Physicians legally allowed to ask patients about firearms
The literature shows that although many physicians report that they believe they have a right and responsibility to counsel patients about firearms, they are also unfamiliar with firearms themselves, with the benefits and risks of firearm ownership, and with what to say during counseling.
Physicians are legally allowed to ask and counsel their patients about firearms, according to a recent article.
Researchers looked at commonly cited barriers to practicing preventive medicine for firearm-related injuries, including physicians' belief that discussing firearms is against the law, and provided recommendations on incorporating such preventive medicine into clinical practice. A review of federal and state statutes found that none prohibit physicians from asking about firearms when doing so is relevant to the patient's health or the health of others. They noted that the only existing gag law, Florida's medical privacy act concerning firearms, has some broad exceptions, including for a practitioner who “in good faith believes that this information is relevant to the patient's medical care or safety, or the safety of others.” In addition, they noted, “only information that ‘is not relevant to the patient's medical care or safety, or the safety of others' is excluded from medical records.’”
The authors concluded that firearm information is directly relevant to the health of an individual patient and his or her direct contacts under 3 general conditions: if the patient is at acute risk for violence to him- or herself or others, based on information or behavior (e.g., suicidal or homicidal ideation or intent); if there are individual-level risk factors for violence to self or others or unintentional firearm injury (e.g., history of violence or alcohol or drug abuse); and if the patient is a member of a demographic group at increased risk for violence to him- or herself or others or unintentional firearm injury (e.g., middle-aged and older white men, young African-American men, and children and adolescents).
The literature shows that although many physicians report that they believe they have a right and responsibility to counsel patients about firearms, they are also unfamiliar with firearms themselves, with the benefits and risks of firearm ownership, and with what to say during counseling. The authors noted that training and education can address these issues and that clinicians' attitude while counseling patients is critical. They recommend providing a context for firearm-related questions and state that such conversations should acknowledge local cultural norms, be individualized, and occur within a well-established clinician-patient relationship when possible. The article also summarizes a list of resources to assist physicians in educating patients about firearm safety.
In an accompanying editorial, Steven E. Weinberger, MD, MACP, ACP's EVP/CEO, wrote that physicians must recognize that no laws currently in effect prohibit discussion of firearms and firearms safety with patients when there is concern about risk to patients or others and must not shirk their responsibility to have such discussions. He also called on the medical and legal communities to band together to ensure that clinicians understand their rights and responsibilities in this area. “Collaboration on this specific issue of such public health importance provides an unprecedented opportunity for the health care and legal professions to apply their expertise in complementary areas and ultimately have a major effect on the health and well-being of the American public,” he wrote.
The article and editorial were published online May 17 by Annals of Internal Medicine.