Ruling 'Destructive' to Patient-Physician Relationship
July 28, 2014
(Washington) The American College of Physicians (ACP) today said that it strongly disagrees with last week's Florida court decision upholding a state law that bars doctors from asking patients about gun ownership. The ruling in the case, which included the Florida ACP chapter as a plaintiff, overturned a decision by a lower court that had struck it down two years ago.
The ruling said that there is no First Amendment protection for doctors providing their best medical advice to their patients. "At the very least, this ruling is destructive to the patient-physician relationship," said ACP President David A. Fleming, MD, MA, FACP. "Many doctors ask about gun ownership as a normal part of screening patients, including it on a long list of health questions about drug and alcohol use, smoking, exercise and eating habits."
A confidential relationship between patient and physician is essential for the free flow of information necessary for sound medical care. Only in a setting of trust can a patient share the private feelings and personal history that enable the physician to comprehend fully, to diagnose logically and to treat properly. If they are to provide proper care, physicians should be able to gather any information that can have an impact on the health of their patients and families.
Safety and injury prevention are crucial components of preventive medical care. Primary care physicians can help improve the health of the American public by providing accurate and meaningful patient education.
The panel of the 11th U.S. Circuit Court of Appeals last week described the law as a "legitimate regulation" of professional conduct that simply codified good medical care.
This legislation could limit physicians from asking their patients about firearm ownership, and prevent the discussion of their safe storage and handling. Firearms education of both adults and children has been shown to decrease the likelihood of unintentional injury or death. The presence of firearms in the home, when improperly stored, can present a health danger to patients and others.
Last year, ACP underscored a list of eight recommendations on firearms-related violence and included: Preserving the rights of doctors to counsel their patients on preventing deaths and injuries from firearms. In this regard, state governments must also do their part, by not imposing restrictions on engaging in such discussions with their patients, as some state legislatures have attempted to do.
Opponents of last week's decision note that there is no change from current treatment of the law. There can continue to be questioning by physicians until there is review by the entire 11th Circuit.
"ACP believes this issue is much bigger than guns," Dr. Fleming concluded. "We believe it addresses whether the government or any other body should be allowed to tell physicians what they can and can't discuss with their patients, consistent with evidence-based standards of care."
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.