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Review: Docs legally allowed to inquire about guns, disclose information to third parties when necessary

Physicians are legally allowed to ask their patients about firearms, counsel them as they would on any other health matter, and disclose that information to third parties when necessary, according to a review published in Annals of Internal Medicine.

A growing body of evidence shows that having a firearm in the home or purchasing a handgun substantially increases a person’s risk for violent death. While physicians have a responsibility to diagnose and treat illness, they also have a broader obligation to prevent illness and injury and to improve population health. Many prominent physicians’ organizations believe that this includes counseling their patients on firearm safety. However, some physicians believe that it is against the law to discuss firearms with their patients and many are unsure what they are legally allowed to say about guns in practice.

Authors reviewed current federal and state statutes and found that none prohibit physicians from asking about firearms when that information is directly relevant to the health of the patient or others. As such, the authors recommend, at a minimum, that clinicians determine access to firearms for patients who fall into any of the high-risk categories for firearm violence, such as those who have suicidal or homicidal ideas or intent; those with a history of intentional or unintentional violence to themselves or others caused by alcohol or drug abuse, serious mental illness or other conditions that impair judgment; and patients who are members of high-risk demographic groups, such as middle-aged and older white men, young African American men, and children and adolescents.

The authors write that although many physicians believe they have the responsibility to counsel patients to help prevent firearm-related injuries, they lack the training to counsel patients in clinical practice. The physicians cite lack of familiarity with firearms, lack of knowledge about the risks and benefits of firearm ownership, and what to say to patients about the issue as the main barriers to intervention. The authors suggest that with training and the development of referral resources, physicians can overcome these barriers. They summarize a list of resources to assist physicians in educating patients about firearm safety.

Steven E. Weinberger, MD, MACP, FRCP, Executive Vice President and Chief Executive Officer of the American College of Physicians (ACP) authored an accompanying editorial. According to Dr. Weinberger, physicians should not shirk their responsibility to seek information about gun ownership. He writes that it is essential for individual physicians and other health care providers, the organizations that represent them, and the legal community to band together to ensure that clinicians understand what they can and should do to assess and mitigate the risk for firearm-related injury and death. Dr. Weinberger’s words echo a policy position paper released by ACP in 2015 Firearm-Related Injury and Death in the United States: A Call to Action From 8 Health Professional Organizations and the American Bar Association.

Article: Yes, You Can: Physicians, Patients, and Firearms, Garen J. Wintemute, MD, MPH; Marian E. Betz, MD, MPH; and Megan L. Ranney, MD, MPH, doi:10.7326/M15-2905, published online 17 May 2016.