMA opposes criminalization of any appropriate medical care provided by a physician.” Abortion is currently criminalized in Kentucky; providers who perform abortions in cases where the life of the pregnant person is not imminently threatened can be charged with a Class D felony.

The second, brought by current KMA President Dr. Monalisa Tailor, calls on the association to publicly advocate for “revisions” to state statute that “restricts access to abortion-inducing medications for women who experience underlying medical conditions currently with life-threatening pregnancies.”

It’s aimed at Brandenburg Rep. Nancy Tate’s House Bill 3, an omnibus bill passed into law in 2022. The law prohibits doctors from providing abortion-inducing medication to patients with certain medical histories, including if they have a history of ectopic pregnancies, are taking steroid hormones for rheumatoid arthritis, or are on a blood thinner medication for a heart condition, for example.

“The unintended consequences of HB3 could adversely impact women and risk their lives during a life-threatening pregnancy,” the proposal reads.

The third asks for abortion training opportunities in OBGYN residency settings to be protected. “There are no current family planning fellowship training programs in Kentucky,” it says. If nothing is done to protect abortion training, “Residents will compromise the future of OBGYN health care and failure to incorporate abortion training in resident curriculum will lead to a generation of physicians ill-equipped to fulfill their duty to care for patients.”

Transgender health care and human sexuality curriculum

Last year, before most GOP-controlled states around the country began outlawing gender-affirming care for transgender youth, KMA adopted a policy supporting access to hormones and puberty blockers, and the preservation of the doctor-patient relationship in such settings, devoid of political tampering.

According to the current policy handbook, KMA “advocates against any prohibition of physicians or other health care providers (from) socially affirming gender identity or discussing evidence-based therapies for management of gender dysphoria with their patients and their parents.”

The association also supports behavioral health options and “non-surgical treatment provided to youth by appropriately trained and experienced health care providers.”

Since this policy was adopted in 2022, the General Assembly passed Senate Bill 150, outlawing all forms of gender-affirming medical care for trans youth, contradicting the advice of the KMA and major U.S. medical associations.

No proposed policy changes this year address gender-affirming care. But a few address SB150’s mandate that no instruction on human sexuality and sexually transmitted diseases be taught to students under grade 6.

This portion of the law, the first proposal reads, “has raised the question of whether teaching students human health-related curriculum, including puberty and menstrual health education, is permitted in Kentucky before grade 6.”

Elementary students should have access to sex education “related to menstruation and puberty,” the proposal, written by two University of Louisville School of Medicine students, says.

It opposes “abstinence-first sex education” — currently the standard in Kentucky — and asks that sex-ed be offered to elementary students in an age-appropriate manner. The proposal also asks for sex-ed curriculum to include “LGBTQIA practices for safe sex, in the interest of equality of prevention of sexually transmitted diseases,” as well as information on sexual assault.

A final proposal from Louisville physicians applicable to restrictions on abortion and gender-affirming care addresses burnout among doctors, in part caused by “moral injury.” It asks the General Assembly, directly, for help in solving the problem.

The resolution describes moral injury as “the challenge of simultaneously knowing what care patients need but being unable to provide it due to a variety of constraints that are beyond a physician’s control.”