Despite valiant efforts to defeat Privacy of Firearm Owners (HB 155/SB 432), the bill passed in both Florida House and Senate sessions and is awaiting Gov. Rick Scott (R-FLA) to sign into Florida law. The Florida Pediatric Society (the Florida chapter of the American Academy of Pediatrics) maintains its opposition to this irrational and irresponsible bill, which will restrict physicians’ ability to discuss gun safety.
Ultimately, the bill will infringe on the patient-physician relationship, increase government intrusion in the practice of medicine, and decrease the safety and health care of Florida’s children. The bill is an unnecessary intrusion into the physician/patient relationship as privacy regarding patient visits is currently covered under national law under the Health Insurance Portability and Accountability Act (HIPAA). Because of the existence of HIPAA, no law is needed.
Dr. Lisa A. Cosgrove
A substantial amount of research has shown firearms in the home pose significant risks. Most notably, the 2008 annual summary of vital statistics found that firearms contribute to otherwise avoidable suicide, homicide, and accidental death, which are among the leading causes of death among children and teenagers. Within the American Academy of Pediatrics Bright Future Guidelines, pediatricians are given explicit recommendations to ask about firearms and safe storage as standard routine for child health counseling.
It is important to understand that, during an exam, several aspects of the home are discussed, including swimming pools, hazardous chemicals, smoke detectors, medications, and firearms. Answers to these questions help parents protect their child from multiple forms of harm.
The Florida Pediatric Society remained strong in its opposition of the bill amidst a compromise between the National Rifle Association and the Florida Medical Association. The agreement between these two major organizations removed civil and criminal penalties from the original bill, yet introduced referral to the Florida Board of Medicine for possible sanctions if a physician harasses a patient or enters unnecessary information in a medical record regarding firearms in the home. However, the compromise language does allow physicians to ask patients about gun ownership and enter it into the medical record, if it is found medically necessary. The physician can also choose which patients to see for reasons other than firearm ownership.
The AAP joined with the Florida Pediatric Society in opposition. Their involvement was extremely beneficial to the Florida chapter, as they provided governmental and communications staff support, press releases, leadership advocacy, and major media coverage. The AAP received further support from the American College of Surgeons and the American Academy of Child and Adolescent Psychiatry, who also vigorously objected to this bill.
Surprisingly, these bills are not new to the profession or the nation. Similar legislation has already been proposed in Alabama and North Carolina this year. In 2006, similar bills were introduced, yet subsequently defeated, in the Virginia and West Virginia legislatures. Since Florida’s version of the bill has been pacified, these states and more receive bills that are expected to be worse.
Aside from the obvious infringement of the First Amendment, this potential Florida law raises medical malpractice concerns by limiting the appropriate standards of care a physician is obligated to perform. Referencing the Virginia and West Virginia bills, an article in the 2006 issue of Pediatrics noted that a pediatrician who failed to inquire about firearms and counsel appropriately might have been subject to a malpractice claim if a child were injured or killed as a result (Pediatrics 2006;118:2168-72).
What is next? Will physicians not be allowed to ask about sexuality issues in teens or whether the patient takes care of their teeth? We cannot help prevent health risks if we do not ask about them.
Dr. Lisa A. Cosgrove is president of the Florida Pediatric Society and practices pediatrics in Merritt Island, Fla. She said she had no relevant financial conflicts to disclose.