Doctors, Gun Groups Compromise on Gun Ownership Questions

Confidentiality biggest hurdle to overcome
By: David Royse News Service of Florida | Posted: March 29, 2011 3:55 AM
In many cases, doctors would still be able to ask patients questions about whether they have guns under a measure approved by a Senate committee on Monday, a result of a compromise between gun rights groups and the medical establishment.

The National Rifle Association and other gun rights groups had pushed for a much stronger bill that would have precluded doctors, in many cases, from asking patients about whether they own guns. Backers of the measure, sponsored by Sen. Greg Evers, R-Baker, had said patients were being harassed over gun ownership.

But citing the confidentiality of what is said between doctors and patients, and a broader desire to protect other members of patients’ families, doctors had pushed back hard against the bill (SB 432). The issue had promised a fight between two of the most powerful lobbies at the Florida Capitol.

But an amendment adopted before the committee’s vote on Monday would now generally allow doctors to ask questions about gun ownership, as long as the physician doesn’t “harass” the patient, and doesn’t enter the information into the patient’s record without a good reason. That leaves enough room that doctors now support the measure, as does the NRA.

“We have an agreed-to, good bill here,” said Evers.

While the committee advanced the bill, four members -- two Republicans and two Democrats -- said they still were uncomfortable with anything that would give doctors pause about asking questions about safety issues, and voted against it.

“I am concerned this degrades and diminishes the doctor-patient relationship,” said Sen. Eleanor Sobel, D-Hollywood. “A doctor should ask about safety in the home, whether it’s pool safety, helmet safety or gun safety.”

Sen. Mike Bennett said his opposition was personal – because of his own experience as a child with a father who “chased his wife around” the house with a gun.

“I’ve been there, done that,” said Bennett, R-Bradenton.

“What about the patients’ children? What about the patient’s wife getting a beating every Saturday night?” Bennett asked.

Evers said the new version of the legislation would take care of that concern – allowing doctors to ask questions now, if they feel there’s a valid reason.

“There has to be a justification (however),” said the sponsor of the compromise amendment, Sen. Thad Altman, R-Viera. “The doctor can’t do it arbitrarily.”

The bill also no longer carries any civil or criminal penalties, leaving it up to professional medical boards to police the requirement.

The compromise appeared necessary to get the proposal moving – the bill had been stalled in the Health Regulation Committee for more than two weeks, and even some who voted for it on Monday expressed some skepticism.

The bill still has two more committee stops in the Senate, but Evers gave the panel his commitment that only minor changes would be made in those committees, and that the bill wouldn’t revert to its former form. A similar House bill (HB 155) still has two committee stops there.

Comments (5)

Oliver Johnson
2:25PM MAR 29TH 2012
First and foremost, who is the doctor's client? Is it the patient? Or is it the State of Florida? If the client is the patient, the state has no business imposing the gathering data that is not relevant to the medical issue at hand. In fact, it is morally dishonest to collect gun ownership, knife ownership, hammer ownership, blunt object ownership, sharp object ownership, car ownership, etc. as a by product of a medical visit. If there is a law, that law should make illegal such data collection!
If the state is the client, I don't have liberty in medical matters except by the grace of the state. I don't want any doctor I visit to have any information about any property I have in his or her records. That includes guns, computers, cars, shovels, ... you get the picture.
If someone thinks I am a public safety risk, let them use the public safety resources to mitigate that risk, and with due process of course.
Putting my doctor in the middle is a threat to my health, as it creates divided loyalty when I seek medical attention.
This is just another case of treating the symptom, and not the disease. Harming people is a malevolent person problem. Whatever tool the malevolent person used did not inflict the harm.
Keeping and bearing arms were explicitly allowed (shall not be infringed) in the constitution's 2nd amendment. Using doctors to infringe subverts the roles of doctors and the rights of citizens.
Robert Lloyd
10:28AM MAR 31ST 2011
I really don't care what a doctor thinks of my God given rights. They are not up for discussion. He should assume everyone has a gun... duh, we are Americans are we not? Or we once were.

Come on folks... look here what is really going on. This isn't something a doctor has any business questioning.
Ronald Pies MD
6:01PM MAR 30TH 2011
It is the physician's moral, legal, and clinical responsibility to inquire into all relevant risk factors related to a patient's safety, both with respect to self-harm and potential harm to others. The possession of firearms in the home--legal or otherwise--markedly increases the risk of both gun-related suicide and homicide, as well as unintentional gun-related harm to others.

The constitutionality of legal possession of firearms is emphatically not the issue here. The issue is the physician's professional right and duty to inquire into risk factors for harm to self or others, including but not limited to possession of firearms. Indeed, failure to so inquire--particularly in cases involving suicidal or homicidal individuals seen in emergency room settings--would pose a serious threat to the safety and well-being of both the patient and, potentially, society. It would also expose the physician to tremendous liability in the event a patient with violent tendencies left the medical setting and inflicted harm upon him/herself or others.

No law that has a chilling effect on pertinent medical assessment of risk factors for violence should be tolerated by any state or any citizen. I would urge all legislators to ensure that any law written to protect the privacy of patients includes language stating that, "Nothing in this legislation shall be construed as restricting a physician's right and duty to carry out a thorough and professional assessment of the patient's safety vis-a-vis self and others.
No liability shall be attached to a physician's inquiries re: firearms possession, when such inquiry occurs in the course of the professional medical assessment of a patient's safety."

Ronald Pies MD
Professor of Psychiatry
SUNY Upstate Medical University
Syracuse NY; and Tufts USM, Boston
3:56PM MAR 31ST 2011
So does a swimming pool, but I've never had a doctor ask about that.

While asking a patient the doctor suspects might be suicidal would be entirely appropriate, asking patients the doctor does not have cause to be concerned about is not appropriate.
Ronald Pies MD
10:38PM APR 1ST 2011
Just to clarify my earlier letter: inquiries regarding firearms or any other risk factors for violence (previous assault history, intoxication, etc.) are not automatically made by physicians in all clinical encounters. They are made when the clinical situation and history make it appropriate. In psychiatry, this would usually involve cases in which a patient is threatening harm to self or others, appears agitated and intoxicated or psychotic, etc. There may be other factors to consider for other medical specialties, such as pediatricians. --Ronald Pies MD

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