Several years ago, the American Medical Association advised doctors
to ask their patients about firearms and “educate patients to the
dangers of firearms to children” in the name of public health. But
doctors in Florida may be suppressed from giving this medical advice,
now that a federal appeals court upheld a Florida law that became known as the “physician gag rule” because it punishes doctors for talking about guns.
The ruling could have major implications as policymakers examine gun
violence as a public health issue. The National Rifle Association-backed
law it upheld imposes severe limits on when doctors can ask their
patients about guns or keep records in their patients’ charts about
firearm safety. Doctors who are found to have violated the provision
risk sanctions or loss of their license.
At least ten medical associations and the American Bar Association
argued that the law should be struck down because doctors must be able
to discuss safety topics freely in engaging in preventive care.
In an American Bar Association resolution opposing Florida’s law, the
organization reasons, “Preventive care through safety counseling is a
pillar of modern medicine, and is vitally important to the health and
welfare of patients.” Among other public health topics doctors may
discuss with adult patients are alcohol and drug use, wearing bicycle
helmets and seat belts, and storage of household toxins. Discussions of
gun violence, also, may come into play, both for doctors advising
parents on keeping their children safe, and psychiatrists concerned
about the psychological well-being of their patients. The American
Psychiatric Association has recommended that “health professionals and
health systems should ask about firearm ownership whenever clinically
appropriate in the judgment of the physician.”
The doctor plaintiffs in this case had argued that they have a First
Amendment right to discuss these issues with their patients, and a
federal trial court agreed, reasoning that the Firearm Owners Privacy
Act “chills practitioners’ speech in a way that impairs the provision of
medical care and may ultimately harm the patient.”
But a two-judge majority on the U.S. Court of Appeals for the
Eleventh Circuit reversed that ruling and upheld the law, concluding
that this speech is “professional in nature” and only has an
“incidental” impact on free speech. The majority judges — appointees of
Nixon and Bush — reason that the law is limited to “harassing” or
“unnecessary” speech, so the law shouldn’t limit doctor remarks that are
directly related to patients’ health. ...
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