Should doctors ask patients about guns?

Physicians acknowledge that they ask their patients questions that, in any other context, would be considered nosy and meddlesome.

They expect to get some pushback. But when physicians in Florida ask whether a patient — or a young patient’s parent — has a gun in the home, they are now bracing for a call, and possibly a letter of discipline, from their state’s medical board. Physicians in Indiana and Texas are on notice that for them, too, such questions may soon be limited by law.

Since 2011, Florida has had a law on its books that restricts physicians from making routine inquiries about gun ownership and the storage practices of their patients or their patients’ legal guardians. The state legislatures of Indiana and Texas are currently considering similar bills.

The state of Florida, backed by the National Rifle Association, has asserted that gun owners need protections from “irrelevant inquiry and record-keeping by physicians regarding firearms.”

But Florida’s law is now at a legal crossroads, and the Journal of the American Medical Association this week weighed in to suggest that when physicians ask their patients about guns, they’re just doing their jobs — and exercising their First Amendment rights to speak freely.

In a “Medical News &Perspectives” article published online in JAMA on Wednesday, JAMA news writer Brigit Kuehn brought physicians up to date on a court ruling that may reverberate through medical practices across the country: a July 2014 court ruling upheld the 2011 Florida law; but the U.S. Court of Appeals 11th Circuit has been asked to reconsider that ruling.

After the Florida bill was signed into law by Gov. Rick Scott in 2011, several physician groups sued to block its implementation. The American Academy of Pediatrics, American Academy of Family Physicians, and state chapters of the American College of Physicians argued that gun-safety counseling is a physician’s legal and ethical obligation to his or her patients, and that the 2011 Florida law infringes on physicians’ and patients’ freedom of speech.

They won a preliminary injunction from a federal district judge in Atlanta. But last July, a three-member panel of the Court of Appeals 11th Circuit Court found Florida’s law to be “a valid regulation of professional conduct that has only an incidental effect on physicians’ speech.”

With support from the American Medical Association and the American Bar Association, the physicians groups have asked all nine judges of the 11th Circuit Court to review its panel’s earlier ruling.

A national survey conducted in 1997 for the Justice Department found that more than half of firearms in private hands were stored unlocked, and 16 percent were stored unlocked and loaded. That information is certainly dated (largely because the U.S. Congress put tight strictures on the use of taxpayer funds for gun research). But few doubt that if more guns were stored in locked cases, separate from ammunition, the result would be a decrease in firearms injuries, which in 2009 sent 20 kids to the hospital every day and claimed the lives of 453.

Physicians’ groups are growing increasingly restive about gun violence as a public health issue. Both in the public debate over guns and in private consultations with their patients, theirs is thought to be an influential voice.

According to a 2003 study, two-thirds of patients who were counseled briefly about safe-storage practices by their doctor reported that they stored their firearms locked, unloaded and inaccessible to children. Among gun-owning patients who got no such counseling from their physician, only a third said they followed such “triple safe” gun-storage practices.

The Florida law includes an exemption that allows a physician to inquire about guns in the home if he or she “in good faith believes this information is relevant to the patient’s medical care or safety or to the safety of others.” But physicians believe even with this exemption, the law would have a chilling effect on physicians’ inquiries and their willingness to counsel patients on safe gun practices.

“When questions are relevant to the health and safety of the patient, physicians should ask the questions, because that’s what the practice of medicine is all about,” Dr. Garen Wintemute, an emergency physician and gun-injury researcher at University of California Davis told JAMA.

If the July ruling by the 11th Circuit Court of Appeals panel stands, physicians fear not only that Florida doctors will shy from counseling their patients about guns; they worry too that Indiana and Texas will adopt similar laws, with some others following suit. Three other states — Montana, Minnesota and Missouri — already have weakened versions of such laws on their books, and measures have been introduced and failed in eight other states.

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

A firefighter stands in silence before a panel bearing the names of L. John Regelbrugge and Kris Regelbrugge during the ten-year remembrance of the Oso landslide on Friday, March 22, 2024, at the Oso Landslide Memorial in Oso, Washington. (Ryan Berry / The Herald)
‘Flood of emotions’ as Oso Landslide Memorial opens on 10th anniversary

Friends, family and first responders held a moment of silence at 10:37 a.m. at the new 2-acre memorial off Highway 530.

Julie Petersen poses for a photo with images of her sister Christina Jefferds and Jefferds’ grand daughter Sanoah Violet Huestis next to a memorial for Sanoah at her home on March 20, 2024 in Arlington, Washington. Peterson wears her sister’s favorite color and one of her bangles. (Annie Barker / The Herald)
‘It just all came down’: An oral history of the Oso mudslide

Ten years later, The Daily Herald spoke with dozens of people — first responders, family, survivors — touched by the deadliest slide in U.S. history.

Victims of the Oso mudslide on March 22, 2014. (Courtesy photos)
Remembering the 43 lives lost in the Oso mudslide

The slide wiped out a neighborhood along Highway 530 in 2014. “Even though you feel like you’re alone in your grief, you’re really not.”

Director Lucia Schmit, right, and Deputy Director Dara Salmon inside the Snohomish County Department of Emergency Management on Friday, March 8, 2024, in Everett, Washington. (Ryan Berry / The Herald)
How Oso slide changed local emergency response ‘on virtually every level’

“In a decade, we have just really, really advanced,” through hard-earned lessons applied to the pandemic, floods and opioids.

Ron and Gail Thompson at their home on Monday, March 4, 2024 in Oso, Washington. (Olivia Vanni / The Herald)
In shadow of scarred Oso hillside, mudslide’s wounds still feel fresh

Locals reflected on living with grief and finding meaning in the wake of a catastrophe “nothing like you can ever imagine” in 2014.

Imagine Children's Museum's incoming CEO, Elizabeth "Elee" Wood. (Photo provided by Imagine Children's Museum)
Imagine Children’s Museum will welcome new CEO in June

Nancy Johnson, who has led Imagine Children’s Museum in Everett for 25 years, will retire in June.

Kelli Littlejohn, who was 11 when her older sister Melissa Lee was murdered, speaks to a group of investigators and deputies to thank them for bringing closure to her family after over 30 years on Thursday, March 28, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
‘She can rest in peace’: Jury convicts Bothell man in 1993 killing

Even after police arrested Alan Dean in 2020, it was unclear if he would stand trial. He was convicted Thursday in the murder of Melissa Lee, 15.

Ariel Garcia, 4, was last seen Wednesday morning in an apartment in the 4800 block of Vesper Dr. (Photo provided by Everett Police)
Everett police searching for missing child, 4

Ariel Garcia was last seen Wednesday at an apartment in the 4800 block of Vesper Drive. The child was missing under “suspicious circumstances.”

The rezoned property, seen here from the Hillside Vista luxury development, is surrounded on two sides by modern neighborhoods Monday, March 25, 2024, in Lake Stevens, Washington. (Ryan Berry / The Herald)
Despite petition, Lake Stevens OKs rezone for new 96-home development

The change faced resistance from some residents, who worried about the effects of more density in the neighborhood.

Rep. Suzan DelBene, left, introduces Xichitl Torres Small, center, Undersecretary for Rural Development with the U.S. Department of Agriculture during a talk at Thomas Family Farms on Monday, April 3, 2023, in Snohomish, Washington. (Olivia Vanni / The Herald)
Under new federal program, Washingtonians can file taxes for free

At a press conference Wednesday, U.S. Rep. Suzan DelBene called the Direct File program safe, easy and secure.

Former Snohomish County sheriff’s deputy Jeremie Zeller appears in court for sentencing on multiple counts of misdemeanor theft Wednesday, March 27, 2024, at Snohomish County Superior Court in Everett, Washington. (Ryan Berry / The Herald)
Ex-sheriff’s deputy sentenced to 1 week of jail time for hardware theft

Jeremie Zeller, 47, stole merchandise from Home Depot in south Everett, where he worked overtime as a security guard.

Everett
11 months later, Lake Stevens man charged in fatal Casino Road shooting

Malik Fulson is accused of shooting Joseph Haderlie to death in the parking lot at the Crystal Springs Apartments last April.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.