Pediatrician’s Editorial in JAMA Makes a Strong Case for Lifesaving Discussions
The number of concealed weapons license holders in Florida topped one million this week, doubling in just five years. The millionth permit was handed out the same week Americans witnessed one of the most horrific acts in the country’s history – the Connecticut school massacre, which claimed 27 lives, 20 of them children no older than 7.
Following this and other tragedies involving children and firearms, an editorial published “Online First” in the Journal of Pediatrics and Adolescent Medicine by injury prevention advocate Judy Schaechter, M.D., M.B.A., professor and Interim Chair of Pediatrics, highlights the importance of discussing gun safety with patients and families, the issue surrounding the “Docs vs. Glocks” gun rights case in Florida. South Florida physicians including Schaechter, Tommy Schechtman, M.D., voluntary professor of pediatrics, and Bernd Wollschlaeger, M.D., a family medicine practitioner, filed suit to block the Florida law that prohibits health care providers from discussing gun ownership with patients.
“Pediatricians play a key role in injury and disease prevention by providing anticipatory guidance to minimize risk in a child’s everyday environment,” Schaechter wrote in the editorial, “Protecting the Patient-Physician Relationship in Florida,” which also will be published in the print edition of JAMA Network publication in April.
Despite attempts to block it, the “Physician Gag Law” was adopted in spring 2011 by the Republican-controlled state Legislature after an Ocala couple complained that a doctor asked them about guns, they refused to answer, and the physician refused to see them anymore. The original bill would have made it a third-degree felony with penalties of up to $5 million in fines and five years of imprisonment for any health care personnel who asked patients or family members if a gun was in the home.
Although the final bill was stripped of criminal penalties, it still calls for disciplinary action by the Florida Board of Medicine if physicians violate any of its provisions, including causing a patient to feel harassed by asking questions about gun ownership. It says doctors and other health care practitioners “shall respect a patient’s right to privacy and should refrain” from asking about gun ownership or whether people have guns in their homes.
The statute also says physicians may ask about guns if they believe in “good faith” that the information is “relevant” to a patient’s medical care or safety. But the law doesn’t spell out those acceptable circumstances, leading lawyers for the doctors to say it is so vague that they could be vulnerable to patient complaints filed with the Board of Medicine.
The editorial, co-authored by Lisa A. Cosgrove, M.D., and Mobeen H. Rathore, M.D., past and present presidents of the Florida Chapter of the AAP, noted that more than 128,000 children in Florida live at home with at least one loaded and unlocked firearm.
“Physicians must ask families about guns and how they are stored, just as they ask about other potential dangers in the home, at school or wherever children play or travel,” the authors concluded. “By asking, pediatricians can provide appropriate information tailored to the needs of the patients and their families to improve health and reduce risk.”
It is in the discussions that follow the questions that Florida pediatricians like Schaechter know that some injuries – suicides, unintentional shootings and even tragic massacres – can be averted.