Florida 'Gag Law' on Asking Patients About Firearms

An Expert Interview With Stephen Hargarten, MD, MPH

Janet Kim, MPH; Stephen W. Hargarten, MD, MPH


July 22, 2011

In This Article

Editor's Note:
Firearm-related violence, injury, disability (physical and psychological), and death continue to be major public health problems in the United States.

According to the Centers for Disease Control and Prevention (CDC), firearms account for 2 of the top 5 leading causes of mortality from injury.[1,2] In the United States, firearm-related injuries averaged 28,687 fatalities per year between 1999 and 2007. For every firearm-related death, approximately 2 nonfatal injuries occur.[1,3,4]

Adolescents and young adults are disproportionately affected by firearm-related injuries; most of the leading causes of death for individuals aged 15-24 years (from homicide #2 and suicide #3) are firearm-related.[1,2]

About one third of US households have firearms[1,5]; 61% of these residences (or 19% of all homes in the United States) likely have handguns in the home.[1,6]

Many clinicians recognize the value of asking patients about the presence of firearms in the home as part of their patient history taking and counseling patients about firearm precautionary measures. As a result, healthcare providers can play a significant role in the prevention of firearm-related morbidity and mortality. Some providers are also involved in the direct care of patients with firearm-related injuries, and these interventions help to improve outcomes.

However, Florida recently signed into law a measure that would prohibit clinicians from asking their patients about gun ownership and whether they keep guns in the home environment.[7] A group of physicians and medical organizations have since filed a suit seeking a temporary injunction against the new law. The result of this case is significant, as it could set a precedent for similar bills pending in other states.

Stephen Hargarten, MD, MPH, is professor and chair of the Department of Emergency Medicine, director of the Firearm Injury Center, and associate dean of the Global Health Program at the Medical College of Wisconsin in Milwaukee, Wisconsin. Dr. Hargarten, a well-recognized expert on injury prevention and control, is interested in researching the intersection of injury prevention and health policy to address the burden of injuries. Medscape spoke with Dr. Hargarten about the new Florida law and its potential effects on healthcare providers and the public's health.

Medscape: What are your thoughts on this "gag" legislation and lawsuit case in Florida?

Dr. Hargarten: It is very interesting and very sobering that the legislature is intervening in the very important relationship between a clinician and his or her patients and his or her patients' families. I think the broad issue that is being lost in this discussion is that injury [morbidity and mortality], unintentional or intentional -- from car crashes, firearms, homicides, suicides, accidental discharges in the home, falls, and many other injury challenges that are part of a community's problem -- are related to products. Products are either designed unsafely or have challenges around their usage and their storage.

This legislation is putting a division between a clinician's responsibilities for addressing injury prevention in the home -- and injury, by the way, is the single largest cause of death in youth today in the United States [-- and the safety of his or her patients and their families]. In children and youth, the number-1 cause of death is an injury caused by or related to a car, a gun, and other products. Clinicians, in their responsibility to counsel families on the best ways to address injury risk and injury prevention, are led naturally to ask questions about their patients' cars, seat belts, booster seats, and guns -- guns that are not stored properly, guns that are not secured properly, guns that are at risk for despondent youth to use or for children to gain access to them as unauthorized users. It is very disappointing and very sobering to have legislatures intervening in this way that is not in the best interests of communities. Obviously rights or ownership interests are to be respected. I just didn't see [injury prevention] adequately discussed in this legislation.


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