There are certain things you expect your doctor to ask you about.
Are you getting enough exercise and sleep? Are you avoiding junk food?
But there’s one thing your doctor may not be able to ask you about: guns.
Currently, there are no state laws that prohibit doctors from discussing gun ownership with their patients, according to a review of state and federal laws published in the Annals of Internal Medicine.
The study’s lead author, Dr. Garen Wintemute, an emergency room physician and director of the Violence Prevention Research Program at the University of California at Davis, says many states have considered legislation that would restrict doctors from asking about firearms.
This concerns him and other medical professionals as they say it interferes with physicians’ abilities to help their patients.
“Where will this stop? When will legislators keep their hands off what doctors can talk about with their patients?” he told Healthline. “Gun violence is a health problem.”
In 2015, nearly 13,000 people died from injuries sustained from gunshots, including homicides, murders, unintentional shootings, and suicides. Of those, 756 were children, according to The Trace.
While mass shootings dominate news coverage, they only account for 2 percent of gun-related deaths.
Florida Gun Talk Ban
In Florida, a state law that could land a doctor in legal trouble if they ask whether there are guns in the home is now in the appellate courts.
The law, dubbed “Docs vs. Glocks,” was upheld last year after doctors groups sued the state, arguing their First and Fourth Amendment rights were being violated.
Currently, the law isn’t in effect, but a decision from an appellate court could allow it on the books. About a quarter of Florida residents own at least one gun.
The law was originally passed in 2011 after a physician declined to see three children after their mother refused to say whether there were firearms in the home. The National Rifle Association (NRA) supported the law.
One concern is that these laws could spread to other states, as Florida is often the testing ground for gun laws such as Stand Your Ground and conceal and carry laws.
To many medical professionals, these types of laws would have a chilling effect on what doctors can and cannot ask their patients.
As gun violence is a major facet of the American culture, asking questions to relevant parties could help reduce a person’s likelihood of being a victim, they say.
Dr. Steven E. Weinberger, executive vice president and chief executive officer of the American College of Physicians (ACP), wrote an editorial accompanying the Annals study arguing for doctors to address sources of gun violence with their patients.
“Physicians need to recognize that regardless of the ultimate outcome of legislation in Florida and other states, neither that law nor any others currently in effect prohibit physicians from discussing firearms and firearm safety when there is concern about the risk to self or others,” he wrote. “Therefore, they should not shirk their responsibility to seek information about gun ownership when appropriate or to counsel, educate, and take other actions if necessary to mitigate the risk for firearm-related injury or death.”
Life or Death Matter
Some patients are more at risk of gun violence than others, especially those in the midst of a mental health crisis.
One in five adults in the United States will experience an episode of mental illness at any given point in a year, according to the National Alliance on Mental Illness (NAMI).
Those experiencing suicidal ideation or expressing concerns are at the greatest risk of immediate self-harm or violence to others.
As an emergency department physician, Wintemute says there are many factors — including whether the person has a plan, and if it’s feasible go into a person’s “lethality assessment.”
“If this law were in effect, at least in theory, I’d have to defend [myself] in court if my decision making was relevant and why I asked that question,” he said.
Other times when gun ownership becomes relevant is when domestic violence is an issue or when children are in the home. This is when doctors should counsel patients on safe storage, risk reduction, or talk with family members, especially in an emergency situation.
“A doctor’s role is not to tell people what to do, rather to provide them with good information to make the decisions for themselves,” Wintemute said.
Certain demographics are also at higher risk of gun violence, including young African-American men, middle-aged and older white men (suicide risk), as well as young children.
Gun Violence as a Disease
At Seattle’s Harborview Medical Center, they’re treating gunshot wounds differently. Actually, they’re treating them similar to alcoholism.
Beyond removing the bullet and stitching up the hole, social workers interview victims of gun violence to help them address social and personal behaviors that put them at risk. Follow-up visits include face-to-face meetings with the victim and their families.
A similar program in Oakland, Calif., which began in the 1990s and involved similar intervention strategies for victims of gunshot violence, made a drastic reduction in related offenses.
Youths who were counseled six months after their injury were 70 percent less likely to be arrested for any offense.
While gun violence remains a major public health problem in the United States, policies to protect people are limited and research is scant.
While there has been a two-decade long ban on the U.S. Centers for Disease Control and Prevention (CDC) on researching gun violence, the journal for the JAMA Internal Medicine is seeking papers on the subject.
“The time is right to respond to the epidemic of firearm injuries and gun violence with high-quality research and cogent analysis that can inform policy,” the open letter to researchers states.