Florida, doctors and questions about guns: what's going on?

Claire McCarthy, MD

I don’t know whether you’ve heard about this, but on June 2nd Governor Scott of Florida signed a bill making it illegal for doctors to ask if families own a gun. Apparently the National Rifle Association and other gun activists feel that doctors have an agenda when it comes to guns.

They’re right. We do have an agenda.

Our agenda is keeping kids alive.

In pursuit of that agenda, we pediatricians aren’t just concerned about guns. We are passionate about car seats, bike helmets and immunizations. We want to be sure that pools are secured, and that medications and dangerous chemicals are kept out of reach. We worry about whether people are smoking cigarettes around our patients—and as our patients get older, we worry about whether they are smoking cigarettes, or drinking alcohol, or using drugs. Talking to families about guns is just one piece of what we do in our attempt to be sure that our patients grow up.

I was going to blog about this a while ago, when the House and Senate versions of the bill were still floating around the Florida Congress, but I thought: no, why bother, it will never pass. After all, guns really are dangerous. Here are a few scary statistics:

• Death by firearm is the 2nd leading cause of death for children 0 to 18 (behind motor vehicle accidents). It is the leading cause of death for African-American males aged 15 to 24.

• One-third of U.S. homes with kids under 18 have a gun, and in 40 percent of those homes the gun isn’t locked up.

• More than half of the adolescents less than 20 who used a gun to attempt or commit suicide used their parent’s gun.

• Children ages 5 to 14 who live in the U.S. are 11 times more likely to be killed accidentally by a gun than those who live in other developed countries

• A household gun is 43 times more likely to kill someone known to the family than it is to kill someone in self-defense

Honestly, how can we call ourselves responsible doctors if we don’t ask if the family has a gun? This, I figured, would be obvious to any sensible legislator. I guess it wasn’t.

The supporters of the law say that doctors can give information about gun safety (which is all we would do anyway if a family said they owned one). We just can’t ask about gun ownership—or at least we can’t ask unless it is clearly relevant to the medical care, and unless we don’t do or say anything that might be interpreted as harassing the family. The language of the law is so vague it would make me nervous about even mentioning guns if I were practicing in Florida.

“It’s not good health education, or good care, to just point parents to a rack of pamphlets. Good care is impossible if we can’t ask questions.”

That’s the other mindboggling aspect of this. The other reason I didn’t blog about it before is that I couldn’t imagine they would pass a law stopping doctors from asking questions. We need to ask questions. It’s how we diagnose things, how we figure out the best treatments, how we support families in parenting, how we connect them with resources, how we know what information they need to keep their children healthy and happy. It’s not good health education, or good care, to just point parents to a rack of pamphlets. Good care is impossible if we can’t ask questions.

This, I thought, would be even more obvious to any sensible legislator. But it turns out that somehow it wasn’t obvious to the Florida legislators (nor were the First Amendment implications; the law is being challenged already). And here’s what’s even scarier: other states are considering similar laws.

What is happening to us? Don’t people see the slippery slope this could become? Will the cigarette lobby stop us from asking questions about cigarettes? Will the pool lobby stop us from asking about pools? Once you start getting into exam rooms and dictating the conversation between doctor and patient, you endanger the care, and the health, of that patient. That can’t be what we want.

Yes, I have an agenda, about which I am passionate: ensuring the health, safety and happiness of children. Most of all, I want to keep them alive.

Here’s my question to those who support the Florida law and laws like it: is your agenda really more important than that?