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Gun Safety: A Florida Invasion on the Doctor-Patient Relationship

You’re working at a pediatric primary care clinic and enter the room of a five-year-old boy and his mother for a routine physical. You ask about the child’s general health the past year, his diet, exercise, among other things.

Then you start to ask questions relating to the patient’s safety, such as his use of seat belts and helmets, and you start to ask about guns in the home. But then, alarms start to go off in your head.

You are unable to complete this section of the interview, and are not able to provide counsel on keeping the child safe from any guns that may be in the home because state law prohibits you from doing so. This is now a reality in Florida.

On July 25, a federal appeals court upheld a Florida law that prevents physicians from asking their patients if they own guns. Judge Gerald Tjoflat wrote that guns are a private matter irrelevant to health care. I could not disagree more. The law was originally signed in 2011, threatening doctors with fines, citations and potential loss of license for disobeying. A lower court initially struck down the law in 2012, but the decision was then appealed and now overturned this year.

Regardless of your view on guns and gun control, this decision is wrong because it steps right in the middle of the patient-doctor relationship. The idea that a law can dictate what a physician can and cannot discuss with a patient is unprecedented and seemingly unheard of. A physician should have the freedom to ask the patient whatever they want, so long as it is relevant to the health of the patient.

Gun safety is most certainly relevant to patients’ health, and every good physician should ask about it. Every year, 32,000 people in the United States die from injuries caused by firearms, and about the same number suffer non-fatal wounds. Suicides accounted for 61% of gun injury deaths in United States in 2010.

Furthermore, one study found that the adjusted odds ratio for homicide was 1.41 for adults with a gun at home, as compared to those without a gun at home.

Most striking, for every case of self-protection death with a gun in the home, there are 37 suicides by gun in the home. Therefore, despite frequently cited self-defense reasons for owning a gun, an individual or a family member is more likely to die from a gun in the home than be protected by one.

With regard to the health of children, nearly 10,000 children are killed or injured by guns every year in the United States. Another study estimates that on average nearly 20 kids are sent to the hospital every day in the United States for gun-related injuries.

Clearly there is enough evidence to show that this issue is relevant to patients’ health. Many of these deaths may be prevented by keeping guns unloaded, locked, and separate from ammunition, providing further justification for physician intervention.

It’s time to stop letting our political views and obstinacy get in the way of our patients’ health.

Ryan Denu Ryan Denu (7 Posts)

Contributing Writer

University of Wisconsin School of Medicine and Public Health

Ryan is a Class of 2019 MD/PhD student at the University of Wisconsin School of Medicine and Public Health. He graduated in May 2012 from the University of Wisconsin-Madison with a BS in molecular biology. He enjoys thinking and writing about health care policy and bioethics, and is also an avid tennis player, instructor, coach, umpire, and fan.

  • Ryan Denu

    On a related note, this recent NEJM article (http://www.nejm.org/doi/full/10.1056/NEJMp1404846) mentions in their table that “firearms in the home” are part of “common current topics” that physicians ask about when obtaining a social history.