Experts warn in a “Current Issues” article published online in the American Journal of Preventive Medicine that a Florida law that restricts physicians from counseling patients and parents about firearms safety endangers open communication between doctors and patients on a critical prevention and public health problem.

Signed into law by Gov. Rick Scott on June 1, the law states that doctors, emergency medical personnel and other healthcare providers cease asking questions about gun ownership unless they believe “in good faith that this information is relevant to the patient’s medical care or safety, or the safety of others.” If the question has been asked, the response cannot be entered in patient’s medical records.

Authors Eric W. Fleegler, MD, MPH, of the Division of Emergency Medicine at Children’s Hospital Boston and an instructor at Harvard Medical School, and colleagues, declares the law to be an assault on the physician-patient relationship, writing:

“The open and confidential nature of the physician-patient relationship is fundamental and allows doctors to talk effectively with their patients about a wide range of social issues such as smoking, alcohol use, health insurance, and intimate partner violence.”

They point out, that:

“As early as the 1890s, physicians have made recommendations about the ownership and safe handling of firearms. The physician visit offers a unique and valuable opportunity to provoke reflection among our citizens on these health-related topics. How can a physician instruct and encourage their patients to lock their guns and store them unloaded if the physician cannot even ask about gun ownership?”

After Gov. Scott’s signing of the law, he and other state officials in federal court were sued by three Florida physicians, the American Academy of Pediatrics (AAP), American Academy of Family Physicians and American College of Physicians to block the measure on the grounds that the law effectively barred doctors from talking with patients, or their guardians, about guns and gun safety and therefore violated their First Amendment right to free speech.

According to a preliminary injunction issued in September by U.S. District Court Judge Marcia Cooke of the Southern District of Florida, Miami Division, enforcement of the law has been prohibited and although the state said it would appeal, so far this has not been done. The states of Alabama, Minnesota, North Carolina, Oklahoma and West Virginia introduced bills that also would bar physicians from asking about guns in the home after the Florida law was signed, however, according to an AAP spokesperson all of the bills died when those states’ legislative sessions ended.

In the United States, one in 25 admissions to pediatric trauma centers are due to gunshot wounds, according to the AAP, who also pointed out that the possession of a gun in a home is 43 times more likely to be used to kill a family member or friend than burglars or other criminals. Fleegler and his team cited the American Medical Association’s and AAP guidelines, which state to “encourage physicians to inquire about the presence of household firearms and support the storage of unloaded firearms with trigger locks and in locked cabinets.”

Referring to data from the Centers for Disease Control and Prevention the authors stated that in the period from 1999 to 2007, a total of 269,871 deaths occurred due to firearms, including 19,846 children. They declared:

“In 2007 alone, firearm fatalities accounted for over 1 million years of potential life lost. Notwithstanding the personal costs, firearm injuries and deaths result in substantial economic costs as well. In 2005 the combined medical and work loss cost of all firearm injuries and fatalities in the U.S. was $31.7 billion.”

The authors highlight the fact that “guns and ammunition that are stored safely can protect children and youth from suicide and unintentional firearms injuries,” and conclude: “Morbidity and mortality from firearm injury represent a ubiquitous and costly epidemic. But if physicians are not allowed to ask about firearms as a health issue, then they cannot even attempt to work toward prevention of injury. The only way to deal with a problem is to talk about it, not to suffer in silence.”

Written by Petra Rattue