As a physician, I had always prided myself on being free to advise patients about all health issues, including risks that could endanger their personal well-being and that of their families and loved ones. This meant that I could inquire not only about immediate risks such as smoking and diet, but, among others, about whether a patient was using his/her seat belt when driving, or exposing family members to the toxic effects of secondary cigarette smoke in the home. I was also free to inquire whether a given patient had a firearm at home, because of the potential dangers involved. In that regard, evidence shows that the presence of a gun in a home increases by threefold the risk of death for all household members, especially by suicide, when compared with homes free of guns. Even worse, this risk rises to fivefold greater for children residing in homes possessing firearms. Thus these dangers are so great that it is incumbent on physicians to counsel patients about risks of home firearms and to recommend countermeasures, which include use of safety devices and meticulous storage of weapons, or better yet, total removal of guns from the household. This is so important that all major physicians’ organizations, including the AMA, have recommended that physicians discuss firearm safety with their patients.
So can such responsibilities be forbidden? Outrageously, Florida’s Firearm Owners’ Privacy Act was enacted in 2011 in response to concerns raised by some patients whose physicians asked them about gun ownership. The law prohibits physicians from intentionally entering information into a patient’s record about firearm ownership that “is not relevant to the patient’s medical care or safety, or the safety of others.” Thus physicians my not ask about firearm ownership unless they believe “in good faith” that “such information is relevant to the patient’s medical care or safety, or the safety of others.” Physicians who violate this law may be “disciplined” (whatever that means). Whew! How disingenuous can a law be?
Now several physicians and their organizations are rightly suing the Governor of Florida, claiming that the law violates the First Amendment. Subsequently, a 3-judge panel of the Florida Court of Appeals voted to uphold the Act. Although the legal interpretations were mixed, this court believed that physician counseling may be so persuasive as to deter patients from exercising their second amendment right to own guns. But they got it wrong! This amendment doesn’t protect anyone from hearing information about the risks of firearms. As a matter of fact, some limited studies suggest that gun owners counseled in this way are more likely to change storage and handling practices, thus reducing the odds of gun-related catastrophes.
This case is still being contested, and the associated First Amendment issues are apt to be major. Missouri and Montana already have laws similar to Florida’s, which have been (not surprisingly) strongly supported by the NRA. In 2011, the West Virginia legislature even considered a law that defined physicians’ questions about gun ownership as gross negligence.
If the Florida law is upheld, additional states may then enact similar restrictions, endangering physicians’ ability to counsel patients about gun safety. Even more egregious, this could lead to more invasive regulation of physician counseling; for instance, several states already require doctors to provide women—often against their wishes—with medically questionable information prior to abortions. All such laws threaten to compromise the physician-patient relationship, which relies on truthful and confidential communication in order to arrive at shared health goals. These laws unduly reflect the invasion of a physician’s ability to speak truthfully in the effort to protect a patient’s own health as well as that of their families.
Perhaps the NRA is creating more mischief than merely protecting the Second Amendment!